Add Referring Providers

Add Referring Provider from the NPI Registry

Use the NPPES NPI Registry to save time and quickly auto-populate the required information for a referring provider into CollaborateMD. 

Follow the steps below to add a Referring Provider from the NPI Registry.

  1. Select Customer Setup > Referring Providers.

  2. Click the New Referring button > Add via NPI Registry.

  3. Enter the referring providers NPI number into the field. Or use the search field to search the NPPES NPI Registry for all NPI records of Healthcare Providers.

    Searching with a partial name or are unsure of the spelling? It must be followed by an asterisk * 

    Failure to add the wildcard (*) will result in the registry only searching for an exact match and may not pull up the record you are searching for. (i.e., When searching for “James Jones”” type in “Jame*” in the first name field and “Jon*” in the last name field so it pulls up all records that include “Jame” and “Jon” in the first/last name).

  1. Click the Search button.

  2. A window will open displaying the NPI numbers that match your search results; select the NPI of the Referring Provider you would like to add.

  3. Review the information copied over for accuracy and make any required changes .

  4. Click Save.

Add Referring Provider Manually

Follow the steps below to manually add a Referring Provider.

  1. Select Customer Setup > Referring Providers.

  2. Click the New Referring button> Add Manually

  3. Enter the referring provider Last Name, First Name, MI & Credentials.

  4. Add the referring provider’s NPI number. Or click the to search the NPPES NPI Registry for all NPI records of Healthcare Providers.

  1. Enter the Taxonomy Specialty that defines the referring providers area of specialization. 

  2. Add the referring providers Contact Information (e.g., phone, fax, cell phone, email). 

  3. Enter any applicable ID Numbers by referencing the Referring Provider Field Descriptions

  4. Click Save.


Referring Provider Field Descriptions

Required fields are indicated in red.

  • Credentials: The referring provider’s medical credentials. (MD, OD, RN etc.)

  • This referrer is an: Select the referring providers type. For example, choose Individual (Type 1) if the referring provider is a person and choose Organization (Type 2) if the referring provider is a place. 

  • Referring Type: Select the referring providers' type. By default, Referring Provider is selected, however, select Primary Care Provider if the referring provider is the patient's assigned physician that provides primary care and acts as the gatekeeper that controls access to other medical services. 

  • Do not send referrer on claims: Check this box to include or not include this referring Provider on claims. 

  • NPI: The referring provider’s NPI number. 

  • Taxonomy Specialty: The referring provider’s Taxonomy code that identifies the provider type and area of specialization.

  • Sequence#: This number is auto-populated by CollaborateMD. This field is informational and does not appear on the claim.

  • Reference#: In the event, you have to enter a referring provider into the system twice, use this field to help distinguish between the two providers. (i.e. TAX ID, EIN, Provider A, Provider B). This field is informational and does not appear on the claim.

  • Address: The referring provider’s address information.

  • City: The referring provider’s city. 

  • State: The referring provider’s state.

  • Zip Code: The referring provider’s zip code.

  • Phone #: The referring provider’s phone number.

  • Fax #: The referring provider’s fax number.

  • Home Phone #: The referring provider’s home number.

  • Cell Phone #: The referring provider’s cell phone number.

  • Email: The referring provider’s email address.

  • Pager #: The referring provider’s pager number.

  • Tax ID: The referring provider Tax ID number.

  • Tax ID Type: Define whether the provided Tax ID number is an SSN or a TIN number.

  • UPIN: Medicare assigned number to identify providers. This number populates to box 17a on the CMS-1500 form.  

  • BCBS ID: Bluecross Blueshield assigned number is used to identify providers on professional paper claims:

    • This value is put into box 17a with a G2 qualifier when sending to a payer type of either Blue Cross Blue Shield or Blue Cross.

    • Printing of referring providers. This value is included in the printout when printing from the Referring section.

  • Champus ID: Tricare assigned number is used to identify providers on professional paper claims: 

    • This value is put into box 17a with a G2 qualifier when sending to a payer type of Tricare/Champus.

    • Printing of referring providers. This value is included in the printout when printing from the Referring section.

  • Specialty License #: The Referring provider’s Specialty License number:

    • Professional paper claims: This value is put into box 17a with a G2 qualifier when sending to CPID 2742.

    • Professional electronic claims: This value is used in Loop 2310A, specifically in the REF~G2 segment for CPID 2742.

  • State License #: The Referring provider’s State License number: 

  • Anesthesia License #: The Referring provider’s Anesthesia License number is used solely for information purposes.

  • Medicare ID: Medicare assigned ID to identify providers. The value for this field is only used in the printout when printing from the Referring section.

  • Medicaid ID: Medicaid assigned ID to identify providers: 

  • Professional paper claims: This value is put into box 17a with a G2 qualifier in any of the following circumstances:

    • Payer type is Medicaid.

    • CPID is 4427.

    • Professional electronic claims:

      • This value is used in Loop 2310A, specifically in the REF~G2 segment for CPID 4427. 

      • This value is used in Loop 2300, specifically in the REF~9F segment for CPID 1478.

  • Marketer: The Referring provider’s Marketer ID number is used in: