Setting Up Your Organization, Payers, and Providers

Overview

Before submitting your first claim, you need to set up three things: your organization profile (the billing entity), your payer contracts, and your provider list (BCBAs, RBTs, and supervisors). This guide walks through each step.

Organization Profile

1. Go to Settings → Organization.
2. Fill in your legal organization name, NPI (Type 2), Tax ID (EIN), and billing address.
3. Add your clearinghouse credentials (ClaimMD Submitter ID) if submitting electronically.
4. Upload your organization logo for patient-facing documents.
5. Click Save.

The organization NPI and Tax ID appear on all 837P claims. Make sure these match your payer enrollment records exactly.

Adding Payers

1. Go to Settings → Payers.
2. Click Add Payer.
3. Search for the payer by name or Payer ID.
4. Enter your Provider ID (your practice's ID with this specific payer).
5. Add contract fee schedule rates if you want Onvelas to calculate expected vs. actual reimbursement.
6. Click Save.

Repeat for each payer you bill. You can add Medicaid, commercial insurance, and school districts as separate payers.

Adding Providers

1. Go to Settings → Providers.
2. Click Add Provider.
3. Enter the provider's name, credential (BCBA, BCaBA, RBT), and NPI (Type 1).
4. Set the provider's taxonomy code (the default for BCBAs is 106S00000X).
5. Add payer-specific provider IDs if the payer requires them.
6. Click Save.

Providers marked as Rendering Provider appear on claims. Providers marked as Supervising Provider populate the supervision fields on 97155/97156 claims.

Locations

If you provide services at multiple locations (clinic, home, school), add each as a service location under Settings → Locations. Set the Place of Service code (POS 11 = office, POS 12 = home, POS 99 = other) for each location. Appointments and claims pull POS automatically from the linked location.

Roles and Users

Go to Settings → Team to add users and assign roles:

• Admin — full access including settings and financial data
• Biller — access to billing, claims, and reports
• Clinician — scheduling and clinical module access only
• Viewer — read-only access to reports

Tips

• Double-check NPI numbers against the NPPES registry before your first submission — invalid NPIs are a top cause of claim rejections.
• If a payer requires a group NPI on claims, enter it in the payer configuration, not the provider record.
• Contact your payer's provider relations team to confirm your Payer ID before going live.