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Back  RFI # 538: Supervising Provider Usage

Formal vs. Informal Help Informal Formal

Submitter

David Foulke

Description

When sending claims with a Nurse Practioner or Physicians Assistant as the Render Provider must the Supervising Provider Loop then be present and recognized as the NP and PA require a Physicians supervision? If so would this apply even if the NP or PA did not require certification by the Payer?

Submitter Assigned Keywords

Supervision Provider

Response

Whenever the provider reported as "Rendering Provider" is supervised by a physician, the Supervising Physician Name loop ID-2310E must be sent. This requirement is stated in usage note 2 of the Supervising Provider Name NM1 segment. This requirement is not dependent on the certification requirements of the payer.
Submission 3/28/2007
Status Date 5/25/2007
Status F - Final
Primary References
Document 004010X098A1
Section3
Page312
Set ID837P
Table2
Loop2310E
Segment Position250
Segment IDNM1
Industry NameSupervising Provider Name