In the claim creation process, what does 'picking the payer' entail in Resolute?

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Choosing the payer establishes which payer-specific rules and contracts will govern the claim. In Resolute, the payer profile tells the system how to price services, what benefits and coverages apply, what documentation or edits are required, and how the claim should be electronically submitted. This ensures the claim is calculated and adjudicated under the correct contract terms for that payer. If a payer isn’t selected, the system can’t apply the correct rate tables or payer-specific edits, leading to incorrect pricing or potential denials. After picking the payer, you can proceed with eligibility verification against that payer, apply the proper benefit details during charge capture, and submit the claim for adjudication under that payer. The other steps—verifying eligibility, supervisor approval, or entering a billing address—are separate actions in the workflow and data entry that support the claim but do not determine which payer rules are used.