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

  • Updated

What claim change is needed?

When a payer requires the billing provider's name and NPI to be submitted in Box 24j as the rendering provider on a claim, then use this claim rule.

Box Number

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_5.26.24_PM.png 
  3. Select the Practice.
    mceclip2.png
  4. Name the claim rule.
    Screen_Shot_2021-05-23_at_5.25.05_PM.png
    Set Claim Type to Professional.
     Screen_Shot_2021-05-19_at_12.54.10_PM.png
  5. Set conditions for claim rule using any appropriate condition for the rule. Example:
    Screen_Shot_2021-05-23_at_5.25.15_PM.png
  6. For the Behaviors, select the "Set Rendering Provider Name & NPI to:" and then click on the Select dropdown arrow and choose Practice Billing Entity.
    mceclip0.png
  7. At the bottom of the window, click the Create button.

Prerequisites

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