Health Care Professional or Supplier Information

First, we’ll discuss completing health care professional and supplier information on the CMS-1500 and 837P. This includes referring or ordering information and how health care professionals or suppliers bill for the service.

• Name of Referring Provider or Other Source
• NPI of Referring or Ordering Provider
• Federal Tax ID Number
• Signature of Physician or Supplier
• Service Facility Location Information
• NPI of the Service Facility
• Billing Provider Information & Phone Number
• Billing Provider NPI