Add Secondary ID to Referring Rendering Provider ID

This rule allows users to add a secondary ID to the referring rendering provider ID on claims. This rule uses information from the rendering provider profile, so it is imperative that all necessary information is entered before creating the rule. For information on configuring rendering provider profiles, click here. 

To use this rule, the referring rendering provider setting must be turned on for your organization. If you do not have this feature, please contact support at [e-mail]. 

Workflow

Let's review how to create a claim rule to add a secondary ID to the referring rendering provider ID!

1. Navigate to Management Center > Claim Rules.
   
    
2. Next, click Create Claim Form Rule.
   
3. Select the Practice.
   
4. Then give the rule a name.
5. Update the Claim Type field 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 Secondary Referring Provider ID.
   
9. Next, click Add.
   
10. Update the dropdown to one of the following options:
    1. Omit the secondary ID on a claim. 
    2. Require and Write to always include one of the:
       • Provider Commercial Number
       • Referring Rendering Provider NPI
       • State License Number
       • UPIN
    3. Write to Claim if Present to only include one of the following options if it is present within the rendering provider profile:
       • Provider Commercial Number
       • Referring Rendering Provider NPI
       • State License Number
       • UPIN
         
11. To create multiple behaviors, repeat steps 7-10.
12. Click Save to complete the process.
    

Box Number(s)

• UB-04: Box 78: Other Provider Names and Identifiers and Box 79: Other NPI, ID, or Qualifiers.
• CMS-1500: Box 17a -Other ID#

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.