Setting Up Claim Override Settings in Kareo

Owned by Dawn Mackey
Last updated: Jan 28, 2021
2 min read

  1. In Kareo, go to “Settings” - “Providers”

     

  2. Find provider who needs the override and open profile

    1. Once provider profile is open, click the “Claim Settings” tab

      1. By default, system will bill  under group & individual NPI (individual in 24J and group in 33a), if requirements are different you will adjust under this tab

    2. If claim settings need to be adjusted based on provider and not based on funder, adjust information under NPI and Tax ID fields 

      1. Drop option down between bill with group & individual or individual only

        1. Override NPI’s here by checking off “Override Group NPI?” 

        2. Cannot override individual NPI here

      2. Override Tax ID if applicable by checking off “Override EIN?”

    3. If claim settings need to be adjusted based on payor by provider, you will need to add in payor level overrides. To do this under, the bottom section of the provider profile, click “Add”

      1. Select insurance company you need to add the override setting for, and make necessary adjustments

        1. Select locations for override to be used (if overrides are only for certain service locations) 

          1. Helpful for multi-state groups if TIN/NPIs are different across locations

        2. Select NPI to be used for this payor/provider combo

          1. Override if needed (you can override both individual or group in this section)

          2. Helpful for groups that have different NPI combos for different states or services

        3. Override EIN if applicable

          1. Helpful for groups that have different TINs for different states or services

        4. Click “Show Advanced Settings” to see other override options

          1. Override practice name

          2. Override practice address

          3. Paper & electronic claim settings (use these settings if payor has special requirements for certain ID numbers that to be listed in a certain place on the claim or taxonomy needs to be listed for individual/group)

  3. Once overrides are complete, click “Save” for the override screen and “Save” on provider profile screen.