Some payers may require an additional identifier (such as Medicaid ID, Medicare ID, etc.) for the referring provider. A new option is now available to include Referring Provider Other ID information in claims to help reduce rejections from payers.
When adding a Medical contact under Related Contacts, a new Other ID text field is now available. This field is optional and accepts alphanumeric values.
You can also create a payer rule to send the Referring Other ID when submitting claims. In Payer Rules, under Referring Provider Contact Info, you’ll see a new option for Referring Other ID.
If required by the payer, this information will now be included in electronic claims.
This update ensures claims with Referring Provider requirements are processed smoothly and have a higher chance of payment approval.
Navigate to the client’s chart.
Go to the Communications tab.
Expand the Related Contacts panel.
Select the Medical Contacts tab.
Click Create New Contact or Edit.
Locate the new Other ID field.
Refer to the screenshots below:
Go to Settings > Revenue Cycle Management > Payer Rules.
Click Create Payer Rule or Edit.
In the Create Payer Rule screen, open the Object/Field dropdown.
Select the new Referring Other ID option under the Referring Provider section.
In the New Value field, enter the Referring ID that you want to send when submitting claims.