Skip to main contentThe document explains three strategies for converting client payor identifications into Silna payor IDs when creating patient plans.
Three Primary Approaches
1. Internal Mapping
Build the mapping internally by exporting patient plan data from Silna and reconciling it with your systems. This offers accuracy but requires ongoing maintenance for new payors.
2. Clearinghouse Standards
Leverage established clearing house formats (Availity, Office Ally, ClaimMD) via the Get Provider Payors API endpoint. However, this method has limitations: some standards assign identical IDs to multiple distinct payors, and mapping philosophies may differ between organizations and Silna.
3. Payor Inference
Send an insurance card and we will tell you the patient information through the Payor Inference API. Alternatively, submit payor names for matching. This asynchronous method may require up to one minute for responses.
Key Limitation Examples
- ClaimMD assigns ID 68069 to all Centene family payors
- Behavioral health administrators (like Magellan) may handle claims for multiple payors but aren’t themselves the plan holder
Recommendation
The documentation suggests combining multiple approaches—such as maintaining internal mappings supplemented by payor inference for unmapped entities—as most effective for achieving success. 
