Box 17 - Name of Referring Provider or Other Source

What is it?

Box 17 identifies the name of the referring provider on the claim. Enter the applicable qualifier to the left of the vertical dotted line to identify which provider is being reported.

• DN - Referring Provider 
• DK - Ordering Provider (Specific Payers only)

In Application:

Note: To make this change permanent, you must update this information directly in WebPT. Otherwise, the next time you save in WebPT, the information entered there will flow over and overwrite any changes you've made.

To manually change this information:

1. Navigate to Clients > Client List.
2. Edit the desired client using the icon.
3. Under Referring Physician/Provider, enter the name into the corresponding fields.
4. Select Save & Close.

Note: To add additional information, navigate to Providers > Referring Providers.

In WebPT:

To manually change the physician:

1. Navigate to the desired patient's chart.
2. Select Patient Info.
3. Click the  icon for the corresponding case.
4. Enter the information into the Referring Physician field and select the physician from the drop-down.
5. Select OK and click Save Patient.

Note: If you need to edit the spelling or change the NPI of the physician, use the Display Physicians link on the left-hand side of WebPT to edit the physician's record.

EDI File

Loop 2310A, Segment NM101 (Qualifier), Segment NM103 (Last Name), and NM104 (First Name).