Legal Entity is an important setup screen, and you need to ensure you have the information correctly updated here to have your claims filed correctly.
The following are the pertinent information regarding a Legal Entity :
a. Legal Entity holds your Practice’s Physical and Pay to Address and also controls whether the billing is done at an individual level or a Group level. This information is defined at the Entity Type field of the LE screen.
If you’ve chosen any of the Group Entity Types, such as – Partnership or Corporation, then the billing NPI needs to be entered on the Group NPI field. On the contrary, for all individual entity types, the billing NPI is populated to the claim from the Provider’s NPI.
b. You could create multiple Legal entities to list multiple offices on the scheduler with independent schedules and working hours. Any additional Legal Entity added would appear on the scheduler LE drop-down.
c. The information on the Primary Legal Entity is generally what carries over as the Billing Provider information on every claim created.
d. You can create additional Legal Entities with the separate billing information, as opposed to sending all the claims using the Primary LE information. For any additional LE you set up, the “Separate Account” field needs to be selected as “Yes”.
To bill using the new Legal Entity, the Provider would need to be linked to it. This is discussed in a separate chapter.