Claim Form Rule: Adding or Removing Facility Blue Shield Provider Number

  • Updated

What claim change is needed?

Depending upon Blue Shield's requirement, the Blue Shield Provider ID may or may not be required on the CMS-1500 claim.  This claim form rule with either add, remove, or/and write to claim if this ID is present.

Box Number

UB-04: n/a

CMS-1500: Box 32b - Other ID#

Steps

  1. Add the Blue Shield Provider ID in Practice Admin > Facilities.
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  2. Navigate to Management Center > Claim Rules
  3. Click "Create Claim Form Rule".
  4. Select the Practice.
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  5. Name the claim rule.
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    Set Claim Type to Institutional depending upon service.
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  6. Set conditions for the claim rule to be met.
  7. Select the Available Behavior: Facility - Blue Shield Provider Number.
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  8. Then click Add.
  9. Depending upon the situation, from the Select dropdown arrow - Omit, Require and Write to Claim, or Write to Claim if Present.
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  10. At the bottom of the window, click the Create button.

Related Articles

Manage Facilities

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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