Primary Credentials

Payers may require charge-level modifiers on claims that identify the rendering provider's credentials. For example, in the state of Ohio, a Registered Nurse (RN) that provides services as a Licensed Professional Clinical Counselor (LPCC) requires a UH modifier on claims that reflects under what license they were operating.

In cases where a provider has multiple credentials, a Primary Credential can be identified on the Credentialing tab. Their primary credential, in combination with another credential, can then be used in the configuration of the Claim Modifiers Library to add the appropriate charge-level modifier to claims during the billing process in NextGen® Enterprise PM.