| Professional and Institutional
| Professional Notes
| Institutional Notes
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| 1. We need to know your UHIN Trading Partner Numbers |
1. Anesthesia units must be in minutes (pg. 403 of the Professional Implementation Guide: segment - Professional Service; data element - SV103 = MJ and SV104 = Quantity) |
1. We are only taking attachment information at the claim header level (Loop 2300). Do not send us information on attachments at the claim line level (Loop 2400, segment - Line Supplemental Information - pg. 452 of the Institutional Implementation Guide #1) . |
| 2. We need to give you our IDX Provider numbers for both the Vendor and Master Vendor
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2. Header level and line level POS (place of service) can not be different |
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| 3. Do not use Aeterick's (*) as a delimiter. |
3. Use claim note text (pg. 247 of the Professional Implementation Guide: segment - claim note; data element - NTE02) to indicate if the rendering non-contracted physician was covering for a (name them) contracted physician. Or if the rendering non-contracted physician was on-call at a hospital facility.
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4. You must have only have one Rendering Provider per claim.
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5. We must have the name of the Service Facility Location if it is different than the providers office (pg. 303 of the Professional Implementation Guide: segment - Service Facility Location; data element - NM103 = Last Name).
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6. DME only: Can not use future service dates.
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7. Use claim note segment (pg. 247 of the Professional Implementation Guide: segment - claim notes; data element - NTE02) to indicate the radiology time. All claims with a claim note will pend. If you would like to discuss a different way to submit radiology time that will not require all claims to pend, please contract Tracy Reynolds.
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