In the Admin>Insurance>Fee Schedule, there is a box at the bottom for Group? to be checked. My question(s) is/are: is this necessary to be checked? Is there a place to uncheck it for all insurances? Am I going to mess claims up if I do uncheck it? We never have an instance where the group NPI would be listed in both the rendering and billing fields, but our individual NPI is. I have had a few denials where the insurance company said the reason for denial was that the rendering NPI was not there. It was not there b/c of the group? box, I believe. What is the correct usage for this box?
Don't let what you can't do keep you from doing what you can do!
Currently, having the "group?" box checked for ANSI claims will send the designation of "2-Organization" for the Billing Provider loop instead of a designation of "1-Person" whether you are billing as a group or a solo provider. So if you left box 33a blank in Admin>>Insurances>>CMS then the provider would go across as the billing provider with an organization designation. Going forward and currently in the beta version, that box is going to send the designation of "2-Organization" for the Billing Provider loop but will also automatically pull the company name, address, and NPI that you have set in Admin>>Company even if you have box 33/33a blank. So, if you have box unchecked and 33/33a is blank then the billing provider information will pull from the doctor's employee record (name, address and NPI).
If you have some denials that you would like me to look at you can email me, email@example.com, and we can take a look.