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Health Care/Claims experts - help plz - question about Provider types


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Posted

Hello friends,

could you please explain me the following Providers with an example?

  • Rendering Provider
  • Referring Provider
  • Operating Provider
  • Attending Provider
  • Affiliated Provider
  • Billing Provider
  • Ordering Provider
  • Performing Provider

I tried google, but I am always getting different Provider Types; but not the above ones :( 

Any info is greatly appreciated.

TIA.

Posted
6 minutes ago, vatsayana said:

Hello friends,

could you please explain me the following Providers with an example?

  • Rendering Provider
  • Referring Provider
  • Operating Provider
  • Attending Provider
  • Affiliated Provider
  • Billing Provider
  • Ordering Provider
  • Performing Provider

I tried google, but I am always getting different Provider Types; but not the above ones :( 

Any info is greatly appreciated.

TIA.

what is the problem bujji ?

Posted

Recently joined a project and started working on claims. I am generating claims, but always getting issues about Providers. Claims are not able to go thru. Also, all the documents that I need to study specifies the above providers are needed to specific type of claims. but they didn't really mention, what are these providers and how to identify them and so on...

so, I just want to get an initial idea on what these providers are. I know couple of these, but not the others:

  • Rendering Provider - Example Doctor we visit for check-ups
  • Referring Provider - Example, we visit a Doctor, who ask us to go to Specialist. In this case, Specialist will be Rendering provider and Doctor we visited will be Referring provider.
  • Operating Provider
  • Attending Provider
  • Affiliated Provider
  • Billing Provider - The group that we pay to. Example, we visit a Doctor, but the bill comes from the Institution and we pay to them.
  • Ordering Provider
  • Performing Provider
Posted
  • Rendering Provider - attending provider ani kuda antaru - who does the care anko 
  • Referring Provider - oka referral ichi he directs you to goto a specialist doc
  • Operating Provider - idi rendering doc same ankunta...not exactly sure
  • Attending Provider - similar to rendering provider - common ga okaka healthcare okkaka word use chestadi but attending provider is the most commonly used. Overall care/surgery/treatment ki main doc ni attending antaru & he'll have a team
  • Affiliated Provider - doc or facility velaki plans ninchi pay chestaru they come under one type of agreement to hospitals/plans
  • Billing Provider - prathi claim submit ki oka billing provider undali generally the same provider who does the treatment
  • Ordering Provider - he is responsible for ordering labs, rad, any test thats required for the pt
  • Performing Provider - treatment/surgery provide chese doc 

Okaka healthcare hospital/plans okaka verbage use chestaru but in general lets say oka patient hospital ki velthe main doc evariathe untaro he can be all of the above depending on what care. Regular Doc dagarki velthe he'll refer you to a specialist who does the particular care alantapudu Providers martaru.

Posted
10 minutes ago, romeo09 said:
  • Rendering Provider - attending provider ani kuda antaru - who does the care anko 
  • Referring Provider - oka referral ichi he directs you to goto a specialist doc
  • Operating Provider - idi rendering doc same ankunta...not exactly sure
  • Attending Provider - similar to rendering provider - common ga okaka healthcare okkaka word use chestadi but attending provider is the most commonly used. Overall care/surgery/treatment ki main doc ni attending antaru & he'll have a team
  • Affiliated Provider - doc or facility velaki plans ninchi pay chestaru they come under one type of agreement to hospitals/plans
  • Billing Provider - prathi claim submit ki oka billing provider undali generally the same provider who does the treatment
  • Ordering Provider - he is responsible for ordering labs, rad, any test thats required for the pt
  • Performing Provider - treatment/surgery provide chese doc 

Okaka healthcare hospital/plans okaka verbage use chestaru but in general lets say oka patient hospital ki velthe main doc evariathe untaro he can be all of the above depending on what care. Regular Doc dagarki velthe he'll refer you to a specialist who does the particular care alantapudu Providers martaru.

Thx bro. any additional information is highly appreciated. 

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