Problem with Provider and Practice Grids

mbpros · Post by **mbpros** » Tue Apr 05, 2011 3:33 am

I thought I had the Provider and Practice Grids all figured out, but I'm having a small problem. I have some practices where the provider practices with his SS # as his Tax ID #. BUT some payers want both Loop 2010AA (Bill-To) AND Loop 2310B for the Rendering Provider, even though it's the same.

If I have Individual checked off for the provider, then Loop 2310B does not get written (I'm using the 4010 IGuide in V17).

If I have Group checked off for the provier, Loop 2310B gets written BUT the Tax ID # does not get written as part of Loop 2010AA.

How do I configure both the Practice and Provider Grids so Loop 2010AA will get written with an SY qualifier and the provider's Tax ID # AND Loop 2310B will be written with the NPI and also the SY qualifier and provider's Tax ID ?

Steve

Post by **Gavin Walker** » Tue Apr 05, 2011 9:01 am

Hi Steve try this:
Edit Receiver and select Non-Person and Group Practice
Edit Practice and change entity type to person
Setup a PINS grid entry for both practice and provider for this payer and then select social security, but enter tax id. (Kind of confusing, but it sounds like the practice was enrolled wrong with this payer).

mbpros · Post by **mbpros** » Tue Apr 05, 2011 9:03 am

Thanks...It actually is for any provider with Highmark Blue Shield (PA) who uses a SS # as their Tax ID #. I know in RM 16 RM was not looking at the Receiver set-up for Non-Person and Group but was simply pulling the info from Medisoft (unlike the old CM4 where you had to properly configure the receiver). Did V17 change things so it does look at the receiver settings in RM?