Integrations and Add-ons

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Adding a Provider to Medicare Online Claiming

Nookal Written by Nookal
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📖 In This Article

Adding a New Provider or a New Provider Number to an Existing Claiming Group


If a new practitioner joins the practice or new Provider Numbers are released for a new location, it is essential to update the Medicare Online integration and provide the new details to Medicare prior to submitting claims.

If the Medicare Online integration has not been set up yet, Please refer to this article for additional details: Setting up Online Claiming for Medicare and DVA.

Adding a New Provider or a New Provider Number to an Existing Claiming Group

The steps are the same in both cases as each Provider/Provider Number combination is processed independently. However, if a new Claiming Group is required, refer to Creating a New Medicare Claiming Group.

A Provider can have multiple Provider Numbers linked to the same Claiming Group (Minor ID).

 

Each Provider Number can only be linked to a single Claiming Group (Minor ID).

Before a Provider/Provider Number combination can be added to a Claiming Group, the 8-digit Provider Number will need to be added in the staff Profile. Click here for more details.

1

Once the Staff Profile is set, head to Setup > Connections > Integrations.

2

Click Configure Medicare.

3

Click View Provider on the appropriate Claiming Group row.

4

Click Add Provider in the pop-up window.

5

Select the Provider and the appropriate Provider Number from the drop-down list.

If the Provider Number is not displayed, it might be already linked to a different Minor ID. See Can I Link a Provider Number to a Different Medicare Claiming Group? for more assistance.

6

Click Add Provider.

7. Contact Medicare/DVA eBusiness on 1800 700 199 for the online claiming/banking form(s) relevant to your business.

Ask your Medicare representative:

“I need to add a provider number to a new Location ID (Minor ID). What forms do I need to complete?”

Generally, they will provide this form:

  • Online Claiming Provider Agreement – to connect your Provider Number(s) to the Location ID (Minor ID).

These forms may not suit your situation, so it’s best to confirm with the Medicare representative.

8

Fill in the Medicare online claiming paperwork, before submitting to be processed by Medicare, make sure:

  • The Minor ID/Location ID is added to the Medicare forms.
  • The Provider has signed the form.

When completing the Online Claiming Provider Agreement DO NOT complete the ‘Registration Authority (RA) Number’ field as this will cause issues with claiming.

Leave the ‘Registration Authority (RA) Number’ field blank.

The Location ID (Minor ID) can be found in the Medicare setup (Setup > Connections > Integrations > Medicare/DVA Online Claiming), next to the name of the Group for the appropriate Location.

 

9

Once Medicare confirms that the provider has been linked to the Minor ID, submit online claims by following the steps here.

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