Referring Provider Lookup

athenaCollector

This page allows you to locate a referring provider by last name, provider number, or specialty, then populate the current claim field. You can search for a referring provider in the context of a claim or by adding an authorization or referral to a patient's insurance.

 

You can also edit a referring provider's provider number, update the selected provider's information, add a provider number (for a provider that does not have one in the system), and add a new referring provider to the list of referring providers.

 

In the Referring provider field, click the Choose/view link

 

 

 

To add a referring provider or referring provider number when you look them up, you need one of the following user roles:

  • *Practice Superuser
  • Management – Collector
  • Add/Edit Referring Providers via Lookups

 

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Locate the referring provider you need using one of the following options:
    1. Search — Enter the provider's last name or the first letters of the provider's last name. You can also enter letters that occur in the middle of a name.
      Note: The "name" option is selected in the by menu.
    2. Search — Enter the provider's provider number or the first digits(s) of the provider number. (Note that the "number" option is automatically selected in the by menu.)
    3. Select the specialty option from the by menu. The Search field changes to a menu. Select the specialty that you want from the Search menu.
    4. Enter the provider's NPI number or the first digits of the NPI number in the Search field.
  3. Click Find. The list of referring providers that match your search entry appears, with the number of matching results displayed at the bottom of the list. The list is in alphabetical order.
  4. Locate the provider you want in the list, then click select to select the provider and populate the Referring provider field on the current athenaOne page (Charge Entry, Insurance Authorization, Claim Edit, or other page).

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Search for the provider using the Search field (see Step 2, above) and click Find. The list of referring providers that match your search entry appears, with the number of matching results displayed at the bottom of the list. The list is in alphabetical order.
  3. Locate the provider you want in the list. The Update Referring Provider Insurance Number view appears.
  4. Enter the NPI number in the NPI Number field.
  5. Click Update. This action automatically selects the referring provider to populate the Referring provider field on the current athenaOne page (Charge Entry, Insurance Authorization, Claim Edit, or other page).

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Follow the steps (2 & 3, above) to locate the referring provider.
  3. Click the edit number link (to the far right of the referring provider's name). The "referring providers insurance number entry/edit" view appears. Note that the insurance category displays at the top of the page.
  4. Update the provider number as needed.
  5. Click Update. The updated number is saved; the Charge Entry page reappears.

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Follow the steps above to locate the referring provider.
  3. Click the add number link (to the far right of the referring provider's name). The "referring providers insurance number entry/edit" view appears. (Note that the insurance category is displayed at the top of the page.)
  4. Enter the new provider number in the Referring Provider Number field.
  5. Click Add. The new number is saved; the Charge Entry page reappears.

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Click the edit link (to the right of the Current Referring Provider heading) at the top of the page. The Update Referring Provider view appears.
  3. Update fields as needed.
  4. Click Update. The updated information is saved; the Charge Entry page reappears.

 

  1. Display the Referring Provider Lookup tool: In the Referring provider field, click the Choose/view link.
  2. Follow the steps (2 and 3, above) to locate the referring provider. If you do not find the provider, click the add new referring provider link (at the bottom of the list). The Add Referring Provider view appears.
  3. Select Person or non-person entity from the Entity Type menu. (A medical group or clinic is an example of a non-person entity.)
  4. Last Name/Organization Name — If the referring provider is a person, enter the referring provider's last name. If the referring provider is not a person, enter the entire name. For a person, enter the referring provider's first name in the First Name field; for non-person entity, leave blank.
  5. M. Name + Suffix — For a person, enter the referring provider's middle name and suffix (Jr., Sr., III, etc.); for a non-person entity, leave blank.
  6. Enter the referring provider's address in the address fields.
  7. Fax — Enter the referred-to provider's fax number to be displayed on outgoing referrals. (The fax number for the referred-from provider is taken from the patient's primary department, or, if none is specified for the patient's primary department, from the medical group.)
  8. Notes — Enter any notes about the referring provider.
  9. Specialty — Select the referring provider's specialty.
  10. Legacy Referring Provider Number — Enter the referring provider's provider number for the current patient's insurance package.
  11. NPI Number — Enter the referring provider's NPI number.
  12. Click Add. The information is saved; the Charge Entry page reappears with the new referring provider displayed in the Referring Provider field.

 

 

Current Referring Provider fields
(appears only if a current provider is selected)
Name

Name of the current referring provider (last name, first name).
Phone

The contact phone number for this provider.
Insurance number

The provider number for the current patient's insurance package.
Column Headings for search results list
ID

The system-generated ID number for the referring provider in athenaOne.
Name

The name of referring provider (last name, first name).
Address

The billing address for the referring provider.
Medical License #

The medical license number of the referring provider.
NPI Number

The NPI number of the referring provider.
Referring Provider's Insurance Number Entry/Edit Fields
Provider Number Category

The current patient's insurance package.
Referring Provider

Name of the current referring provider (last name, first name).
Legacy Referring Provider Number

The provider number for the current patient's insurance package.
NPI Number

The provider's NPI number.
Add / Update Referring Provider Fields
Entity Type

This is an ANSI format field.

Person if the referral came from a person; Non-person entity if the referral came from another source, such as a medical center.
Last Name/Organization Name

The referring provider's last name, if the referring provider is a person. If the referring provider is not a person, the entire name.
First Name

The referring provider's first name, if the referring provider is a person.
M. Name + Suffix

The referring provider's middle name and suffix (Jr., Sr., III, etc.).
Address

The referring provider's address.
Address (ctd)

The (optional) second line of the referring provider's address.

Phone

The referring provider's phone number.
Zip

The referring provider's ZIP code.
City

The referring provider's city.
State

The referring provider's state.
Fax

The referring provider's fax number.
Notes

Any notes about the referring provider.
Specialty

The referring provider's provider specialty.
Insurance

The insurance package associated with this appointment provider.
Legacy Referring Provider Number

The referring provider's provider number for the current patient's insurance package.
NPI Number

The referring provider's NPI number.

 

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