Payer Rules: Replace Place of Service

If you need to quickly replace a place of service for a specific payer, you can use the Replace Place of Service billing rule for a specific code (or codes).

Required Permissions: You must be a Super Admin to add and edit payer and billing rules.

Creating a Billing Rule

Before you begin, you must create a payer rule. For detailed instructions, click here.

1. Once you've created a payer rule, click Add Billing Rule.
2. Select Replace from the Billing Rule Type drop-down.
3. Then click the Trigger Category drop-down and select Place of Service.
4. Choose the code whose place of service you wish to change from the Codes drop-down.
5. If needed, choose the place of service you would like to apply instead of the original. If no Trigger Place of Service is selected, only the trigger code will be used to replace the place of service of the item.

6. Choose the replacement place of service from the Replacement Place of Service drop-down.

   

7. Finally, click Update.
8.  The billing audit tool report will now reflect the correct place of service for any matching payer/code combination