Guildnet Commercial Home Health (HH), 837I 5010A2 Electronic
The Guildnet Home Health format is a regular fee-for-service claim. To generate the needed electronic claim output, you must select the UB-04 print variations.
For Guildnet Commercial Home Health (HH), 837I 5010A2 Electronic, define the following items:
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In Administration>Financial>Insurance Codes>Print Variations, select the check box under FL 14-15 to ensure the ANSI 5010 Billing Template compliance.
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Note: If values other than 3 or 1 are required, enter them in Patient>General>Claim Constants or Administration>Financial>Claim Constants.
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Ensure that either I or Y is selected for ANSI 5010 in the Rel Infor(Release of Information) field in Patient>General>Payers>HIPAA.
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The following fields in the application are required for Guildnet Commercial Home Health (HH), 837I 5010A2 Electronic.
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Field
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Description
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Assignment of Benefits
and
Release of Information
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In Patient>General>Payers>HIPAA, the Assign Benefits (Assignment of Benefits) and Rel Infor (Release of Information) fields are currently set to Yby default for each carrier. Change to N where applicable.
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Physician's Federal Tax ID
-OR-
Social Security Number
-AND-
Provider Taxonomy Code
-AND-
NPI
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If your commercial carrier requires reporting an attending physician, enter either the doctor's federal tax ID or Social Security Number in Resource>General>Roles in addition to the provider's taxonomy code.
Note: The values from the State License and UPIN fields are also reported.
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Insurance Clearinghouse
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Add Guildnet as an insurance clearinghouse in Administration>Financial>Ins Clearinghouse.
Select Guildnet in the Clearing House field in Administration>Financial>Insurance Codes>EMC for the insurance code being billed.
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Provider ID
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Enter the organization's provider number in the Provider ID field in Administration>Financial>Insurance Companies>Company.
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Provider Taxonomy Code
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Enter the agency's provider taxonomy code in the Provider Taxonomy Code field in Administration>Financial>Insurance Codes>General.
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Receiver ID (File Recipient)
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Enter the receiver ID in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.
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Receiver Name (Payer)
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Enter Guildnet in the Receiver Name (Payer) field in Administration>Financial>Insurance Companies>Company.
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Request Paper EOB
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To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.
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Submitter ID
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Enter the submitter ID (Trading Partner ID) assigned by Guildnet in the Submitter ID field in Administration>Financial>Insurance Codes>EMC
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