What is Box 17 on a HCFA form?

Enter the name of the referring or ordering physician if the service or item was ordered or referred by a physician. All physicians who order services or refer Medicare beneficiaries must report this data.

What goes in box 17 on a CMS 1500?

referring provider
Box 17 identifies the name of the referring provider on the claim. Enter the applicable qualifier to the left of the vertical dotted line to identify which provider is being reported.

What qualifier should be listed in block 17 for a referring provider?

The qualifiers appropriate for identifying an ordering, referring, or supervising role are as follows: • DN — referring provider • DK — ordering provider • DQ — supervising provider • Enter the qualifier to the left of the dotted vertical line on item 17.

What indicates the role of the provider being reported in item number 17?

What indicates the role of the provider being reported in Item Number 17? (The qualifier for Item Number 17 is used to indicate the role of the provider being reported, such as DN for Referring Provider, DK for Ordering Provider, and DQ for Supervising Provider.)

What goes in box 33 on a HCFA?

Box 33 is used to indicate the name and address of the Billing Provider that is requesting to be paid for the services rendered. Enter the name, address, city, state, and ZIP code. P.O.

What goes in box 19 on a CMS-1500?

Box 19 is commonly used on paper claims for data not otherwise accommodated by the CMS-1500 claim form. Data entered in this field will print but will NOT export electronically.

What goes in box 19 on a CMS 1500?

What is a 431 qualifier?

Depending on the carrier, the box 14 will usually require the qualifier “431”, which indicates that it is the date of onset or injury. In Medicare, Box 14 is used to indicate the date the patient first began treatment in your office for the diagnosis listed in line A of Box 21.

What goes in box 33b on a HCFA?

Box 33b is used to indicate a payer-assigned identifier of the Billing Provider. Some payers require the provider’s taxonomy code be listed in Box 33b.

What does the ZZ qualifier mean?

• ZZ – Provider taxonomy – A list of the valid Taxonomy codes. Claim Filing Indicator Code. The Claim Filing Indicator Code identifies the type of claim being filed.

What is Box 32 on a HCFA?

Box 32 is used to indicate the name and address of the facility where services were rendered. Enter the name, address, city, state, and ZIP code of the location. Note: If Box 32 has the exact same information as Box 33, the clearinghouse will remove that from the EDI file.

What goes in box 19 on HCFA?

Box 19. Box 19 is commonly used on paper claims for data not otherwise accommodated by the CMS-1500 claim form. Data entered in this field will print but will NOT export electronically. Please contact your payer to determine where the data is expected.

What are the rules of the law of Jante?

The Ten Laws of Jante Rule 1 Do not to think you are anything special Rule 2 Do not to think you are as good as we ar Rule 3 Do not to think you are smarter than we Rule 4 Do not to imagine yourself better than w Rule 5 Do not to think you know more than we do

Who is required to use the HCFA form?

Clinical practitioners and physicians use the HCFA to submit claims for professional services. Federal regulations require all healthcare providers to use the HCFA or UB-04 form for filing claims.

Where did the concept of Jante come from?

In it, Sandemoose tells the story of a fictional small Danish town, Jante, where all individuals are expected to subsume their identity to the group. Though he first articulated the concept, Sandemoose argues that this is something that can historically be found throughout the villages and cities of Scandinavia.