Clinician Billing Setting Overrides

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In some circumstances, a clinician may need to bill with different information than the practice, such as when a clinician is paneled with a payer separately from the practice. A clinician billing setting override allows clinicians to override the default practice information (such as NPI or tax ID) when submitting claims to all or select payers.

Role Required: Practice Biller

To set up a clinician billing setting override:

  • Click the User Icon > Settings > Staff User Accounts > Staff Name > Billing tab
  • Click anywhere on the box labeled Clinician Billing Setting Overrides to edit

clinicianbillingsettingoverride.png

  • Select the Enable clinician billing setting overrides checkbox
  • Choose which payer the override affects from the Applicable for dropdown. Select Any Payer to apply the override to all payers
  • In the remaining fields, enter only the information that differs from the default practice information. All other fields should be left blank
Quick Tip: To bill using the Billing Provider information for the practice instead of the clinician's name and NPI, select Non-Person (Type 2) from the Rendering Provider Type dropdown.
  • To enter an override for a different payer, click the Add Overrides button
  • After you have entered all of your overrides, click the Save Changes button
Have more questions? Submit a request

Comments

  • Avatar
    Stephnie Thomas

    What if I have different NPI and/or different tax id's for multiple practice locations where the clinician is the same?

  • Avatar
    Jordan

    Stephnie,

    You do not need to change anything. You have these as actual locations. Please let me know if you have any questions. Thank you!

  • Avatar
    Eva Hartley

    Medicaid is requiring my state provider number in 33B but my taxonomy number is filling the space. How do I correct?

  • Avatar
    Jordan

    Box 33b on the cms-1500 is for the taxonomy code. Would you be able to provide documentation from Medicaid regarding this. Please send this documentation to support@therapynotes.com.

  • Avatar
    Counseling Intern

    Im still struggling with this. I am a provider at two locations. I did the practice setting override but now I can't prepare bill that does not have the override information on there. It seems that I should be able to choose which location I want to bill for when creating the statements but the only thing that comes up is the override info. Am I missing something?

  • Avatar
    Kelly Carpenter

    Our facility is not Medicaid certified but our clinicians are. Medicaid is requiring their NPI #s in box 33a as well as the rendering provider's name in the billing box. Is there a way to set up or change these items per CMS-1500 before printing? We are submitting some of these to payers that have different guidelines for the clients that are not medicaid...

  • Avatar
    Jordan

    Kelly,

    You can do this for these clinicians with the Medicaid payer.

    To replace the default practice information, such as the billing NPI or tax ID, on claims for a specific clinician you need to set up a clinician billing setting override. The override can be turned on for a specific payer per clinician.

    Click STAFF > Click staff user > "Billing" tab
    Click anywhere on the "Clinician Billing Setting Overrides" box to open it.
    Check the box to enable.
    Click the blue "+ Add Override" button.
    From the "Applicable for" dropdown select "Any Payer" or a specific payer’s name.
    Fill out the fields.
    Click the green "Save Changes" button.

    If you have any additional questions please contact support at 215-658-4550 or via email at support@therapynotes.com