- Reference#: This is a free-form field where you can enter information regarding the facility, which can be used when searching for facilities or when running reports.
Tax ID: Enter the facilities Tax Id Number.
Location Provider ID: Enter the Location Provider ID number. The value for this field is used on electronic claims. When set, this value will be used in Loop 2310C, specifically the REF~LU segment.
BlueCross ID: Enter the identification number that certifies that the facility has met all Blue Shield Network Provider requirements (informational field).
Medicare ID: Enter the facilities Medicare ID number (informational field).
Locator Code: Enter the Locator Code. The value for this field is used on electronic claims. When set, this value will be used in Loop 2310C, specifically the REF~LU segment for CPID 1502/2782.
CLIA ID: Enter the facilities Clinical Laboratory Improvement Amendments identification number. CLIA regulates laboratory testing and requires clinical laboratories to be certified by the state before they can accept human samples for diagnostic testing. This information prints in Box 32 of the CMS-1500 form.
Site ID: Enter the Site ID number. The value for this field appears to be used in the following areas: Professional paper claim, (This value is put into box 32b along with the facility NPI for the following payers: CPID 5259 CPID 4302 when the master payer name contains "MAINE MEDICAID" Electronic claims: This value is used in Loop 2310C, specifically in the REF~LU segment for CPID9582/5259).
BlueShield ID: Enter the identification number that certifies that the facility has met all Blue Shield Network Provider requirements.
Medicaid ID: Enter the facilities Medicaid ID number. The value for this field is used on professional paper claims. When set, this value will be placed in box 32b when the customer # is10013180 and the claim is being billed to a payer that is type Medicaid.
POS Code: Select a default Place of Service Code that should always be used when creating claims for this facility.