Rendering Provider Billing

When a payer requires the clinician who rendered a service (for example, RN or PT) to send separate claims, perform the following steps:

1.	In Administration>General>Resource Types>General, in the Require Clinician NPI field, select Yes.

2.	In the Resource component, select a resource.

3.	In Resource>General>Roles, in the Individual NPI field, enter the clinician's NPI number.

4.	In Administration>Financial>Insurance Codes>NPI or Administration>Financial>Insurance Companies>NPI, do the following:

a.	In the IDs to include in EMC files and IDs to include in Paper Claims sections, select either the National Provider IDs (NPI) or Legacy IDs and National Provider IDs (NPI) radio buttons.

b.	Select the Bill by Rendering Provider NPI check box.

5.	In Administration>Financial>Insurance Codes>Print Variations, set the print variations.

For the UB-04 form

Locator

Setup

General Rules

To generate separate claims, select the Split the claim by Resource who provided service check box.

FL 78 or FL 79

Depending on your payer's requirements, select the appropriate check boxes:

>	Print rendering provider's name and split the claim by rendering provider

>	Print rendering provider's identifiers (NPI, Other Phys No and 1D qualifier)

>	Print rendering provider's NPI

For the CMS-1500 (08/05) form

Locator

Setup

General Rules

To generate separate claims, select the Split the claim by Resource who provided service check box.

FL 24J

Depending on your payer's requirements, select the appropriate check boxes:

>	Print rendering provider's UPIN and 1G Qualifier

>	Print rendering Medicare Part B Provider Number and 1C Qualifier

>	Print rendering provider's NPI

You can also generate the following reports:

>	Resources NPI Numbers report – To view resources who are missing NPI numbers when a resource type was defined to require NPI and physicians who are missing NPI.

>	Claim Alerts Report – To view claims with the missing Rendering Provider NPI while the insurance code or insurance company was defined to bill by Rendering Provider NPI. In this report, you can also view claims that will not be generated because the agency NPI was not defined.