Any fields not required for the particular claim being lodged will be greyed out.
This documentation is provided for informational purposes. In most instances the default settings will be correct.
|
Field |
Description |
|---|---|
|
Provider - Servicing |
Is the provider number of the medical practitioner rendering the service(s) as allocated by Medicare. |
|
Payee Provider Number |
the provider number of the principal provider where the payment is to be directed to other than the servicing provider.
|