I need to enter the referring provider information in Box 17 in HCFA 1500. How do I do it?





  Box 17 on the HCFA populates from information found in the Demographics tab, under Referring Doctor. The fields Referring Dr. First Name and Referring Dr. Last Name will be used, and the identifier DN will be applied. If no information is available under Referring Doctor, information found under Ordering Doctor will be used instead, and the identifier DK will be applied.


17a - This item pulls from the fields Referring Dr. Qualifier and Referring Dr. Number under Referring Doctor. The identifiers for this item are as follows, and come from the selection in Referring Dr. Qualifier:

0B State License Number
1G Provider UPIN Number
G2 Provider Commercial Number 


17b - This item pulls from Referring Dr. NPI Number, or if no Referring Dr. data is  present, Ordering Dr. NPI Number.


Supervising provider information can be shown by marking off Display the claim's supervising provider in box 17. (Figure 6) This option can be found in Account Settings > Billing. Selecting this option will cause box 17 to pull data from the supervising provider’s information, once a supervisor is selected in the Appointment details. Relevant information for that supervising provider is First NameLast Name, and Rendering Provider NPI - this information will be pulled from that provider’s DrChrono Account Settings.


Figure 6 - Go to Account > Account Settings > Medical Billing


***Please note that Box 17 will not update if the demographics of the patient chart are updated AFTER the appointment is scheduled.***


If you need to update this box after the appointment is scheduled, we need to get to the Billing Details of an appointment. Access this screen by clicking Billing Details next to the Other Forms button we use to generate HCFA 1500s (see Figure 0) For the items in Box 17, click on the pencil icon next to Providers (Figure 7, Red Box)


Figure 7 - Billing Details


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