Skip to main content
Procentive Knowledge Hub

Determine How Billing Data Populates on a Claim

Overview

Tax ID's, NPI's and Taxonomy codes can be entered in the Payers Module, Programs Module, Locations Module, or the Settings Module based on your registration. This article will explain how Procentive looks for these billing items which will determine what information will populate on a claim.

Data Flow of Billing Information

Procentive will look through Payers, Programs, Locations, and Settings modules to locate the billing information needed for claims. This flow of billing information will go from most specific (Payers Module) to  least specific (Settings Module). Once the three billing items (Tax ID, NPI, Taxonomy) have been located, Procentive will stop searching and select the first point of billing information it comes across.

Note: You do not need to have all three billing items in the same module, you may choose to have an NPI be setup for a Program and the Tax ID and Taxonomy code be setup for a location.

Below is the order Procentive will search for the information and where the information would be entered in each of the four modules. Where this data is entered is based on your registration and how you need to determine what information appears on the claim and when. Based on your needs you may have billing information in more than one of these modules.

Payers Module

Billing information would be entered here only if you have a unique Tax ID, NPI, or Taxonomy code for this payer. This would indicate that no matter which program or location is selected on the service line, when this payer is billed, the billing information listed in this payer would appear on the claim. Some examples of when this may be used would be if your agency is registered with this payer only for a specific NPI that you're not registered with for any other payer or when you're obtaining a new NPI and the payer hasn't approved the registration of your new NPI so you need to bill your old NPI to this specific payer.

  1. Go to Payers Module.
  2. Click Id's tab.
  3. Enter Tax ID, NPI, and/or Taxonomy code needed.


     
  4. Click .
Programs Module

Billing information would be entered here if your billing information has been registered based on the programs you have listed in the Programs Module. Entering billing data here will place this information on the claim when the program has been selected on a service line in the Time Module, regardless of payer, location, or default billing location in the Settings Module. This is most commonly used when you have a unique NPI or Taxonomy Code for a chemical dependency program vs a mental health program.

Note: Tax ID is not an option to setup based on a specific Program.

  1. Go to Programs Module.
  2. Enter NPI and/or Taxonomy code needed.


     
  3. Click .
Locations Module

Billing information would be entered here if your billing information has been registered based on your unique locations. Entering data here will place this billing information on the claim regardless of payer, location, or data in the Settings Module. This is most commonly used when you provide unique services from different locations (ie. mental health at Office A and chemical dependency at Office B).

  1. Go to Locations Module.
  2. Click Billing tab.
  3. Enter Tax ID, NPI, and/or Taxonomy code needed.


     
  4. Click .
Settings Module

Billing Information would be entered here if you do not have programs or locations setup in Procentive, if you only have one Tax ID, NPI, and/or Taxonomy code, or if your registration is not based on location or program.

  1. Go to Settings Module.
  2. Click Billing Tab.
  3. Enter Tax ID, NPI, and/or Taxonomy code needed.


     
  4. Click  at the bottom.
  5. Log off of Procentive and then login again for this change to take affect.

Important: If you have a location entered in the Locations Module, you must select a default Billing Location in the Settings Module > Billing tab. Any billing information will pull from this location regardless of what has been entered in the Settings Module > Billing tab.

  • Was this article helpful?