Add or Remove Facility Payer-Assigned Provider ID

This rule is used to add or remove the Facility Payer-Assigned Provider ID.

Workflow

Let's review how to create a claim rule to add or remove the Facility Payer-Assigned Provider ID!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Claim Form  Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Facility Payer-Assigned Provider ID.
     
     
  9. Next, click Add.
     
  10. Update the dropdown to one of the following choices:
      1. Omit to create the claim without the Facility Payer-Assigned Provider ID.
      2. Require and Write to Claim to always require the Facility Payer-Assigned Provider ID to be written. 
      3. Write to Claim if Present to only include the Facility Payer-Assigned Provider ID.
         
  11. To create multiple behaviors, repeat steps 7-10.
  12. Click Save to complete the process.
       

Box Number(s)

• UB-04: Box 57 - Other Provider ID
• CMS-1500: Box 33b - Other ID#

Helpful Hints

• If one of your conditions is payer-based, select Current Sequence Behavioral instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. 
• 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.