While it is best to have the same billing provider information (i.e. tax ID and NPI) on file across all of your payers, Therabill does realize that it is not always possible. Or, there may be transition periods while you are in the middle of changing your billing provider information with your payers. Therabill does offer a method that allows you to specify what information should go out as the billing provider information on claims (Box 33 of the CMS-1500) to a specific payer. We have been referring to this as insurance Company Specific Billing Provider Information. Here is a general overview of how Therabill decides what to put in to Box 33 (Billing Provider) on your insurance claims.
Box 33 of the CMS-1500
This is where the billing provider information goes on your claims. This is very important as the information that you provide here is how the insurance company will identify you in their system (or database). For this reason, the information you provide here should be the same information that you have on file with the payer that you are submitting to.
Your (default) billing provider information
Therabill will (by default) always put the information that you have under Admin in Therabill into Box 33 of your CMS-1500 claims. To view / edit your billing provider information, click Admin in the top blue navigation bar of Therabill. You will now see your member information. This is what will go out on all of your claims for all of your therapists to all insurance companies by default if you have not specified elsewhere to use different billing provider information.
Therabill gives you the ability to change your billing provider information based on two criteria: 1.) Who the rendering provider is on the claim is (This is referred to as Groups and is not explained in this article) and 2.) the insurance company (or payer) that you are submitting to.
Changing the billing provider information to go out to a specific payer
Therabill gives you the ability to change the billing provider information (Box 33) on all claims going out to a specific payer. This is done through Insurance Company Specific Billing Provider Information. To change the billing provider information for a specific payer, follow these instructions.
- Click Billing in the top navigation bar of Therabill
- Click Insurance List in the sub-navigation bar of Therabill.
You will now see a list of insurance companies that you have included on insurance card in Therabill (see image to the right). Each insurance company will have various links associated with it. One of those links is labeled Info & Settings (circled in red in image to the right). When you click the Info & Settings link, the insurance company settings form will open up. In the insurance company settings form, click on the Box 33 tab. You can click on the blue pencil to edit the information that will go out on claims to that payer.
When using insurance company specific billing provider information, you do need to remember that you have it entered for the payer. If later in time, you need to convert back to using the information that you have under Admin for this payer, then you will have to remember to remove the insurance company specific billing provider information from that payer.
Using insurance company specific billing provider information along with Groups
If you are also using Groups in Therabill (to control the billing provider information for a set of rendering providers) and if you want the insurance company specific billing provider information to apply to one of your groups, then when you are on the Insurance List page, make sure you enter the group that you want it applied to at the top right.