Each of the provider types below are specific to the individual claim. The billing and rendering provider could be the same for one claim, while for another claim, the billing may be the facility and rendering, the individual physical.

Provider type, send what is in quotes:

• BillingProvider (Loop 2010AA) – A Billing Provider refers to the entity or individual responsible for receiving payments from payers, such as Medicare, Medicaid, and private insurance companies, for medical services rendered.
• ReferringProvider (Loop 2310A) – A Referring Provider is the individual who directed the patient for care to the provider rendering the services being reported.
• RenderingProvider (Loop 2310B) – A Rendering Provider is the healthcare provider who actually renders medical care to a patient.
• OrderingProvider (Loop 2420E) – An "Ordering Provider" is a healthcare professional who is authorized to order or refer a patient to receive medical services or items, such as tests, procedures, or medications.
• SupervisingProvider (Loop 2310D) – A Supervising Provider is a healthcare professional, typically a physician, who oversees and directs the work of other health professionals, such as nurse practitioners or physician assistants, to ensure quality care and compliance with regulations.

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IMPORTANT

Please note that the request requires you to provide all the required field values. These required values are GREYED out, which are pre-populated example values and can be selected to view the canned response. To view the required fields, expand the + symbol (indicated by the variables field below. For more information, please refer to the JSON-to-EDI API Contents section.