Match the provider to the payer's billing rules.
Configure supervising relationships, bill-under rules, NPI selection, taxonomy, and effective dates. Apply them consistently to each claim.
Taxonomy overrides
| Provider | Payer | Taxonomy | Status |
|---|---|---|---|
| A. Rivera, NP | Aetna Better Health | 363L00000X | Active |
| J. Chen, MD | State Medicaid | 207RA0401X | Active |
| A. Rivera, NP | BCBS | 363LF0000X | Active |
| M. Osei, PA | CareSource | 363A00000X | Active |
Billing NPI — group vs individual
| Provider | Payer | NPI mode |
|---|---|---|
| A. Rivera, NP | State Medicaid | Individual |
| J. Chen, MD | BCBS | Group |
Configure provider details once.
Keep taxonomy and facility addresses with the billing rules below.
Supervising clinicians default by provider type.
Bill-under rules set the billing provider and required submission modifier.
Group or individual NPI is selected per payer.
Respect enrollment and rule effective dates.
Apply payer or credentialing changes from the correct date without altering claims already submitted.