Configuring Program Billing Info







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Every program that bills must have program billing information entered for it.  That information, which is entered in step 6 of the setup process, consists of specific data required for electronic claim files or paper invoice forms.

  NOTE: Programs can belong to only one program billing group at a time.

To configure a program's billing information, complete the following steps:

    1. From the AWARDS Home screen, click Administration from the left-hand menu, and then click Fiscal.  The Fiscal fly-out menu is displayed.
    2. Click BillingBuilderThe BillingBuilder Menu page is displayed. 

    1. Click Program Billing Info.  The Program Billing Info page is displayed. 
    2. Click the Program drop-down arrow and select the appropriate program.
    3. Click the Payer drop-down arrow and select the appropriate payer.
    4. Click CONTINUE.  The Program Billing Info page is displayed.

    1. Every program that bills must have program billing information entered for it.  That information, which is entered in the setup process, consists of specific data required for electronic claim files and/or paper claim forms.

IMPORTANT! Each program/payer combination can only belong to one program billing group at a time.

To enter or update program billing information for the selected program and payer combination, configure the fields and options on this page as follows:

  Program Billing Group - Click this drop-down arrow and select the program billing group with which this program should be associated.  When a selection is made the page is automatically refreshed and values for the selected group are dropped into the Agency Sender ID/Submitter ID and Agency Tax ID fields (detailed below) if they were filled out during the configure billing type process.

General Billing Info

  Agency Sender ID/Submitter ID - A read-only value displaying the Agency Sender ID/Submitter ID entered during program billing group configuration.  The Sender Code entered there is also displayed here.  This information can only be changed from within the Program Billing Groups feature.

  NOTE: Defaults to the value entered for the associated billing type, if available for that type.

  Agency Tax ID - In this field, type the agency's tax ID.  When entering the ID, omit the dash after the second character.

  NOTE: Defaults to the value entered for the associated billing type, if available for that type.

  CMS Place of Service Code (837P)/Uniform Bill Type Code (837I) - For 837P billing types, enter the CMS place of service code in this field.  For 837I billing types, enter the NUBC code.  If the payer for this billing type is self-pay, enter "0" in this field.

  837I Revenue Code - In this field, type the four-digit 837 institutional revenue code.  If this program billing info record is being used to generate an 837P (professional) claim file, "N/A" can be entered here. 

Service Facility Information

The information in this section of the billing info page is used as the service facility information when the associated payer has the Report Service Facility Info in 837 option checked off and the procedure being invoiced as the Use Program Billing Info option selected for the "Service Facility Info for 837" setting.

  Street Address - In this field, type the service facility street address for this program billing info record.

  City - In this field, type the service facility city for this program billing info record.

  Street - Click this drop-down arrow and  select the service facility state for this program billing info record.

  Zip Code - In this field, type the service facility code for this program billing info record.

  NPI - In this field, type the service facility NPI for this program billing info record.

  Secondary ID, 837 ID Qualifier - In this field, type the service facility secondary ID and associated 837 ID qualifier for this program billing info record.

  TIP: To report the secondary ID/qualifier, the Payers page needs to have the Report Service Facility Secondary ID option selected.

Default Rendering/Attending Provider Info for Program

The information in this section of the billing info page is used as the Rendering/Attending NPI for an invoice on the Edit Invoice Batch page when the note writer does not have an NPI entered for them under Human Resources > Staff Information > Credentials tab > National Provider Identifier AND when the procedure being invoiced does not have data entered within the Incident To fields.

  First Name - In this field, type the default rendering/attending provider's first name for this program billing info record.

  Last Name - In this field, type the default rendering/attending provider's last name for this program billing info record.

  NPI - In this field, type the default rendering/attending provider's NPI for this program billing info record.

  Taxonomy Code - In this field, type the default rendering/attending provider's taxonomy code for this program billing info record.

  Secondary ID, 837 ID Qualifier - In this field, type the default rendering/attending provider's secondary ID and associated 837 ID qualifier for this program billing info record.

  TIP: To report the taxonomy code and/or secondary ID/qualifier, the Payers page needs to have one or both of the following options selected:  Report Rendering/Attending Provider Taxonomy Code in 837 and/or Report Rendering/Attending Provider Secondary ID in 837.

Atypical Billing Options

The information in this section of the billing info page is used if the program billing info record needs to create an atypical 837 claim file.  Typically, atypical 837 claim files report an MPI (Medicaid Provider ID) and not an NPI (National Provider ID).

  Medicaid Provider ID - If billing an atypical 837 file, enter the agency/program's Medicaid Provider ID in this field.

  Locator Code - If billing an atypical 837 file, enter the agency/program's locator code in this field.

Additional Non Claim Data

If applicable, enter the information below.  Please note that the information below is NOT used in the 837I or 837P claim files.

  Specialty Code - In this field, type the program's specialty code.

  Category of Service - In this field, type the program's category of service.

    1. Click CONTINUE.  The program billing information is saved and displayed on a confirmation page.
    2. Click CONTINUE to return to the Program Billing Info page.
    3. Repeat steps 4 through 9 until the program billing information has been entered for all programs that will bill.

The process of configuring program billing information is now complete.

  TIP: If it is later necessary to update a program's billing information, use the same procedure outlined above.

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