CLAIMS DENIED ISSUE

bel915 · Post by **bel915** » Thu Oct 11, 2012 6:37 am

GOOD MORNING!

My issue is pretty simple, but i just cant figure it out.

One of my client's practice is dba under the practice name, but for some reason the insurances are receiving my claims under the physician's name in box # 33 (CMS-1500 FORM) instead of the practice name (its a group of docs, but it's showing the Doc that is the owner of the practice).

I do have the on the 'Practice Information' tab under the practice name...but i can't seem what setup i have to have in order for the PRACTICE name to show on their end on box 33?

Any help is greatly apprectiated!

Thanks!

Have a nice day

Belinda

Post by **Gavin Walker** » Thu Oct 11, 2012 8:07 am

On v16 of higher, edit the provider's pins tab and make sure "file claim as group" is selected. Add a line to the pins grid for this insurance if you need to "file claim as individual" to other insurance.

bel915 · Post by **bel915** » Thu Oct 11, 2012 11:05 am

Thanks for replying. I did my research and I actually do have it set up as "file claim as" GROUP. It has been set up like that since the get go.
Is there another field I need to make a change that I'm not aware of?
On the same grid of the provider's pins.... i also have is set as National Provider ID, Taxonomy, and Tax Identifier...do those need to be changed to "From Practice"?

And on the "Practice Information" tab, I have Practice Type set as "Individual" and on Entity type as "Person"....do i need to change those as well?

Thank you for your time.

Belinda

Post by **Gavin Walker** » Thu Oct 11, 2012 9:42 pm

Make sure the corresponding Practice PINs grid entry has the group NPI setup in it. If the name of the practice is not the provider's name, then set the practice type equal to Group and the entity type equal to non-person.