The 'Entity Type Qualifier' is an EDI thing. Every 'entity' (billing provider, rendering provider, referring provider etc..) on an EDI claim goes out with an indicator that they are a business or an individual. This indicator of whether they are a business or an individual is being referred to as an entity type qualifier. The entity type qualifier 2 indicates organization or business.
Because this error is not pointing to a specific entity (billing provider, client, rendering provider, referring physician) on your claim, you may need to do some leg work to find out what they are referring to. Luckily, there are only a few things that need to be looked at if they are complaining about an entity type qualifier of 2. These two things are listed below.
- Referring Provider/Physician: The referring physician is entered on the add / edit client form. The referring physician will go out with entity type qualifier of 2 if you only have a last name entered. If you only have a last name entered for the referring physician, try entering their first name and saving the client. With a first and last name, the claim will then go out with a entity type qualifier of 1 for individual.
- Billing Provider: This is Box 33 of the CMS-1500. You can usually edit this information under Admin (unless you are using Groups or Insurance Company Specific Billing Provider Information). If you have the NPI marked as organizational, then your claims will go out with an entity type qualifier of 2. If you switch that to individual for you NPI, then the claim will go out as entity type qualifier of 1.
If you have received an EDI rejection with this message in Therabill, then once you have updated the information (with the referring physician or the billing provider) then you can go to the claim error page in Therabill and click the Resubmit Electronically button at the top.