The Payer Carve Out function associated with the Orders module allows you to map payers to performing entities. The default value for new orders is the performing test entity.
When you create a new order, the system looks at the insurance (payer) for that order. From the insurance, it finds the performing entity, which is set up in File Maintenance from the
Orders module tab on the
Payers window. If the performing entity is set for that insurance, then the order is created for this performing entity. You need to set up different performing entities for Lab orders and Radiology orders.
Note: Payer carve outs override the practice's default performing entity. For example, if you normally use Labcorp for your tests, but in your state Blue Cross requires you to use Quest Diagnostics, you can make this payer carve out for Blue Cross and leave Labcorp as your default testing entity for all other insurers.
The next time a new order is created for this payer, the default value for the order is this performing entity. For the NextGen® Enterprise EHR Orders module, the carve out is defined using File Maintenance.
