Skip to main content

Set up billing providers

A billing provider is the provider or company identified on billing records. Add a billing provider before you create a facility billing provider rule or a billing episode that uses it.

Before you start​

You need admin access and the billing provider's legal name. Gather the National Provider ID (NPI), federal tax ID, taxonomy code, Medicare Part B participation status, and billing address if they apply to the provider.

Add a billing provider​

  1. Open Billing providers.
  2. Click New billing provider.
  3. In Basic details, enter the Name.
  4. Enter the National Provider ID (NPI), Federal Tax ID, and Taxonomy code when available.
  5. Select Medicare Part B participation when it applies.
  6. In Billing address, enter the street address, city, state, ZIP code, and ZIP+4 when available.
  7. Add tags or notes if they help your team find or identify the record.
  8. Click Save.

RehabAlpha opens the new billing provider's details after saving.

Add a facility billing provider rule​

Creating an organization billing provider does not by itself determine when it is used. Add a facility rule for each payor or group of payors the billing provider covers.

  1. Open the facility.
  2. Click Billing providers.
  3. Click New billing provider rule.
  4. Under Select payors by, choose Choose all payors, Filter by payor type, or Filter specific payors.
  5. Select the Billing provider.
  6. Enter the inclusive Start date and, if applicable, the End date. Leave the end date indefinite when the rule has no planned end.
  7. Click Save.

For a facility, rules that apply to the same payor cannot have overlapping date ranges. Create consecutive rules when the billing provider changes over time.

You should know​

  • An NPI must contain 10 digits, a federal tax ID must contain 9 digits, and a taxonomy code must contain 10 letters or numbers.
  • ZIP+4 requires a ZIP code.
  • Participating Medicare Part B billing providers agree to accept assignment on all Original Medicare Part B claims. Non-participating providers may accept assignment claim by claim.
  • A billing provider is separate from a facility, therapist, or physician. Create separate billing provider records when your organization bills under different legal names, NPIs, tax IDs, taxonomy codes, or billing addresses.