How do I print the referring provider's information in Box 17 on the HCFA 1500?



  There are 2 different ways to print the referring provider's information in box 17 on the HCFA. 

    • Persistent - You can enter into the patient's demographics so that it will appear on all of the patient's future appointments without having to reenter the information on each claim.
    • Claim Specific - You can enter the information at the claim level.  The information will only appear on that claim and will need to be reentered if applicable on future claims.





Adding the referring provider to your contacts

** Note**   If you have already added the referring provider to your contacts, please skip to the adding to the patient's demographic section below.


1) Please click on the message center (envelope icon) towards the top right corner of your screen. 

2) On the left panel, please select Contacts which is located below the Referrals and then click on +New (Towards the top right).



3) In the New Referral Contact screen, enter the Doctors First name, Last name, Address, Speciality & NPI and click on Add Contact.


  Adding to the patient's demographics


1) Hover over the Patients Tab and select Patient List.

2) Enter the Patient's Name or Chart ID in the patient search field.

3) This will direct you to the patient's demographics section.

4) In the Patient's demographics section, click on Demographics tab.



5) Scroll down to the Referring Doctor section and enter the doctor's name in the Referring Doctor Search field.

6) Once you enter the referring doctors information, please scroll down and click on Save Demographics.


Claim Specific

** Note**   If the provider is not already listed in your contacts, please follow directions above to add them before proceeding.


1)  In the Live Claims Feed, pull up the patient's appointment that you would like to add the referring information.

2) In the right column, at the bottom, you will see an option for Provider.  Click on the pencil icon.




3) You will then be given a window where you can add the referring provider.  Once they are loaded as a contact, you can type their name or a portion of their name in the Contact Search box and when you select the provider, all of their demographic information will be pulled over.




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