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

Steps

  1. Enter the provider's ID in Practice Admin > Rendering Providers > Select Provider.
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  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.
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  10. Click Create. 

Corrections will show changes in Box 76.

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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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