Claim not sending prov in box 31 sending group name instead?

Technical problems with Medisoft.
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GinnyH
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Claim not sending prov in box 31 sending group name instead?

Post by GinnyH » Tue Mar 22, 2016 1:00 pm

I am using office ally. All of my claims except the new practice I made are fine. I have double checked and everything seems to be the exact same in the problem practice and the working practice. OA states info not going over with the provider information but the practice info for rendering provider. Appreciate any input as I think I have exhausted my thoughts on how to fix this. OA insists that loop 2310B segment NM109 is the problem. Thanks!

Andrew
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Re: Claim not sending prov in box 31 sending group name instead?

Post by Andrew » Tue Mar 22, 2016 2:25 pm

Look at the provider IDs. The provider ID will always be Providers NPI and tax id. Setting it to group on this screen will pull from practice information > practice IDs for the billing information. Also check the Practice Info is set correct for Group or individual and person or non person..
Andrew Analla
Support Team
MedTech Medical Management Systems
3058 S Delaware Ave
Springfield, MO 65804
Ph: 417.890.6777 | Fax: 417.890.6788

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Gavin Walker
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Re: Claim not sending prov in box 31 sending group name instead?

Post by Gavin Walker » Tue Mar 22, 2016 4:30 pm

Go into the provider's id's grid and enter individual information but check the box to file the claim as a group. Then go to the practice ids's grid and setup the group information.
Gavin Walker
Walker Tek Solutions, LLC
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GinnyH
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Re: Claim not sending prov in box 31 sending group name instead?

Post by GinnyH » Thu Mar 31, 2016 10:05 am

The problem is rendering provider not going electronically to OA and medisoft is sending the groups name and not the individual provider name as rendering provider. Funny thing is I can print the claims and the provider prints on there! My setup is: in practice grid it is all,all,all,npi,taxonomy,tax id and in providers grid it is: all, all, group, npi (providers),taxonomy(providers),tax id I am wondering if it is something in revenue management that I missed? I compared what I have in my other clients and all looks the same. Any help at this point is extremely appreciated. In revenue mgmt entity type is non person. Thank you Andrew and Gavin for the info.

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Gavin Walker
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Re: Claim not sending prov in box 31 sending group name instead?

Post by Gavin Walker » Thu Mar 31, 2016 2:51 pm

You will need to select the option File the Claim as Individual in the Provider IDs grid. If the majority of your payers require you to file your claims as a group, then enter an override record for this particular insurance and set it up to file the claim as an individual.

GinnyH
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Re: Claim not sending prov in box 31 sending group name instead?

Post by GinnyH » Thu Apr 07, 2016 9:02 am

Thank you for your help. I had claims generic instead of standard in revenue mgmt. After I corrected it the claims went without error. :)

meromero2007
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Re: Claim not sending prov in box 31 sending group name instead?

Post by meromero2007 » Mon Mar 09, 2020 10:33 am

I have a claim rejected from Medicaid stating that they need me to send the claim with the performing provider zip code in loop 2310B segment ref

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Gavin Walker
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Re: Claim not sending prov in box 31 sending group name instead?

Post by Gavin Walker » Tue Mar 10, 2020 8:24 am

I think you need to set your provider IDs grid to file the claim as an individual. Rachel made this video where she demonstrates how to set this up: https://www.youtube.com/watch?v=02xGierP9HY&t=4s

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