Submit Electronic Claims with a Supervisor (My Clients Plus 3.0)

  Permissions: You must have Billing Permissions. 

How do I submit Claims under a Supervisor? 

It depends! Each Insurance company will have their own requirements on how they want to see the Claims, and how you are credentialed with them. You'll want to verify this with the Insurance companies directly before submitting Claims. Here are the two ways you can submit a Claim with a Supervisor: 

1. Include Supervisor Name and NPI on Claim in Box 17. The Supervisor will appear in box 17 and the Supervisee remains listed on the Claim as the Rendering Provider. 
2. Replace the unlicensed Clinician name with the Rendering Provider in Boxes 24 and 31. The Supervisee's name will not be listed on the Claim and will be completely replaced by the Supervisor's name in the Rendering Provider fields. 

Once you have set this up, you will submit these Claims just like you would any other Claim.

Include Supervisor Name and NPI on Claim in Box 17

In My Clients Plus you can populate this information in box 17 of the CMS-1500 Claim Form, Loop 2310D on the 837P EDI File. This is a preference you can set in the Client's Bill To & Insurance Info tab and this setting will apply to all Claims for this Client after this is setup.

1. Locate Client and open Client Profile.
2. Click Bill To & Insurance in side menu. 
3. Scroll down to Referrer section.
4. Enter Supervisor's First and Last Name.
5. Enter Supervisors NPI.
6. Select YES for Use Supervising Provider on Claims.
   
   
   

The Supervisors name will populate on the Claim with the "DQ" Supervisor qualifier.

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Replace unlicensed Clinician name with Rendering Provider in Box 24 & 31

Some Insurance Companies require the Supervisor's name to replace the unlicensed Clinicians name as the Rendering Provider in boxes 24 and 31. In these cases you will need to make the change directly on the Client's invoice. Or alternatively, you can set the Default Rendering Provider so you don't have to manually change it each time.

NOTE: This will affect the Payroll Report. Any dollars collected for this Invoice will appear on the Payroll Report under the Rendering Provider name that is entered on the Invoice. 

1. Locate Client and open Client Profile.
2. Click Ledger in side menu. 
3. Click Action for appropriate Invoice and select View Details.
4. Under Rendering Provider, enter in Supervisor Name.
5. Click Save.
   

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Set Default Rending Provider

You can now set a default Rendering provider so that when you are billing under a Supervisor NPI you no longer have to change the Rendering Provider every time on the Invoice details to populate the Supervisor NPI as the Rendering. 

 

Enable Payer Settings

1. Click Billing tab in primary navigation bar.
2. Click Insurers in side menu.
3. Locate appropriate Payer and click Edit.
4. Select Use Rendering Provider designated in Client Payer Settings on Claims.
5. Click Save.
   

Set Rendering Provider in Client Profile

1. Locate Client and open Client Profile.
2. Click Bill To & Insurance Info tab.
3. Scroll to Manage Insurance section and click Edit for appropriate Insurance. 
4. Select appropriate Supervisor Provider in the Rendering Provider drop down.
5. Click Save.
   

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