The Service Providers tab displays information regarding to the various service providers on a claim level. The screen includes the following sections:
Enter any information on the Rendering Provider, Referring Provider, Supervising Provider, and/or Service Facility Provider. Once a Service Provider is selected from the drop-down menu, the provider name displays in the corresponding banner next to the provider type.
Example:
The Service Provider fields are defined by section below:
Attending Provider Attending Provider
Select the attending provider from the drop-down menu.
Attending provider last name.
Attending provider first name.
Attending provider middle name or initial.
Attending provider name suffix.
Attending provider identifier.
Operating Provider Information
Operating Provider Operating Provider
Select the operating provider from the drop-down menu.
Operating provider last name.
Operating provider first name.
Operating provider middle name or initial.
Operating provider name suffix.
Operating provider identifier.
Other Operating Provider Information
Other Operating Provider Other Operating Provider
Select the other operating provider from the drop-down menu.
Other operating provider last name.
Other operating provider first name.
Other operating provider middle name or initial.
Other operating provider name suffix.
Other operating provider identifier.
Rendering Provider Information
Rendering ProviderRendering Provider
Select the rendering provider from the drop-down menu.
Rendering provider last name. The rendering provider is the person or company (laboratory or other facility) who provided the care.
Rendering provider first name.
Rendering provider middle name or initial.
Suffix to individual name.
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.
Referring provider last name. The referring provider is the person or company who referred the patient to the rendering provider for treatment.
Referring provider first name.
Referring provider first name.
Suffix to individual name.
Referring provider identifier.
Service Facility Location Information
Service Facility Service Facility
Select the service facility from the drop-down menu.
Laboratory or Facility NameLaboratory or Facility Name
Individual last name or organizational name where the patient received treatment.
Service Facility NPIService Facility NPI
Laboratory or facility primary identifier.
Address Lines 1 & 2Address Lines 1 & 2
Address information of the service facility.
Laboratory or facility postal zone or zip code.
Laboratory or facility city name.
Laboratory or facility state or province code.
Code identifying the country of the laboratory or facility.
Subdivision CodeSubdivision Code
Code identifying the country subdivision.
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