CLIA Number Not Appearing on Claim

Problem 1:

The CLIA number is entered into the Provider or Facility information but does not appear on claims.

Solution 1:

There are 3 possible places to enter the CLIA number in Medisoft. The highest ranked location for the CLIA number will be sent on the claim with 1 being the highest and 3 being the lowest.

1. The CLIA Number field in the EDI tab of the patient’s case
2. The CLIA Number field in the reference tab of the Provider setup
3. The CLIA number field on the Facility ID line associated with the carrier

If there is a number, or in some cases a few blank spaces or random characters, in the CLIA number field in the EDI tab of the patient’s case, it will supersede the CLIA number found in the provider information. Click into the CLIA Number field in the EDI tab and use the arrow keys to scroll right. If the field is empty the cursor will not move. If the cursor moves, delete everything in the field until the cursor no longer moves when you attempt to arrow over.

Problem 2:

The CLIA number is entered correctly in all possible location, but the number does not appear on the claim.

Solution 2:

The CLIA number is only used by certain carriers. All carriers who use the CLIA number accept claims as formatted for Medicare or Medicaid. Medisoft determines how claims should be formatted based on the “type” assigned to the carrier on the claim. To verify the carrier type:

1. Go to Lists → Insurance → Carriers
2. Find the carrier you are trying to send the CLIA number to on the list and click on it to select it
3. Click Edit
4. Navigate to the EDI/Eligibility tab
5. Under the “Carrier EDI Settings” header, ensure the Type field is set to either “Medicare” or “Medicaid”