Entering NPI Information in Medisoft

Medisoft displays NPI information on the CMS-1500 form when claims are generated. The application gathers NPI information that users enter in various fields and then displays this data in fields 17B and 24J of the CMS-1500 when claims are generated. For more information on the CMS-1500 form see the topic, Clickable CMS-1500 Form.

The following procedures overview entering NPI information in Medisoft.

Adding Group NPI Information

  1. On the List menu select Provider, and from the Provider submenu select Class. The Provider Class List window opens.
  2. On the Provider Class List window, select the appropriate provider class and click the Edit button.
    -Or-
    If the provider classes have not been created, click the New button.
    The Provider Class List data entry window opens.
  3. On the National ID field, enter the NPI for the practice.
  4. Click the Save button.
  5. On the List menu select Provider, and from the Provider submenu select Providers. The Provider List window opens.
    The provider class, edited or created in the previous steps, needs to be assigned to each provider associated with that Practice NPI.
  6. On the Provider List window, click the Default Group IDs tab. From the Provider Class drop-down list, select the appropriate provider class.
  7. Click the Save button.

Adding Provider NPI Information

  1. On the List menu select Provider and from the Provider submenu select Providers. The ProviderList window opens.
  2. On the ProviderList window, select the appropriate provider and click the Edit button.
  3. Select the DefaultPins tab and on the NationalIdentifier field enter the provider NPI number into the National Identifier field.
  4. Click the Save button.

Adding Referring Provider NPI Information

  1. On the List menu select Referring Providers. The Referring Provider List window opens.
  2. On the Referring ProviderList window, select the appropriate referring provider and click the Edit button.
  3. Select the DefaultPins tab and on the NationalIdentifier field enter the referring provider NPI number into the National Identifier field.
  4. Click the Save button.

TIP: A supervising provider is sent on an electronic claim if the rendering provider is being supervised by a physician. The supervising provider uses the Referring Provider list.

Adding Facility NPI Information

  1. On the List menu select Address. The AddressList window opens.
  2. On the AddressList window, select a facility and click the Edit button.
  3. On the Address window select the General tab. On the NationalID field enter the NPI number.
  4. Click the Save button.

TIP: A purchased service provider is only sent on an electronic claim if the Purchased Service Indicator is checked under the procedure code being billed and the Purchase Service Indicator box has also been checked for the facility assigned to the case. The Purchased Service Provider NPI then looks at National Identifier assigned to the facility in the patient’s case.