Setting up Insurance Billing for Group vs Individual

This article provides guidance on configuring settings to ensure the appropriate population of either the group NPI or individual NPI in Box #33a of the CMS-1500 form.

When going through the configuration settings in zHealth, there are two places where billing information must be entered for insurance claims.
This is in the “Facility” settings and “Provider” settings.

Facility Settings

To access the facility settings we will navigate to “Update Info”.
This is where we will enter in the Organization (Group) NPI. This NPI number is also known as a “Type 2” NPI

Provider Settings

To access the provider settings we will navigate to “Update Info”.
Once there we will select the “Provider” option and navigate to the “NPI Number” field. This is where the Individual NPI will be entered.

Setting Up Bill by Organization (Group)

In the “Provider” settings, there is a field labeled “Billing Provider Entity Type”. This is how you can set up your zHealth account to bill using the organization’s information, or whether to use the individual provider’s information
By selecting “Individual” you will be using the NPI information given in this “Provider” settings and using that to complete box #33 of the CMS-1500 form.

Setting Up Bill by Individual

By selecting “Organization” you will be using the NPI information given in the “Facility Settings” to complete box #33

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