What it is:
Box 17 is where the name of the referring provider, ordering provider, or supervising provider who referred, ordered, or supervised the service(s) or supply(ies) on the claim. The qualifier indicates the role of the provider being reported. Enter the name (First Name, Middle Initial, Last Name) followed by the credentials of the professional who referred or ordered the service(s) or supply(ies) on the claim.
Enter the applicable qualifier to the left of the vertical dotted line to identify which provider is being reported.
- DN Referring Provider
- DK Ordering Provider
- DQ Supervising Provider
Therabill will use the values from the First Name, and Last Name fields that are in the Referring Physician/Provider section of the edit patient form to build the data for Box 17.
On the top menu bar, select Clients / Client List. Click the blue pencil for the desired client. You will now see the client information form. In the Referring Physician/Provider section, find the fields for First name, and Last name. Enter the appropriate values of the referring physician for this patient. Therabill will insert the DN qualifier automatically.