Taxonomy

Medisoft 16 implements a new, flexible method for including taxonomy information on claims. The new implementation method provides a flexible method to address specific taxonomy requirements for different carriers. You can easily address your carrier’s needs with options to send taxonomy in Loop 2000A PRV, in Loop 2310B PRV, or in both segments, or even send mixed taxonomy (group taxonomy number in one segment and individual taxonomy in the other segment).

The Loop 2000A PRV only creates if the Insurance Carrier window, EDI/Eligibility tab Send Practice Taxonomy in Loop 2000A box is selected. A BI is sent in PRV01 if the Practice Type Individual button is selected (Practice Information window, Practice tab). A PT is sent in PRV01 if the Practice Type Group button is selected. In either case PRV02 sends a ZZ and PRV03 pulls the practice taxonomy number entered on the Practice Information, Practice IDs grid.

The Loop 2310B PRV segment only creates the Practice Type Group button is selected (Practice Information window, Practice tab) or if the Practice Information, Practice Pay To tab is filled in. The taxonomy number is pulled from the From Practice button (pulls taxonomy from the Practice Information, Practice IDs grid) or the Taxonomy button on from the Provider IDs grid—the button is selected and a taxonomy number is entered.

Taxonomy Scenarios

Need Taxonomy in 2000A only

This setting is used if you file claims as an individual. Select the Send Practice Taxonomy in Loop 2000A box on the Insurance Carrier window, EDI/Eligibility tab for each insurance carrier that requires taxonomy in 2000A.  On the Practice Information, Practice IDs grid, create/edit at least one record that includes all insurance carriers, the specific insurance carrier or the insurance class along with selecting the Taxonomy button and entering a taxonomy number. On the Provider window, Provider IDs tab, create/edit at least one record that includes all the insurance carriers, the specific insurance carrier, or the insurance class along with selecting the From Practice button on the taxonomy line.

Need Taxonomy in 2310B only

This setting is used if you file claims as group. Make sure that the Send Practice Taxonomy in Loop 2000A box on the Insurance Carrier window, EDI/Eligibility tab is not selected for each insurance carrier that does not require taxonomy in 2000A.  On the Practice Information, Practice IDs grid, create/edit at least one record that includes all insurance carriers, the specific insurance carrier or the insurance class along with selecting the Taxonomy button and entering a taxonomy number. On the Provider window, Provider IDs tab, create/edit at least one record that includes all the insurance carriers, the specific insurance carrier, or the insurance class along with selecting the From Practice button on the taxonomy line.

Need Taxonomy in both 2000A and 2310B

This setting is used if you file claims as a group. Make sure that the Send Practice Taxonomy in Loop 2000A box on the Insurance Carrier window, EDI/Eligibility tab is selected for each insurance carrier that requires taxonomy in 2000A.  On the Practice Information, Practice IDs grid, create/edit at least one record that includes all insurance carriers, the specific insurance carrier or the insurance class along with selecting the Taxonomy button and entering a taxonomy number. On the Provider window, Provider IDs tab, create/edit at least one record that includes all the insurance carriers, the specific insurance carrier, or the insurance class along with selecting the Taxonomy button on the taxonomy line and entering the taxonomy number.

Need Mixed Taxonomy in both 2000A and 2310B

This setting is used if you file claims as a group and the carrier requires the group taxonomy and the provider's taxonomy number. Make sure that the Send Practice Taxonomy in Loop 2000A box on the Insurance Carrier window, EDI/Eligibility tab is selected for each insurance carrier that requires taxonomy in 2000A.  On the Practice Information, Practice IDs grid, create/edit at least one record that includes all insurance carriers, the specific insurance carrier or the insurance class along with selecting the Taxonomy button and entering the group taxonomy number. On the Provider window, Provider IDs tab, create/edit at least one record that includes all the insurance carriers, the specific insurance carrier, or the insurance class along with selecting the Taxonomy button on the taxonomy line and entering the provider’s taxonomy number.