Click Add Group button to add a new Group/Pay to information.

Enter Pay To/Billing Provider information for the Clinic.  Creating a Group and associating a provider with a Group, will cause the group information to default as the Provider's Pay To/Billing Provider information, with each insurance company. If there a specific Insurance Company that recognizes a different Pay To (or Group) for a particular Provider, the Group information can be overridden in the Insurance Company dialog, as needed.

It is highly recommended that you set up your Groups after your Facilities, as it will greatly streamline your setup of insurance companies later in the setup process. Note: It is recommended that even if a Provider in the clinic is his/her own group, you can setup a single provider as a group. The Group information will be the default Pay To Provider for the Provider. All in all, a group can represent a single doctor or a group of doctors. It is really just who the billing entity is for the Provider.  

1. Contact Information: Enter the basic demographic information for the group. (Name, Address and Phone)

2. Person or Non Person Entity type

3. Tax ID: Enter the appropriate ID for the group. You can indicate either the EIN or social security number.

4. Submitter ID:  Select Mutually Defined - ZZ for the identifier for the Submitter ID. This ID is how Gateway EDI knows who is submitting the claim file. The ID field will be your 4 digit Site ID code provided to you by Gateway EDI.

5. Legacy ID: (Optional) Select from the drop down to indicate a particular ID/number, if your state requires a particular ID on every claim. For instance, if your state requires the Taxonomy Code, you can enter the taxonomy identifier and code, and the information will go in the legacy field of every claim, along with the NPI number. If you are not aware that a particular ID is required for every claim for your state and payer base, other than the NPI, you may be able to ignore this field.

6. NPI: Enter the NPI number that has been assigned to the Group.

7. Insurance Information: When setting up a brand new system, you can ingnore the Insurance Information section, initially. You will have to have your insurance companies setup first, before you can really take advantage of this field. Once you have finished the setup process, and need to change a legacy ID to be used for the group, with a particualr insurance company, you can change that information here at the group level, if needed.

     - To create a new legacy ID for a specific insurance company (for your group), you will click the Create New button (with the green + sign). Search for the needed Insurance

        Company. Click Select. Select the Legacy identifier from the drop down box, and enter the associated code.  

8. Click Save when done.

Newly added Group/Pay to Provider is added to the List. Most often there will only be a single Provider or a single group listed here per clinic. A Group can contain one to many Providers, but a Provider can only be associated with one group.