Setting Up Rendering Providers in Kareo

Login to Kareo > Settings > Providers

To add a provider not in this list, click “New” at the bottom of the screen

Any provider in this list can be billed under when exporting the billing export from Rethink.

Depending on how your authorization is set up in Rethink is whom will be listed as the rendering provider on your your billing export and ultimately on your claim form. On you export, column AQ will list the rendering provider’s name that pulls onto box 31 on CMS-1500 form, and the rendering provider’s NPI in column AR is the NPI that pulls onto box 24J on the CMS-1500 form. If they are NOT set up as a provider in Kareo, the export will fail.

On the general tab, add the basic information for the provider:

1. Full name

2. Individual NPI number

3. Specialty

4. Phone number

5. User

6. Address

Full Name: input name exactly as it appears in Rethink

Specialty: this is the providers taxonomy code, click ‘Specialty’ to search the taxonomy code list to find the best taxonomy for the provider

Phone Number: all providers MUST have a phone number associated with them, common practice to add the practice phone number under Work

User: all providers must have an associated user, this does NOT give them access to Kareo nor any permissions. Click “New” (highlighted in yellow) and add the providers email address – this will auto create a user for them.

If your provider requires an override for a specific funder (or all funders) you will want to next click on the “Claims Settings” tab

• If you need to set this up differently for any funder, you will set that up under this tab

  • Bill under individual NPI only

  • Override group NPI

  • Override TIN

  • Override Claim settings (for advanced settings per funder)

Default settings are to bill under the group & individual NPI on claims (typical practice for most insurance companies)

To set up overrides per funder, click “Add” under “Override Claim Settings > select the appropriate insurance to assign the overrides settings for > Click “Advanced Settings for more override options

Select the insurance company box & then click “Show Advanced Settings”

Override Claim settings - this is where you can set up by funder per provider

After adding/updating any applicable claim settings/overrides, when prompted to check for discount, always select “no” as this does not apply for Rethink users

For more information on setting up overrides, view information here: Setting Up Claim Override Settings in Kareo