Update Place of Service

This rule allows a user to update the place of service on a claim without reconfiguring the service billing profile. 

Workflow

Let's review how to create a rule to update the place of service on a claim!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Service Grouping Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
     
  5. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  6. Under Service, update the dropdown with the service you want the rule to apply to.
     
  7. Next, under Set Values, click Set Place of Service to:.
  8. Update the dropdown to the desired place of service. 
     
  9. Click Save to complete the process.
      

Box Number(s)

• UB-04: N/A
• CMS-1500: Box 24b  - Place of Service

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.