01. To enter a new provider, or edit an existing record, go to LISTS then PROVIDER, then PROVIDERS.
02. If you want to edit an existing record, highlight it then click EDIT. Otherwise click NEW to create a new entry.
03. Starting from the top, first create a CODE. This will be a short five-character identifier for the provider. For example, if the doctor’s name is “John Doe” you could enter JD, or JOHND, or JDOE for the code. You can also leave the field blank, in which case the program will create a code for you.
04. Next enter the LAST NAME, and FIRST NAME. The MIDDLE NAME and CREDENTIALS are optional.
05. Next enter a STREET address, CITY, STATE and ZIP CODE.
06. Next enter any contact information you would like in the OFFICE, HOME, FAX, and CELL fields.
07. Next place a check-mark in the SIGNATURE ON FILE box. Most often the SIGNATURE DATE field is left blank.
08. Next place a check-mark in the MEDICARE PARTICIPATING box if the provider is considered a Medicare participating provider. A Medicare participating provider agrees to accept assignment on all Medicare claims for covered services and supplies.
09. Last on this tab, you can enter the provider’s LICENSE NUMBER.
10. Now click on the REFERENCE tab.
11. This tab is as the name suggests mostly for reference. If you converted data from a previous version of Medisoft you may already have data on this tab, however the fields are not used for claims generation. You may enter IDs here you would like, but again the program will not use them for anything.
12. There is one field on this tab that could be used, and that is the PROVIDER CLASS. This field is used to group providers in practices with a large number of providers where common IDs are used. If setup, this code can be used in the Practice IDs grid mentioned on pages 4-5. To set this up go to LISTS then PROVIDER then CLASS. Click NEW then enter a CLASS ID, CLASS NAME, and DESCRIPTION. You can then enter the CLASS ID here in the provider record.
13. Now click on the PROVIDER IDs tab.
14. Like the Practice IDs grid mentioned earlier (pages 4-5), this grid allows you to setup rules for how the program populates ID fields like 24j shaded and un-shaded. In each provider’s record you will need at least one line.
15. You can add a line by clicking NEW.
16. In this screen select whether the provider sends claims as an INDIVIDUAL or as a GROUP. If the provider’s individual NPI is sent in both 24j and 33a; select INDIVIDUAL. If the provider’s individual NPI is sent in 24j, but the practice or group NPI needs to be sent in 33a; select GROUP. Also note the LEGACY IDENTIFIER 1 field populates 24j shaded.
17. Next enter the NATIONAL PROVIDER ID for the provider, and the TAX IDENTIFIER or SOCIAL SECURITY NUMBER.
18. Click OK then SAVE when finished.
19. If a particular insurance carrier wants different IDs than what was setup in the first entry, you can add another entry making sure to select that INSURANCE CARRIER. Any specific entries where an Insurance Carrier, Insurance Class, or Facility are selected will over-ride the “all, all, all” entry. An example of this can be seen on the previous page. In that example, the second line will take precedence over the first line when the insurance claim being printed or sent electronically is MCR. Note, you may have to come back to this section if the insurance carriers have not yet been added to Medisoft.
20. Click OK then SAVE when finished.