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Kareo Help Center

Override Claim Settings

Updated: 01/06/2020
Views: 4717

You can override claim settings for any insurance company or service location that has exceptions to the provider's general claim settings

Navigate to Claim Settings to add, edit, or remove an override. To ensure any changes made are saved successfully, click Save until the Confirmation pop-up appears in order to confirm those changes.

Add Override

  1. Under the Override Claim Settings section, verify the override is not in the system to prevent duplication. Then, click Add on the right. The Override Claim Settings window opens.
Desktop_OverrideClaimSettings_Add.png
  1. Select the appropriate claim settings:
    1. Click Insurance Company. Then, double click to select the specific insurance company the override applies to. 
      • If the override is for a specific location and applies to all insurance companies, leave this blank. 
    2. Select the specific Location the override applies to in the drop-down menu; otherwise, leave this set to All.
    3. NPI: Select how the provider is credentialed with this payer to send claims in the drop-down menu.
      • If the provider's claims need to be sent with a different Group or Individual NPI, click to select "Override NPI?". Then, enter the Group NPI Override or Individual NPI Override.
    4. Tax ID: Select how the provider is credentialed with payers to send claims in the drop-down menu.
      • Select Bill with EIN if the provider is credentialed with payers to send claims using an Employer Identification Number (EIN) assigned by the IRS to the practice. This applies to any business entity including a Corporation, LLC, LLP, Partnership, or other taxable business entity.
        • If the provider's claims need to be sent with a different EIN, click to select "Override EIN?". Then, enter the EIN Override
      • Select Bill with SSN if the provider is credentialed with payers to send claims using the provider's Social Security Number (SSN). This might be the case if the practice is a sole proprietorship and has not been assigned an EIN from the IRS. 
    5. If additional settings (e.g., Practice, Paper Claim, Electronic Claim, or Eligibility) need overrides, click to select "Show advanced settings" and make the appropriate selections. If not, continue to step 4.
  2. Click Save in the Override Claims Settings window.
  3. Click Save in the Edit Provider window.
  4. The Confirmation pop-up appears > Click Yes
Desktop_OverrideClaimSettings_Save.png

Edit Override

  1. Under the Override Claim Settings section, double click the appropriate override or click once to select it then click Edit. The Override Claim Settings window opens.
  2. Make the desired changes.
  3. Click Save in the Override Claims Settings window.
  4. Click Save in the Edit Provider window. 
  5. The Confirmation pop-up appears > Click Yes.
Desktop_OverrideClaimSettings_Edit.png

Remove Override

  1. Under the Override Claim Settings section, click once to select the appropriate override then click Remove. The override is removed from the list.
  2. Click Save
  3. The Confirmation pop-up appears > Click Yes.
Desktop_OverrideClaimSettings_Remove.png