Revenue Management Referring Provider

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bocpg
Posts: 33
Joined: Tue Oct 23, 2012 6:01 pm

Revenue Management Referring Provider

Post by bocpg » Tue Jan 03, 2017 5:46 pm

Hi Gavin,
I processed the claims per our conversation last week and it appears your guy did set my claims up to go electronically when he set up RM for me. :) When I imported my claims from RM into pc-ace everything was perfect with one exception. The physical therapist "attending provider" is where WPS wants the "referring provider" to be listed, in ub04 box 76. Is there anything I can change so RM will pick up referring instead of attending?

Thanks,
Bo

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Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Revenue Management Referring Provider

Post by Gavin Walker » Tue Jan 03, 2017 9:49 pm

Box 76 is documented to be the attending provider so try setting up the referring provider as a regular provider in the system and enter them as the attending provider on the charge. Strange that Medicare is wanting you to report the referring provider as the attending provider if they didn't provide the service.

And another thing, if we didn't know to setup institutional claims, then we would have setup professional claims. I wonder if PC-Ace is processing an ANSI professional claim as though it were institutional that is what is causing the mis-match. And we would have setup a UB04 smart screen as one of your Case tabs.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

bocpg
Posts: 33
Joined: Tue Oct 23, 2012 6:01 pm

Re: Revenue Management Referring Provider

Post by bocpg » Wed Jan 04, 2017 3:34 pm

Hi Gavin,
You were right the map I was using was placing the referring / rendering in the correct place. Today I sent in 6 test claims and was told that they rejected because LOOP 2000B SBR09 was set as MB and should be MA, since I am filing part a claims. He said it was the only error? Would this be something that I can change myself?

Thanks again,
Bo

bocpg
Posts: 33
Joined: Tue Oct 23, 2012 6:01 pm

Re: Revenue Management Referring Provider

Post by bocpg » Wed Jan 04, 2017 9:01 pm

UPDATE: Loop 2000B SBR09 ~ I figured it out :) Also just to let you know your guy did set up the smart screen for me when he set up RM.

Thanks for your help, look forward to receiving the new version from you.

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Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Revenue Management Referring Provider

Post by Gavin Walker » Thu Jan 05, 2017 10:31 am

You'll need to setup a new receiver for your institutional claims and then setup one of the institutional iguides on it. Then install the corresponding smart screen. This is all setup in Revenue Management.

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