Claim Line Item Rule - Adding Rendering Provider Modifiers

  • Updated

What claim change is needed?

Add the Rendering Provider Modifier from the Rendering Provider profile to the UB-04 and CMS-1500 claim forms. To add a modifier to the profile, see Manage Rendering Providers.

Box Number(s)

Rule Creation Steps

Use the following steps to pull the Rendering Provider modifier onto the desired claim type.

  1. Navigate to the Management Center and open the Claim Rules tab. mceclip0.png
  2. Click Create Claim Line Item Rule.mceclip1.png
  3. Select the practice.
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  4. Name the claim rule.
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  5. Set Claim Type to Professional or Institutional.
  6. Under Available Behaviors, select Rendering Provider Modifier.
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  7. Change the drop-down to Omit or Require and Write to Claim.
  8. Click Create.

Prerequisites

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