What claim change is needed?
Use the Practice NPI as Billing Provider NPI. There are times when Payers require the Practice or Group NPI to be on the claim instead of the individual Billing Provider NPI. In AveaOffice, Practice NPI and Billing NPI are the same.
- Navigate to Management Center > Claim Rules
- Click "Create Claim Form Rule".
- Select the Practice.
- Name the claim rule.
- Set Claim Type to Institutional or Professional depending upon service.
- Set conditions for the claim rule to be met.
Typically, this is a payer requirement so you'll select the appropriate payer type (i.e. Primary Behavioral Payer; refer to the Claim Rules article for definitions if needed).
- Select the Available Behavior: Billing Provider - NPI.
- Then click Add.
- From the Select dropdown arrow, choose Practice NPI.
- At the bottom of the window, click the Create button.
To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.
To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.