Claim Form Rule: Adding or Removing the Payer Assigned Provider ID

  • Updated

What claim change is needed?

Add or remove the provider's unique payer-assigned ID on a UB-04 or CMS-1500 claim.

The Payer-Assigned Provider ID is a unique identification number assigned to a provider from a payer that the payer may require on claims.

Box Number

UB-04: Box 57 - Other Provider ID

CMS-1500: Box 33b - Other ID#

Steps

Professional Claims

  1. Add the Payer-Assigned Provider ID to Practice Admin > Payers > Select Payer. 
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  2. Navigate to Management Center > Claim Rules. 
  3. Create a Claim Form Rule. 
  4. Select the Practice and set the conditions.
  5. Select the Claim Type - Professional or Institutional.
  6. Select the behavior "Payer-Assigned Provider ID".
  7. Select between options:
    Omit - Remove from the claim form
    Require and Write to Claim - The ID is required for claims to be submitted.
    Write to Claim if Present - The ID will be added to the claim form if it is added to the payer profile
  8. Click Save

Claim corrections will show for Box 33b (below):

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Institutional Claims

If the ID is present on a payer profile in Practice Admin > Payers, the ID will print to institutional claims by default.

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Related Articles

Manage Payers

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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