The following instructions are to setup an insurance company with appropriate data for submitting claims.
- Access Admin > Vendors/Partners > Insurance Companies. Ensure the following fields have been populated for each insurance company.
- Insurance Company Name.
- Address (only required if not sent electronically).
- Classification: This field is required for paper claims and pertains to Box 1 of the CMS-1500 form. Please complete accordingly. See Example
- Claim Submission: If claims for this payer will be sent electronically from RevolutionEHR to the clearinghouse, select Electronic. If the claim will be sent another way (not through the clearinghouse) select either "mail or print." These selections allow you to manually mark these claims as submitted. For any payer that you do not want to create a claim, select None.
- Payer ID: If you are filing electronic claims a Payer ID is generally required. Please refer to your clearinghouse for payer ID listing requirements.
- Claim Filing Code: This is required for electronic claims.
| Claim Filing Code Payer | Claim Filing Code Indicator |
| Medicare, Railroad Medicare, Medicare Advantage Plans, DME, anything "you think of" as Medicare. | MB-Medicare Part B |
| Medicaid, Ucare, anything "you think of" as Medicaid. | MC-Medicaid |
| Champus | CH-Champus |
| Blue Cross Blue Shield | BL-Blue Cross/Blue Shield |
| Tricare | OF-Other Federal Program |
| All other payers; e.g. UHC, Cigna, Aetna, UMR. | CI-Commercial |
- Participating Practice: If you accept assignment, check the participating provider checkbox. If you do not accept assignment, you will not check this box and the patient will receive the insurance check. This is Box 27 on the CMS-1500 form.
- NPI Only on claims: If this is checked, then box 24J and 33a will only display the NPI on paper claim. If it is not checked E1 and Tax id will list on 24j and 33b of paper claim.
- User Rendering Provider as Referring: If checked, this automatically enters the rendering provider as the referring provider on the claim (CMS-1500 Box 17). Payer requirements vary; check with the payer if unsure. We recommend checking this for Medicare payers at a minimum. The setting applies to new invoices; add the referring provider manually to invoices created before it was checked.
- Remove matching service facility NPI: We recommend leaving this unchecked. If checked, this removes the service facility NPI from the electronic claim when it matches the billing NPI.