ePayment.05Healthcare Provider Type Signing Physician Certification Statement
The type of healthcare provider who signed the Physician Certification Statement.
Validation Rules
State Custom Extensions
1 stateWyoming
Healthcare Provider Type Signing Physician Certification Statement
The type of healthcare provider who signed the Physician Certification Statement
Allowed Values
| Code | Label |
|---|---|
| 2605001 | Clinical Nurse Specialist |
| 2605003 | Discharge Planner |
| 2605005 | Physician (MD or DO) |
| 2605007 | Physician Assistant |
| 2605009 | Registered Nurse |
| 2605011 | Registered Nurse Practitioner |
| 2605013 | Licensed Practical Nurse (LPN) |
| 2605015 | Case Manager |
| 2605017 | Social Worker |
Element Metadata
Other Payment Elements
ePayment.01Primary Method of Payment
11 rules
11 states
ePayment.02Physician Certification Statement
1 rules
1 states
ePayment.03Date Physician Certification Statement Signed
0 rules
0 states
ePayment.04Reason for Physician Certification Statement
0 rules
0 states
ePayment.06Last Name of Individual Signing Physician Certification Statement
0 rules
0 states
ePayment.07First Name of Individual Signing Physician Certification Statement
0 rules
0 states
ePayment.08Patient Resides in Service Area
0 rules
0 states
ePayment.09Insurance Company ID
0 rules
0 states
ePayment.10Insurance Company Name
1 rules
1 states
ePayment.11Insurance Company Billing Priority
0 rules
0 states