Claim Form Rule: Adding Institutional Secondary Provider ID

  • Updated

What claim change is needed?

Adding a secondary provider ID number to a UB-04, such as:

  • Provider Location Number
  • Provider Commercial Number
  • Provider Taxonomy Code
  • Rendering Provider NPI
  • State License Number
  • UPIN

Box Number

UB-04: Box 76 - Attending Provider Name and Identifiers

CMS-1500: n/a


  1. Enter the provider's ID in Practice Admin > Rendering Providers > Select Provider.
  2. In Management Center > Claim Rules, select Create Claim Form Rule.
  3. Select Practice.
  4. Name the rule.
  5. Set claim rule conditions.
  6. Select Claim Type: Institutional. 
  7. Select behavior "Institutional Secondary Provider ID". 
  8. Click Add.
  9. Choose the provider ID option.
  10. Click Create. 

Corrections will show changes in Box 76.


Related Articles

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.

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