Allegheny Messages

Changes to the previously posted instructions are needed to correct Ohio Medicaid ANSI billing for referring and rendering physicians.  The Main office software must be updated to Version 5648 dated 1/27/15.  In the Insurance data base under the ANSI tab, Additional Items tab for the appropriate payer, there is a new section labeled 2420E Rendering Provider.  The check box for ‘Add 2420E Rendering Provider Segment must be marked.  In section labeled 2310 B, C, D, F Other Rendering Provider Information remove the check mark in ‘Add Referring Physician if Different from Rendering 1:2310F.  If the check box for ‘Add 2310 B Rendering Provider segment Loop’ was marked prior to the previous instructions, it may be left marked.  If this ckeck box was marked due to the previous instructs, please remove the check.

Available with the current software version, agencies required to include the Referring and Rendering Physician in ANSI Electronic Claims must go to the Insurance Database and select the appropriate insurance company  in the look up field.  Once the correct Insurance Company is displayed, select the ANSI tab then the Additional Items tab.  On the right side of the screen in the section labeled 2310 B, C, D, F Other Rendering Provider Information, the check boxes for ‘ADD 2310 B Referring Provider Segment Loop’ and ‘ADD 2310 F Referring Physician if different from Rendering” must be marked.

Agencies will then need to ensure in the Patient data base that each patient’s  Referring and Rendering Physician are documented.  In the Physician screen the Rendering Physician will be entered in the Primary Physician field.  The Referring Physician (if different) will be entered in the 4th Physician field.

Additional labeled instructions will be added to the Physician screen with software versions dated 1/27/15 or later.  These label changes will be in addition to the already present instructions for Hospice agencies.