Claim Line Item Rule - Using Rendering Provider as Rendering Provider Name and NPI

  • Updated

What claim change is needed?

When a payer, for example, requires the Rendering Provider's Name and NPI to be accompanied on this claim as the Rendering Provider, then use this claim rule.

Box Number

UB-04: n/a

CMS-1500: Box 24j - Rendering Provider

Rule Creation Steps

  1. Navigate to Management Center > Claim RulesScreen_Shot_2021-05-19_at_5.13.17_PM.png
  2. Click "Create Claim Line Item Rule".
    Screen_Shot_2021-05-23_at_5.45.50_PM.png
  3. Select the Practice.
    mceclip2.png
  4. Name the claim rule.
    Screen_Shot_2021-05-23_at_5.48.14_PM.png
  5. Set Claim Type to Professional.
    Screen_Shot_2021-05-19_at_12.54.10_PM.png
  6. Set conditions for the claim rule.
  7. For the Behaviors, select the "Set Rendering Provider Name & NPI to:" and then click on the dropdown arrow and choose "Rendering Provider".  
    mceclip0.png
  8. At the bottom of the window, click the Create button.
    Screen_Shot_2021-05-19_at_1.16.07_PM.png

Prerequisites

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