Add or Remove DOH License Number

This rule will add or remove the facility's DOH (Department of Health) license number from a claim. Click here for information on configuring the facility. 

Note: This rule will add information to box 32b on the CMS-1500 and can conflict with this rule as well as this rule that adds the facility location number to the same box. To learn more about claim rule ordering, click here.

Workflow

Let's review how to create a claim rule to add or remove the DOH license number from a claim!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Claim Claim Form Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Facility - DOH License Number.
  9. Next, click Add.
     
  10. Update the dropdown to one of the following options:
      
      1. Omit to create the claim without the facility taxonomy. 
      2. Require and Write to Claim to always include the facility taxonomy.
      3. Write to Claim if Present to only include the facility taxonomy if it is present within the facility profile.
         
  11. To create multiple behaviors, repeat steps 7-10.
  12. Click Save to complete the process.
      

Box Number(s)

• UB-04: Box 57b - Other Provider ID - A G2 qualifier with the DOH license number will automatically be added to this box.
• CMS-1500: Box 32b - Other ID - A G2 qualifier with the DOH license number will automatically be added to this box.

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.