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How Can I Bill Under a Different Provider if the Rendering Provider is not Credentialed

If you need to set an overriding rendering provider for all claims for billing purposes, you can set a global billing override. 

This is handy if you have a new provider that is not yet credentialed. 

 

Go to Admin -> Personnel -> Personnel Entry and search and select the provider that needs the override. 

Go to Provider Info tab then for EACH location if your practice has multiple, select the appropriate provider

you wish to override with from the dropdown labeled "Billing Rendering Provider Override"

Be sure to SAVE with the button in the top right of the screen. 

 

 

If you only have 1 or 2 Payors that still need to be billed under a different provider, you can just set the override on the Payor record.

Go to Admin -> Payor Entry, search and select the payor.

From the "Billing Provider Overrides by Provider" selection, choose the appropriate provider that needs overriding,

then under Group Type select "Rendering Provider" and then under Value select the provider that you need to bill

under just for this Payor and this provider. 

Be sure to select the SAVE button at the bottom of the screen. 

 

 

It will be clear for that particular claim, that this provider is being overridden by going to the 

"Referral/Authorization" tab under Claim Info from Billing -> Edit Claims where billing will scrub the claim:

 

 

This is also where you can override the provider on just particular claims as well. 

Simply click on the ellipse button [...] to the right of the Rendering provider fields and this will 

allow you to pick any of the other providers in the practice for this claim.

Be sure to answer "YES" to saving the overrides when you select the Claim Details tab again to bill the claim.