Scenario C: Referring Provider Legacy ID (when an External Provider is listed as the Referring Provider)

This lesson describes the workflow for adding a legacy ID for a Referring Provider in Block 17a onto the CMS 1500 claim.

External providers will need to be set up as a Contact in the Contacts dialog. To access the Contacts dialog, go to the Tools menu and select Contacts.

If an Internal Provider must be listed as the Referring Provider on a claim AND must have a legacy ID indicated (that is other than their Taxonomy code), the Internal Provider will need to be set up as a Contact, as well. Follow the instructions below to indicate the Legacy ID for a Contact.

Locating the Contact in the Contacts list.

Locating the Contact in the Contacts list.
  1. After finding the referring provider listed for the claim in Step 1, if the provider listed is an external provider of the clinic, go to Tools menu and click on Contacts.
  2. Locate the Contact in the list, and edit.

Add the Insurance Company for which the Legacy ID must be indicated.

Add the Insurance Company for which the Legacy ID must be indicated.
  1. Click the button with the green + to add an insurance company.

Select the Insurance Company.

Select the Insurance Company.

HIghlight the appropriate insurance company in the list, and click Select.

Enter the Legacy ID Qualifier.

Enter the Legacy ID Qualifier.

Select the appropriate type of ID from the drop down. (The associated 2 digit code is listed to the right of each option.)

NOTE: The Legacy Qualifier and ID entered in these fields will only show up any time the specified Contact is selected as the Referring Provider on a claim to the Insurance Company selected in the previous step.

Enter the Legacy ID Number.

Enter the Legacy ID Number.
  1. Type in the associated ID number for the type of number indicated.
  2. Click Save.

NOTE: The Legacy Qualifier and ID entered in these fields will only show up any time the specified Contact is selected as the Referring Provider on a claim to the Insurance Company selected in the previous step.

Ensure Show Legacy IDs is checked.

Ensure Show Legacy IDs is checked.

Ensure that the Show Legacy IDs box is checked. If it is not checked, even if the legacy IDs are entered appropriately, they will not be placed on the claim.

The Legacy ID for the Contact populates Block 17a.

The Legacy ID for the Contact populates Block 17a.

The Legacy qualifier and ID number populate Block 17a.