MVP (Formerly Preferred Care NY) Commercial Home Health (HH), 837I 4010A1 Electronic
The following fields in the application are required for MVP Home Health (HH), 837I 4010A1 Electronic.
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Field
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Description
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Submitter ID
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Enter the agency's submitter ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.
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Receiver ID (File Recipient)
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Enter PCNY in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.
Note: This format uses PREFERREDCARENY. The PCNY value is merely a value that you can enter in the required field.
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Test Submission Indicator
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Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.
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Receiver Name
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Enter PREFERED CARE NY in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.
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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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Preferred Care Provider No.
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Enter the provider number assigned by Preferred Care in the Provider No field in Administration>Financial>Insurance Codes>General.
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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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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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MVP (Formerly Preferred Care NY) Commercial Home Health (HH), 837I 5010A2 Electronic
For MVP Home Health (HH), 837I 5010A2 Electronic, define the following items:
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>
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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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>
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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 MVP Home Health (HH), 837I 5010A2 Electronic.
|
Field
|
Description
|
|
Submitter ID
|
Enter the agency's federal tax ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.
|
|
Test Submission Indicator
|
Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.
|
|
Receiver ID (File Recipient)
|
Enter the Provider Tax ID Number in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.
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Receiver ID (Payer)
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Enter the PaySpan Tax ID Number in the Receiver ID (Payer) field in Administration>Financial>Insurance Codes>EMC.
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Receiver Name (Payer)
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Enter the Payer Tax ID Number in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.
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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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MVP Provider No.
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Enter the provider number assigned by MVP in the Provider No field in Administration>Financial>Insurance Codes>General.
|
|
Request Paper EOB
|
To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.
|
|
Assignment of Benefits
and
Release of Information
|
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.
|
MVP (Formerly Preferred Care NY) Commercial Hospice (HO), 837I 4010A1 Electronic
The following fields in the application are required for MVP Commercial Hospice (HO), 837I 4010A1 Electronic.
|
Field
|
Description
|
|
Submitter ID
|
Enter the agency's submitter ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.
|
|
Receiver ID (File Recipient)
|
Enter PCNY in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.
Note: This format uses PREFERREDCARENY. The PCNY value is merely a value that you can enter in the required field.
|
|
Test Submission Indicator
|
Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.
|
|
Receiver Name (Payer)
|
Enter PREFERED CARE NY in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.
|
|
Provider Taxonomy Code
|
Enter the agency's provider taxonomy code in the Provider Taxonomy Code field in Administration>Financial>Insurance Codes>General.
|
|
Preferred Care Provider No.
|
Enter the provider number assigned by Preferred Care in the Provider No field in Administration>Financial>Insurance Codes>General.
|
|
Request for paper EOB
|
To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.
|
|
Assignment of Benefits
and
Release of Information
|
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.
|
MVP (Formerly Preferred Care NY) Commercial Hospice (HO), 837I 5010A2 Electronic
For MVP Commercial Hospice (HO), 837I 5010A2 Electronic, define the following items:
|
>
|
In Administration>Financial>Insurance Codes>Print Variations, select the check box under FL 14–15 to ensure the ANSI 5010 Billing Template compliance.
|
Note: If values other than 3 or 1 are required, enter them in Patient>General>Claim Constants or Administration>Financial>Claim Constants.
|
>
|
Ensure that either I or Y is selected for ANSI 5010 in the Rel Infor(Release of Information) field in Patient>General>Payers>HIPAA.
|
The following fields in the application are required for MVP Commercial Hospice (HO), 837I 5010A2 Electronic.
|
Field
|
Description
|
|
Submitter ID
|
Enter the agency's federal tax ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.
|
|
Test Submission Indicator
|
Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.
|
|
Receiver Name (Payer)
|
Enter MVP Health Plan in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.
|
|
Provider Taxonomy Code
|
Enter the agency's provider taxonomy code in the Provider Taxonomy Code field in Administration>Financial>Insurance Codes>General.
|
|
Preferred Care Provider No.
|
Enter the provider number assigned by MVP in the Provider No field in Administration>Financial>Insurance Codes>General.
|
|
Request for paper EOB
|
To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.
|
|
Assignment of Benefits
and
Release of Information
|
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.
|
