Billing Profiles
Who the payer pays. A billing profile is the entity on the claim’s billing provider loop: its name, its tax identity, and the NPI it bills under.
Who Can See It
Section titled “Who Can See It”User and Administrator. Unlike most screens this one has no licensed module of its own, so it is available wherever the sidebar shows it.
The List
Section titled “The List”| Column | What it shows |
|---|---|
| Organization | The billing entity’s name, or the person’s full name marked Individual where it bills as one |
| NPI | The identifier it bills under |
| Tax ID | Its tax identity and type |
| Location | The city and state of the profile’s own address. A location points at the profile it bills under, not the other way round. PO Box warns that the physical address is a PO Box, so the profile’s claims can’t be exported until a street address is added |
A profile is either an organisation or an individual, never both, and that choice decides which identifiers the payer expects.
The Form
Section titled “The Form”| Field | What it holds |
|---|---|
| Entity Type | Individual (Type 1) bills under a person’s own name and NPI; Organization (Type 2) under a practice name |
| Taxonomy Code | The billing provider’s taxonomy |
| Practice Timezone | The calendar day a payer’s filing window closes on. Left at UTC, the window can shut an evening early for a US practice |
| First Name, Middle Name, Last Name | For an individual |
| Organization Name | For an organization |
| NPI | Ten digits |
| Tax ID, Tax ID Type | Nine digits, as an EIN or SSN |
| Physical Address | Where the practice is located. A PO Box is refused here; add it as the pay-to address instead |
| Payments Go to a Different Address | Opens Pay-To Address, sent on electronic claims as the pay-to address. Paper claims keep the physical address in box 33. A pay-to address must be filled in whole |
| Signature On File, Bill Under This Profile | Under Filing. Bill Under This Profile makes it the default |
| Statement Template | Under Documents, when the client is licensed for statements: “Statements for this practice print with this template.” It offers Use Default with the default’s name, or one of the practice’s templates |
Statement Template appears only on the default profile, on one you are making the default, or on the first profile you create, because statements are always printed under the default profile’s identity. When another profile becomes the default, the old default’s statement template choice is cleared.
Actions
Section titled “Actions”| Action | What it does | When it is offered |
|---|---|---|
| Create | Adds a profile | Always |
| Edit | Changes one | From the row menu, or by selecting the row |
| View History | Shows who changed the profile and what they changed | From the row menu |
| Delete | Removes one. A profile a location bills under is refused, naming the locations to move to another profile first. Deleting the default makes the oldest remaining profile the default | From the row menu |
If someone else saved the profile after you opened Edit, your save is refused with a notice above the form, and Reload refills it with their version (A Save Was Refused).
States
Section titled “States”- Empty - a client with no billing profile says so. Claims need one before they can be filed.
Related: Providers · Claim Batches