Edit Billing Information dialog is used to identify Billing/Pay To information (top portion) and Rendering Provider of service (bottom portion). This information will be included on all claims submitted to this Insurance Company.  

8. Insurance Payment To: This section is populated with data used when setting up Manage Groups. Verify that this is the correct Pay To information. To edit information or add additional IDs required for this payer, click to place a check mark in the Override Group Values box.

9. Tax ID: If the Pay To provider is an individual and payments are reported to his Social Security number, Click SSN and type social security (Block 25)

10. Legacy ID for paper claims: When filing paper claims, if payer requires a Billing legacy number in addition to the Billing NPI, select legacy qualifier from the drop down list and enter the legacy ID.

11. Electronic Claims-Additional IDs: Add additional ID numbers, if required for selected payer.

12. Pay-To Address: If Pay-To address is different than Billing Provider street address, enter that information here.

13. Eligibility Request Info: Some payers require a Tax ID or a legacy ID to be sent with an eligibility request. If a payer does not require one, this section can be left blank.

14. Select to check eligibility using the Group/Billing NPI or the Individual/Rendering provider NPI

Below is a list of some that do require either a Legacy ID or a Tax ID as shown in step 13:

Payers requiring Legacy ID                        

• BCBS of Arkansas
• BCBS Michigan
• California Medicaid
• Maine Medicaid
• Mercy Health Plan of Arizona
• Ohio Medicaid
• University Family Care of Maricopa
• Wisconsin Medicaid Well Woman Program

Payers requiring Tax ID

• AFTRA
• American Postal Workers Union
• American Republic Insurance
• Amerigroup, Carefirst BCBS
• Cariten Healthcare
• Cariten Senior Healthcare
• Fallon Health Plan
• Keystone Mercy Health
• Kaiser Foundation Health Plan of Northwest
• Lovelace Health Plan
• Mayo Management Services
• Mega Life
• Midwest National Life
• Physicians Mutual Insurance
• Preferred Health Systems
• Significa Benefit Services
• Texas CHIP
• Trustmark Insurance
• Writers Guild

15. Provider Information: This section is populated with data used when setting up Provider Manager . If this insurance requires a Rendering Provider Legacy number in addition to the NPI, use the drop down arrow to select an identifier for the ID and then type the ID into the field. (Block 24j)

16. Electronic: Enter any additional IDs to be included on electronic claims, if required by this payer for Rendering Provider.

17. Click Save.