Clinical Levels

Version 14.19
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
Version 14.10
Main Menu > Utilities > Staff/Provider Directory > Basic Info Tab

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 has created a plan of care for patients but will require 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.

For more information on how to add providers to the payers in which they are credentialed, click here.