Which information should be included on a claim form sent from a specialist to a managed care organization?

When submitting a claim form from a specialist to a managed care organization, including the referring provider's national provider identifier (NPI) is essential. This identifier uniquely represents healthcare providers, ensuring that the claim is correctly attributed to the right person who referred the patient. The referring provider's NPI is crucial for the managed care organization to process the claim accurately, as it directly relates to the authorization and payment process.

The NPI helps prevent billing errors and facilitates quick and efficient communication between the provider and the insurance company. It also aids in ensuring compliance with regulations, supports accurate patient care coordination, and assists in tracking healthcare utilization. Thus, having the referring provider's NPI on the claim form is a key element in ensuring that the claim is processed smoothly and effectively.