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.
UB-04: Box 57 - Other Provider ID
CMS-1500: Box 33b - Other ID#
- Add the Payer-Assigned Provider ID to Practice Admin > Facilities > Select Facility.
- Navigate to Management Center > Claim Rules.
- Create a Claim Form Rule.
- Select the Practice and set the conditions.
- Select the Claim Type - Professional or Institutional.
- Select the behavior "Facility Payer-Assigned Provider ID".
- 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
- Click Save
Claim corrections for Institutional claims will show for Box 57a (below):
Claim corrections for Professional claims will show for Box 33b (below):
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.