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

  • Updated

What claim change is needed?

Add or remove the provider's unique payer-assigned ID to 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. 

Certain billing circumstances call for the payer-assigned provider ID to be more flexible than in the Practice Admin > Payer tab. There is another location for this ID per facility in the Practice Admin > Facilities tab.

Box Number

UB-04: Box 57 - Other Provider ID

CMS-1500: Box 33b - Other ID#

Steps

  1. Add the Payer-Assigned Provider ID to Practice Admin > Facilities > Select Facility. 
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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 "Facility Payer-Assigned Provider ID".
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  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 for Institutional claims will show for Box 57a (below):

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

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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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