ClaimProviderID is the HAAD license number of the provider claiming from the Payer. This can be a facility or a clinician. If the provider has no HAAD license number, the provider should be “@” followed by the name of the provider. Note | ClaimProviderID is sometimes also known as the billing provider. In general, the facility that hosted the Encounter is also the one that claims from the payer. In these cases, ClaimProviderID is the same as EncounterFacilityID. However, under some circumstances, it is a different party that claims, e.g., a clinician or a different facility. Example | A hospital group has multiple licensed facilities. The hospital group centralizes billing and claims on the main site. In this case, an Encounter that occurred in a satellite facility (EncounterFacilityID = SatelliteSite) would be billed by the main site, i.e., ClaimProviderID = MainSite).
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