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Kareo Help Center

Verify or Edit Billing Information

If a claim was rejected due the billing information, follow the instructions below to verify and edit the practice and provider's billing information. When all corrective actions are completed, rebill and resubmit all affected claims.

To prevent future rejections, contact the payer to verify the billing information and enrollment status they have on file. The information should match the practice and provider's set up.

Practice Information

The Group NPI, Tax ID, and Address populated in the practice information is used to bill all insurance companies for all providers unless the provider has a claim setting override.

Follow the instructions below to verify and edit the practice information:

  1. Click Settings > Practice Information. The Practice Information window opens.
  2. Verify that the Group NPI is correct. Enter or edit the number as needed.
  3. Verify that the EIN is correct. Enter or edit the number as needed.
  4. Verify the practice address is correct under Contact Information and has a valid 9 digit zip code. Enter or edit the address as needed.
  5. Click Save



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Provider Settings

The NPI, SSN, Specialty, and Address populated in the provider's setting is used to bill all insurance companies unless the provider has a claim setting override.

Follow the instructions below to verify provider’s settings:

  1. Click Settings > Provider. The Find Provider window opens.
  2. Look for and open the provider record that needs correcting. The Edit Provider window opens.
  3. Verify that the Individual NPI is correct. Enter or edit the number as needed.
  4. If applicable, verify that the SSN is correct. Enter or edit the number as needed.
  5. Verify that the Specialty is correct. Enter or edit the number as needed.
  6. Verify the address is correct and has a valid 9 digit zip code. Enter or edit the address as needed.
  7. Click Save



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Provider Claim Settings

The NPI and Tax ID populated in the provider's claim setting is used to bill all insurance companies unless the provider has a claim setting override.

Follow the instructions below to verify and edit the provider’s claim settings:

  1. Click Settings > Provider. The Find Provider window opens.
  2. Look for and open the provider record that needs correcting. The Edit Provider window opens.
  3. Click the Claim Settings tab.
  4. Verify the NPI is set to bill correctly. Click the drop-down arrow to change the setting as needed.
    1. Click "Override Group NPI" to enter a different Group NPI for just this provider.
  5. Verify the Tax ID is set to bill correctly. Click the drop-down arrow to change the setting as needed.
    1. Click "Override EIN" to enter a different EIN for just this provider.
  6. If "Enable Pay-To Address for Professional Claim" is checked, verify the name and/or address with a valid 9 digit zip code is correct.
  7. Click Save



 

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Provider Insurance Override

The override claim settings is used to set up exceptions to the provider's general claim settings for a specific insurance company.

If an override has not been created, see Override Claim Settings.

Follow the instructions below to verify and edit the provider’s claim settings:

  1. Click Settings > Provider. The Find Provider window opens.
  2. Look for and open the provider record that needs correcting. The Edit Provider window opens.
  3. Click on the Claims Settings tab.
  4. Double-click on the insurance company name. The Override Claim Setting window opens.
  5. Verify the NPI is set to bill correctly. Click the drop-down arrow to change the setting as needed.
    1. Click "Override NPI" to enter a different Individual or Group NPI for just this provider.
  6. Verify the Tax ID is set to bill correctly. Click the drop-down arrow to change the setting as needed.
    1. Click "Override EIN" to enter a different EIN for just this provider. Or click "Override SSN" to enter a different SSN for just this provider.
  7. If "Override practice name" is checked, verify the name is correct.
  8. If "Override practice address" is checked, verify that the address with a valid 9 digit zip code is correct.
  9. If "Override pay-to address" is checked, verify the name and/or address with a valid 9 digit zip code is correct.
  10. If billing via paper, verify the values entered in the correct box(es).
  11. If billing electronically, verify the group and individual type and values are correct.
    • Only Type "0B - State License Number" and "G2 - Provider Commercial Number" are valid for electronic submission.
  12. Verify the Submitter Number is correct. Enter or edit the number as needed.
    • This field is only used for Nordian.
  13. Verify the Group Specialty is correct. Click Group Specialty to select one or edit as needed.
  14. Click Save all the way out (multiple saves may be required).





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