Clearinghouse Rejection: Referring Provider (2310A) is required to be a person
CE - Referring Provider (2310A) is required to be a person (NM102 = '1')
Referring Provider Library: If the full name of a Referring Provider is entered in the Last Name field, it is recognized as an institution instead of a person
This puts a 2 in place of the usual, 1 in the 2310A Loop NM1 segment.
Example:
James Flores MD is entered in the Last Name field of the Referring Provider Library.
Result in the ANSI Claim: 2310A NM1*DN*2*JAMES FLORES MD
Flores is entered in the Last Name, James is entered as the First Name.
Result in the ANSI Claim: 2310A NM1*DN*1*FLORES*JAMES
If an Institution needs to be the referring:
Enter part of the entity's name in the Last Name and part in the First Name field.
Example: The Clinic Health Center is the name of the Institution.
Enter Health Center as the Last Name.
Enter The Clinic as the First Name.
Result: 2310A NM1*DN*1*HEALTH CENTER*THE CLINIC
Related Articles
Add or Modify Referring Providers/PCP
Add or Modify Referring Providers/PCP One Library is kept for both the Referring Provider and PCP. System Settings for Referring Provider Access System Settings Auto-populate the Referring Provider on the Claim If the Referring Provider is chosen on ...Clearinghouse Rejection Articles
If the Subscriber State (AB) is a Canadian province then Subscriber Zip Code (AB T8L0S2) must be six characters Referring Provider (23010A) is required to be a person 2300 NTE02 has a character limit of 80 characters Service Line 1 COB Claim ...Rejections Examples
Rejection: Invalid Subscriber ID Format for ___ Resolution: From the Patient Dashboard, verify Eligibility, view the Eligibility Report, view the Patient's Scanned Insurance Card, and/or call the Patient. Correct the Policy Number. On the Encounter ...Billing/Rendering/Referring Provider FAQs
Billing/Rendering/Referring Provider FAQs Where do I add the Provider's Medicaid number? Billing/Rendering Provider: The Medicaid number is added on the Billing/Rendering Provider screen in the Licensure/Credentialing panel. (Libraries > ...Billing/Rendering Providers
Add Providers Providers can be added using the NPPES Import Tool that completes the Provider screen which only requires editing. If the Provider cannot be found using the NPPES tool, the Provider can be added manually from a link that displays only ...