Service Providers Line Level - Institutional

The Service Providers section provides additional information relating to the claim on the line level. The screen includes the following sections:

 

Enter any information on the Operating Provider, Operating Provider, Rendering Provider, and/or Referring Provider.  

 

The Service Providers fields are defined by section below:

 

Operating Provider Information

Operating Provider Operating Provider

Select the operating provider from the drop-down menu.

 

Last NameLast Name

Operating provider last name.  

 

First NameFirst Name

Operating provider first name.

 

InitialInitial

Operating provider middle name or initial.

 

SuffixSuffix

Operating provider name suffix.

 

Provider NPIProvider NPI

Operating provider identifier.

 

 

 

Other Operating Provider Information

Other Operating Provider Other Operating Provider

Select the other operating provider from the drop-down menu.

 

Last NameLast Name

Other operating provider last name.  

 

First NameFirst Name

Other operating provider first name.

 

InitialInitial

Other operating provider middle name or initial.

 

SuffixSuffix

Other operating provider name suffix.

 

Provider NPIProvider NPI

Other operating provider identifier.

 

 

 

Rendering Provider Information

Rendering ProviderRendering Provider

Select the rendering provider from the drop-down menu.

 

Last NameLast Name

Rendering provider last name. The rendering provider is the person or company (laboratory or other facility) who provided the care.

 

First NameFirst Name

Rendering provider first name.

 

InitialInitial

Rendering provider middle name or initial.

 

SuffixSuffix

Suffix to individual name.

 

Provider NPIProvider NPI

Rendering provider identification.

 

Provider Taxonomy CodeProvider Taxonomy Code

Code designating the provider type, classification, and specialization of the rendering provider for this claim. The taxonomy can be different for the same provider on different claims.

 

 

 

Referring Provider Information

Referring Provider Referring Provider

Select the referring provider from the drop-down menu.

 

Last NameLast Name

Referring provider last name. The referring provider is the person or company who referred the patient to the rendering provider for treatment.

 

First NameFirst Name

Referring provider first name.

 

InitialInitial

Referring provider first name.

 

SuffixSuffix

Suffix to individual name.

 

Provider NPIProvider NPI

Referring provider identifier.

 

 

 

 

 

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