5. Entering/Configuring Provider ID Numbers — (provids)
5.1. Override Identifiers For an Entire Insurance Batch
Do you need to replace all of a provider's identifiers with a different provider's values? Can Partner change a provider's name so it appears differently on some claims, or include a custom insurance eligibility ID# on the claim? How do you configure the legacy PIN and Group numbers required by some carriers? Partner's Provider IDs (provids) program allows you to override any claim identifier information. Use provids to set an alternate provider, or to enter custom values for the name or the NPI, Tax ID, eligibility, or legacy ID numbers.
Claim Control, Not Billing Record Control: When you set provider information in ted or assign a billing provider in chuck or oops, you change the provider information in Partner. The provids program changes identifier information on outgoing claims as they are generated and submitted, when you run preptags or hcfa. With that in mind, provids should be used last, and only in situations where the other solutions are insufficient.
5.2. Run the Provider IDs Program (provids)
You can run the provids program from the Insurance Configuration (insconfig) program found in the Partner Configuration window of your Partner Windows. You can also type provids at a command prompt.
After you run provids, select the insurance batch with which you wish to work. Remember that you may have both a paper (HCFA) and an electronic (ECS) claim batch for each carrier. Choose the correct batch and press Enter.
The first provider you will see is the blank, or "None" provider entry. Press Page Down to cycle through all providers on your system. The provider name and counter in the upper-right corner will help you keep track of whose identifiers you are currently editing.
The top section displays the provider's current Tax ID and NPI numbers, as recorded in the Providers table of the Table Editor (ted). If you wish to update the provider's Tax ID and NPI numbers for all insurance carriers, use ted, not provids.
5.3. Set an Alternate Provider
If you need Partner to replace this provider's identifiers with another provider's identifiers, enter the new provider in the Claim Provider field.
Outgoing claims for the provider shown at the top of the screen will now contain the claim provider's identifiers. This will only occur for the chosen insurance batch. When you submit your claims electronically or print HCFA forms, Partner's claim generating program will replace the provider name, NPI number, and Tax ID number.
5.4. Override Provider Values with Custom Values
Instead of setting an alternate provider, you can enter custom values in the Provider Table Override fields.
No matter which provider appears in the Claim Provider field, entries in the "Provider Table Override" fields will take precedence. Avoid using both a claim provider and the override fields at the same time. However, if a claim provider is selected, any override fields with content will be used first, and Partner will refer to the claim provider or the original provider only for those left blank.
5.5. Legacy Identifiers
Before the complete implementation of the National Provider Identifier, insurance carriers had their own set of identifiers. These might include a PIN, Group, Eligibility, or other ID number. You can still access these fields in provids:
In the example above, the Ins ID and Alt ID numbers, along with the Insurance Eligibility number, may appear on this provider's claims. The provider's Tax ID and NPI numbers will be those entered in the Table Editor (ted), as shown in the top section.
Changes May Not Affect Claims: Are your claims configured to display the NPI number? Or are your claims configured to show the PIN and Group numbers? Changing the Legacy Identifiers will only change your claims if they are configured to use those identifiers. Once PCC configures your claims to use the new NPI number, the legacy fields may be ignored. Contact PCC for further assistance.
5.6. Jump to a Provider
You can cycle through each provider by pressing Page Down and Page Up. Press [F8 -- Jump to Provider] and enter a provider name to jump directly to their provids screen.
