Show Facility Name and NPI as Rendering Provider in an 837 File

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The workflow below describes how to set up the Billing Engine to show your Facility Name and Facility NPI as the Rendering Provider in an 837 file, a setup piece that is particularly applicable to Dispensing Agencies. The information is set up at the staff and Activity Code level and applies to a specific Party Type (e.g. if Party Type 4 is selected this would apply to all plans under Medicaid).

Table of Contents

The steps below are intended to be followed in order to complete the setup.

Step 1: Employee Contractor Form Setup for Facility

1. Navigate to the Employee/Contractor List: Maintenance and Setup > Employees > Employee/Contractor > Employee/Contractor.
2. Click the OK button.
3. In the Employee/Contractor Form, click the Add button.
4. Complete the following fields in the Page 1 tab:

• Employee/Contractor ID: Enter a number.
• Name: Enter the name of your Facility.
• NPI No.: Enter the Facility NPI No.
• 837 Code Qualifier: Enter XX. This field indicates there is an NPI # to go on claims.

1. Click the Save button.

Step 2: Staff Form Setup for Facility

1. Navigate to the Staff List: Maintenance and Setup > Employees > Staff > Staff.
2. Select the Facility "staff entry" you created in Step 1 and click the OK button.
3. Click the Edit button.
4. Click the Discipline drop-down and select a discipline. You can select any discipline here.
5. In the Taxonomy Code field, enter your Facility's taxonomy code.
6. Click the Save button. Do not exit the window.

Step 3: Staff Enrollment Setup for Facility

1. While still in the Staff Form, click the Staff List button.
2. With the Facility still highlighted in the Staff List, click the Auto-Enroll button to enroll the Facility "staff entry" in all Party Types.

1. A window is displayed, "Process Complete!" Click the Ok button.
2. In the Staff List window, click the Enrollment List button.
3. Click the Ok button.

1. Click the Add button. The Staff drop-down retains the Facility "staff entry."
2. Click the Party Type drop-down and select the Party Type.
3. In the Provider Type field, enter MD.
4. In the Nat'l Provider Identifier (NPI) field, enter the Facility NPI.
5. Click the Save button.

Step 4: Setup Staff Enrollment Override by Activity Code

This is the Form used to override who the rendering provider is based on the Activity Code used.

1. Navigate to the Staff Enrollment Override by Activity Code Form: Maintenance and Setup > Staff > Staff Enrollment Override By Activity Code.
2. Click the OK button.
3. Click the Add button.
4. Click the Staff drop-down and select the Facility "staff entry."
5. Click the Enrollment Party Type drop-down and select a Party Type.
6. Click the Activity Code drop-down and select the Activity Code this affects.
7. (Optional) Click the Modifier drop-down and select a modifier. Modifiers are additive, if you have modifiers attached to this Activity Code already, any selections here would be additional.
8. Click the Save button.