BenSelect:Admin:EDI:EDI ASSOCIATED PAYERS

Group Numbers

The Group Numbers tab lets you set up numbers that identify a particular product to a given payer, using group number, network ID, group label, or plan code. While you may use the group numbers interchangeably, the numbers are generally used as follows:

Master Group Number 

A number identifying a specific segment of the employee population enrolled in the product.

Master Group Number Label 

A supplemental master group number.

Plan Code 

A code identifying the product to the payer.

Network ID 

A code identifying a provider network in which participants are enrolled.

Setting up Group Numbers for Reporting

You may also associate an additional payer with any given product for the purposes of reporting. For example, suppose you wish to send separate payer reports to a pharmacy benefits provider associated with a medical product. By adding a group number for the pharmacy benefits payer to the product, you may run reports for that payer with the unique EDI codes (Master Group Number, group label, plan code, or network ID) defined by that payer.

Use the Group Numbers tab to set the group number, network ID, group label, or plan code for a given product.

Location 

Select the location to which you want to apply the group numbers.

Associated Payers 

This section lets you associate a payer with a specific product for reporting purposes.

Product 

Select the product that you want to associate with the payer.

Edit 

Click to provide separate group numbers for specific job classes or deduction frequencies. Enter the group numbers in the space provided and click Save.

Same for all locations 

Click if you want to save the group numbers for all locations.

Same for all plan years

Click this option if you want to save the settings to multiple plan years (if existing) on the case.

Copy From

Select a location, and then click Copy From to copy the EDI settings from another.

Common Buttons

Same for all locations 

Click if you wish your changes to be saved at all locations.

New 

Click to add group numbers for a given product. If you want to associate a different payer with the product for reporting purposes, select a different payer from the Associated Payers drop-down list. Enter a group number in the space provided and click Save.

Save 

Click to save changes made to the Group Numbers.

Cancel 

Click to cancel all changes.

Import 

Click to import an EDI file containing group numbers. File formats accepted include .xls and .xlsx. Click the Select File button to navigate to the import file. The import file should have the Payer Name and corresponding Control Number defined.

Export 

Click to export the Payer and Control Numbers to a file.

Template 

Click to open an Excel spreadsheet that will let you import all EDI information at once. The template file contains a tab with each type of EDI information needed (i.e., Control Numbers, Group Numbers, Deduction Codes, Payroll Company). The file also contains tabs for Agent IDs and Agent Splits. The Help tab in the file contains a "key" for all tabs.