Set Secondary Provider ID

This rule can be used to apply a secondary provider ID to professional claims. 

Workflow

Let's review how to create a claim rule that includes a secondary ID for a rendering provider. 

1. Navigate to Management Center > Claim Rules.
   
    
2. Click Create Claim Line Item Rule.
   
3. Select the Practice.
   
4. Next, give the rule a name.
5. Update the Claim Type to  Professional.
   
6. Select Conditions to create criteria that a claim should meet before the rule will apply. For more information on rule conditions, click here.
   
7. Next, under Behaviors, click Set Secondary Provider ID to:

8. Update the dropdown to select what secondary ID you want written to the claim and when.

   1. Omit to leave the secondary ID out of the claim.
   2. Require and Write to Claim to ensure the ID is not only present in the rendering provider profile but is also included in the claim. 
   3. Write To Claim If Present to only include the secondary ID if it is present in the rendering provider profile.
      • Available options for #2 and #3 include:
        • (Provider) Location Number
        • Provider Commercial Number
        • Provider Taxonomy
        • Rendering Provider NPI
        • State License Number

   

9. Click Save to complete the process.
    

Box Number(s)

• UB-04: N/A
• CMS-1500: 24i - ID Qualifier

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.