General Billing Options Tab

Follow the steps below to view and edit the billing options for payers.

1. Select Customer Setup > Payers.

2. Use the Show All button to view all payers. Or use the Search field to further drill down your search.

3. Select the Payer.

4. Click the Billing Options tab from the side panel. 

5. Make your selections by referencing the Billing Option Descriptions below.

6. Use the to the default the POS (Place of Service) Code to be used on claims for this payer.

   Visit our Claim Defaults Priority Rules Help Article for a detailed list of the order of precedence of claim defaults.

7. Automatically set Claim Follow-Up dates: Check this box to have the system automatically enter a claim follow up date based on the payer.

8. Optional: Copy this payer’s follow-up settings to other payers within your customer account by clicking the “Copy this follow up configuration to other payers” link.

   Important things to know:

   • If you specify to have the claim follow-up 0 days after the claim was submitted, no automatic follow-up date will be set.
   • The date will populate when any of the following actions are taken:
     • The claim is printed from the Claim section, Payment section, or Batch Printing tab.
     • The claim is sent electronically. 
   • The follow-up date WILL get overridden if the claim is re-submitted or send to a secondary/tertiary payer. 
   • The follow-up date WILL be overridden if you manually enter a date BEFORE the claim is actually submitted/printed.

   
   

9. Use the provider name as the pay-to name: Check this box to only send the provider name vs the practice name as the pay to name.

10. Only send the pay-to address: Check this box to only send the pay-to address.

11. Use the office address as the pay-to address: Check this box to print the Office Location/Other Offices address selected within the claim section to print in box 33.

     Selecting this option will default the Practice/Group NPI to print in box 33a even if the provider is set to bill as “Individual.”

12. Print CMS-1500 as NY Workers' Compensation Form (C-4, C-4.2, C-4.3, or OT/PT-4): This option should be left unchecked for NY Workers' Compensation payers to send the CMS-1500 form (required after July 1, 2022).

13. Override billing provider with rendering provider: Check this box if you would like claims to be billed under the Rendering Provider selected on the claim.

14. Professional Options

    1. Default POS: Select the Place Of Service code that should be used when billing claims to this payer.

    2. Default Claim Note: Add a default claim note that will be automatically copied to claims, when billing the claims electronically to this payer.

    3. Do NOT print the payer address on the top of the form: Check this box if you do not want the payer address printed on the top of the CMS-1500 claim form.

    4. Exclude patient payments from Box 29: Check this box if you do not want to include any patient payments on the CMS-1500 claim form in Box 29.

    5. Print the license number in Box 31: Check this box if you wish to include the license number in Box 31 of the CMS-1500 claim form.

    6. Print the following in Box 31: Use the drop-down menu to select whether to use the Provider Name, Supervising Provider Name, Practice Name, the Signature on File, or leave blank for Box 31 of the CMS-1500 form.

    7. Send patient address in Box 32 for Place of Service 12: Check this box if you would like to replace the facility address with the patient’s home address when the professional claim's POS is 12 for Box 32 of the CMS-1500 claim form.

    8. Remove the insured’s ID# from Box1A: Check this box to remove the insured’s ID# from Box 1A of the CMS-1500 claim form.

    9. Print the following supplemental info in Box 24: Use the drop-down menu to select either the Narrative Notes or the Anesthesia Start/Stop Time in Box 24 of the CMS-1500 claim form.

    10. Print ICD code for first diagnosis pointer in Box 24E: Check this box to print the first diagnosis Code in Box 24E on the CMS-1500 claim form.

    11. Send minutes instead of units on anesthesia claims: Check this box if you would like to use minutes instead of units for anesthesia procedures.

    12. Send anesthesia start/stop times in a line note: Check this box if you would like to include the anesthesia start and stop times as a line note on the CMS-1500 claim form.

11. Institutional Options

    1. Print the following in Box 38: Use the drop-down menu to select whether to use the Insured's address, Payer’s address or to leave Box 38 blank on the UB-04 claim form.

    2. Print the following in Box 80: Use the drop-down menu to select whether to use the Insured's address, Payer’s address or the remarks for Box 80 blank on the UB-04 claim form.

    3. Print referring physician in Box 76: Check this box if you would like to include the referring provider in Box 76 of the UB-4 claim form.

    4. Print Taxonomy Code in Box 76: Check this box if you would like to include the taxonomy code as the qualifier in Box 76 of the UB-4 claim form.

    5. Print Taxonomy Code in Box 81CC: Check this box if you would like to print the taxonomy coder in Box 81CC of the UB-4 claim form.

12. Click Save. Or proceed to the Provider tab of Billing Options.