Context
Payer IDs
A Payer ID tells providers where to send medical claims.
Some cards route claims to the Network first for repricing, then to Yuzu for payment (Provider → Network → Yuzu → Provider).
Others route directly to Yuzu, which checks for duplicates, then forwards to the Network for repricing before payment (Provider → Yuzu → Network → Yuzu → Provider).
In this second setup, confusion can arise because “Yuzu” appears as the payer name while the Plan Designer logo is on the card. This is because providers often expect the payer logo to match the claim destination (typically the Plan Designer or Network).
Real-time status
Providers will look up the Plan Designer name in their CRM / EMR (e.g., Epic) to see real-time status updates of eligibility, benefits, claim status and payments (details on this in ‘Real-time status checking’).
Often, providers will only look up the Plan Designers name because it is featured prominently on the card. If they are unable to find the real-time status under the Plan Designer name, they will frequently call the number on the card. This needlessly drives up call volume and delays member care, as these statuses are often checked while with a member.
The section below discusses our white-labeling offering to add robustness and curb this issue.
White-labeling Payer ID and real time status
Through our clearinghouse partner Availity, Yuzu can white-label the Payer ID so the card displays the Plan Designer’s name and unique Payer ID (often at the discretion of the Plan Designer).
This simple change eliminates most provider confusion; they see the familiar logo and matching payer info, submit the claim as usual, and it still routes through Yuzu behind the scenes. On the real-time status checking, they are able to either look up Yuzu or the Plan Designer name and get the info the need.
Real-time status checking
Coming 12/1 providers will have the ability to directly check via EDI Gateway (i.e., directly in their EMR, CRM) the status of:
Eligibility and Benefits (270/271)
Claim Status Inquiry (276/277)
Payment Remittance Status (835)
A note on being the original destination for claims
Because of the high frequency of file sends and our preference to be the central source of truth, we prefer to be the original destination for claims. However, there are networks who have a stated agreement to be the original destination for claims and therefore Yuzu will create the card in compliance.