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Billing Provider Overrides - How to change certain values
By default, Block 33 – Billing Provider Info on a HCFA 1500 billing form, or the EDI segment for Billing Provider is the pulled from the Practice Location
From Admin -> Billing -> Payor Entry screen, you can see this default:
This will pull the Name, Address, Phone, NPI and Taxonomy Code from Admin -> Locations screen.
If you need to override this value, you can do so by Payor from this Payor Entry screen. A complete override would be accomplished by clicking on the [Practice Location] and selecting one of the providers entered in your practice.
Remember to click on Save to save this change.
The system will fill in missing information from the practice location. For example, if the Personnel record for James Getwell did not have an address, it would still use the address on the Locations screen:
Note the NPI, Taxonomy code and name are now changed to the provider.
An alternative to fully overriding the billing provider, is to use the Payor Provider Overrides, also from the Payor Entry screen. You can also enter multiple per provider if needed. This substitution will take place when the provider is on a particular claim for this payor. If you need this for every provider in the practice, it will have to be entered per provider.
Remember to click on Save to save this change.
Taxonomy Code
EIN Tax ID
SSN Tax ID (Same box however it will check the SSN box as opposed to the EIN box)
Billing Provider Name
Location Number
NPI
State License Number
Commercial Number
