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

Frequently Asked Questions and Helpful Hints

Let's review some helpful hints and some more commonly asked questions!

Frequently Asked Questions

• The best way to determine if a scheduled change set is appropriate is to gauge how many claims will be affected. For example, if you want the rule to apply to previously billed claims as well as new claims going forward, create the rule without a scheduled change set. 
  
  However, if you want the rule to apply only to newly created claims, use a scheduled change set to instruct the system to look only for claims with dates of service on or after the set date. For more information on scheduled change sets, click here.
• If you are creating the rule to apply to previously billed claims, navigate to the Patient > Treatment Episode > Claims > Review Corrections section and click Check For Corrections. If corrections are generated, follow the process outlined here to complete the process. If no claims are flagged for rejection, click here to troubleshoot the rule why the rule may not be applying.

Helpful Hints

If one of your conditions is payer-based, select any applicable Current Sequence options 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.