This article explains the four provider roles that can appear on a claim in MedMe and how pharmacy teams add, edit, and delete the providers saved for their pharmacy from the claim form.
Table of Contents
Overview
Payers need to know who performed the service and who should be paid. In MedMe these are stored once per pharmacy and selected from a list on each claim, so a pharmacist's NPI only has to be entered once. Providers added by one user are available to everyone at the pharmacy.
Provider Roles on a Claim
Role | Who it is | Where it appears | Type |
Rendering Provider | The pharmacist (or organization) who performed the service. | General Information — recommended on every claim | Defaults to Practitioner; Organization allowed |
Billing Provider | The entity that is paid — usually the pharmacy, with its Type 2 NPI, EIN, and address. | General Information — required | Defaults to Organization; Practitioner allowed |
Referring Provider | The prescriber who referred the patient, when a payer requires it. | General Information — optional | Practitioner only |
Ordering Provider | The prescriber who ordered a specific service or product. | Each service line — optional | Practitioner only |
Step 1: Add a Provider
In the claim form, open the provider dropdown (for example Rendering Provider).
Select + Add New Rendering Provider at the bottom of the list. The Add Rendering Provider modal opens.
For rendering and billing providers, choose the Type: Practitioner or Organization. Referring and ordering providers are always practitioners.
Enter the details:
First Name and Last Name (practitioner) or Organization Name (organization) — required.
NPI — exactly 10 digits, required.
Taxonomy — the 10-character provider taxonomy code, optional.
EIN — 9 digits, used for billing providers.
Street Address, City, State, ZIP code, Phone Number — required for billing providers. The ZIP code must be in ZIP+4 format (12345-6789) and PO boxes are not accepted.
Email, Fax Number, Extension — optional.
Select Add. The provider is saved, the modal closes, and the new provider is selected in the field that launched it.
Reminder: Payers match the billing provider's NPI, EIN, and address to their enrolment records. Enter them exactly as they appear on the pharmacy's Medicare or payer enrolment, or claims will be rejected.
Tip: Add every pharmacist who administers services as a Rendering Provider once, and the pharmacy once as the Billing Provider. After that, creating a claim is two dropdown selections.
Step 2: Edit a Provider
Open the provider dropdown and hover over the saved provider.
Select the pencil icon on the row. The Edit … Provider modal opens with the saved values.
Change the details and select Save Changes. The same validation applies as when adding (NPI must be 10 digits, and so on).
The updated details appear in the dropdown immediately and on the open claim if that provider was selected.
Step 3: Delete a Provider
Open the provider dropdown and hover over the saved provider.
Select the trash icon. A Delete … Provider confirmation names the provider.
Select Delete Provider to remove it, or Keep Provider to cancel.
Please Note: Deleting a provider removes it from the pharmacy's list for future claims only. Claims and drafts that already reference the provider keep its name and NPI, and when such a claim is edited the provider shows as (deleted) in the dropdown. Only the selection on the form currently open is cleared.
Troubleshooting
"A provider with that NPI is already on file for your pharmacy." The provider exists; select it from the list instead of adding it again, or edit the existing record.
"That provider type can't be used for this provider field." Referring and ordering providers must be practitioners. Add the person, not the organization.
The dropdown only shows "+ Add New … Provider". No providers have been saved yet for this pharmacy. Add the first one.
Address fields are required but I am adding a pharmacist. Address, phone, and ZIP+4 are only required for billing providers. Check that the correct role's modal is open.
Conclusion
Providers in MedMe are saved once per pharmacy and reused on every claim. Add each administering pharmacist as a Rendering Provider and the pharmacy as the Billing Provider, use Referring and Ordering providers when a payer requires them, and edit or delete providers from the same dropdown when details change.