Scenario A: Referring Provider NPI (when an Internal Provider is listed as the Referring Provider)
This lesson describes the workflow for having the taxonomy code for an internal provider, who is listed as the Referring Provider, populate Block 17a on the CMS 1500 claim.
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. See Lesson 2b for instructions to set up that scenario.
Referring Provider Legacy ID (when indicating Taxonomy code for an Internal Provider listed as the Referring Provider)
- After finding the referring provider listed for the claim, if the provider listed is an internal provider of the clinic, go to Tools menu and click on Provider Manager.
- If the NPI number has been entered for the provider in Provider Manager, you will enter it in the Provider Manager. You will also have to ensure that the Show Legacy IDs checkbox is checked for the insurance company dialog. Go to next step.
Ensure Show Legacy IDs checkbox 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 in Block 17a on the claim.