Version 20.12
Path: Practice Management tab > Staff/Providers button
Definitions
- Non-clinical staff (front desk, billing): This is any staff member who will not be administering vaccines, prescribing medications, drawing labs, or rendering services.
- Clinical staff (nurse, MA, vaccinator): This is any staff member who functions as a Nurse or Medical Assistant. This includes anyone who may administer vaccines, prescribe medications, or draw labs. Clinical staff has no billing credentials.
- Mid-Level Billed Under Supervisor: This is a Mid-Level Provider that never bills under their own credentials. They are not added to any payers. The only Provider on claims is the Supervising Provider.
- Mid-Level Includes Billing Supervisor: This is a Mid-Level Provider who requires a Supervising Provider on claims. The Mid-Level must appear under all payers where that Mid-Level is credentialed. Both Providers go out on claims.
- Mid-Level Provider Bills Independently: If a Mid-Level is credentialed to bill to any payer, add the Mid-Level to only those payers that the Mid-Level is credentialed. The Mid-Level is the only Provider on their claims.
- Full Provider, No Billing Credentials (Locum): These are your Locum Providers or any MD/DO that is not credentialed with any payers. This will require a supervising (or Billing Provider in the supervising field in OP). Only the Supervising Provider goes out on claims.
- Full Provider, Has Billing Credentials: These are MDs/DOs that bill under themselves all of the time. They are the only Provider on claims.
- Need cosigner: If this has a checkmark, this staff member will need all Encounter and Well Visit Notes to be co-signed. The Need cosigner checkbox is typically checked for Mid-Level Providers.
How the Mid-Level Clinical Levels Generate on 837 Files
If the Clinical Level is... | Then the claim looks like this: |
| Mid-level provider, billed under Supervisor |  |
| Mid-level provider, includes Billing Supervisor |  |
| Mid-level provider, Bills Independently |  |
Version 20.11
Path: Practice Management tab > Staff/Providers button
Clinical Level Definitions
- Non-clinical staff (front desk, billing): This is any staff member who will not be administering vaccines, prescribing medications, drawing labs, or rendering services.
- Clinical staff (nurse, MA, vaccinator): This is any staff member who functions as a Nurse or Medical Assistant. This will include anyone who may administer vaccines, prescribe medications, or draw labs. Clinical staff has no billing credentials.
- Mid-Level Billed Under Supervisor: This is a Mid-Level Provider that never bills under their own credentials. They are not added to any payers. The only provider on claims is the Supervising Provider.
- Mid-Level Includes Billing Supervisor: This is a Mid-Level Provider who requires a Supervising Provider on claims. The Mid-Level must appear under all payers where that Mid Level is credentialed. Both providers go out on claim.
- Mid-Level Provider Bills Independently: If a Mid-Level is credentialed to bill on any payer, add the Mid-Level to only those payers that the mid level is credentialed. The Mid-Level is the only provider on their claims.
- Full Provider, No Billing Credentials (Locum): These are your locum providers or any MD/DO that is not credentialed with any payers. This will require a supervising (or Billing Provider in the supervising field in OP). Only the Supervising Provider will go out on claims.
- Full Provider, Has Billing Credentials: These are MDs/DOs that bill under themselves all of the time. They are the only provider on the claims.
- Need cosigner: If this has a checkmark, this staff member will need all Encounter and Well Visit Notes to be co-signed. If this is left unchecked they will be able to finalize notes.
How the Mid-Level Clinical Levels Generate on 837 Files
If the Clinical Level is: | Then the claim looks like: |
| Mid-level provider, billed under Supervisor | |
| Mid-level provider, includes Billing Supervisor | |
| Mid-level provider, Bills Independently | |
