Npi Numbers and legacy Numbers - New Rules As of May 23, 2008 For Billing medical assurance Claims

Health Insurance - Npi Numbers and legacy Numbers - New Rules As of May 23, 2008 For Billing medical assurance Claims

Hello everybody. Today, I found out about Health Insurance - Npi Numbers and legacy Numbers - New Rules As of May 23, 2008 For Billing medical assurance Claims. Which could be very helpful for me and you. Npi Numbers and legacy Numbers - New Rules As of May 23, 2008 For Billing medical assurance Claims

On May 23, 2008 assurance carriers were suppose to accept Npi only on all paper & electronic claims. Not only were you required to contain the Npi number, but you were required to Exclude the inheritance numbers. Some assurance carriers were not ready for the deadline and applied for an prolongation (like Nys Medicaid). But Medicare was ready and if you contain your Ptan (legacy) whole on your claims they are being rejected.

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For the assurance carriers who were ready for this deadline, you must make sure you do not have the inheritance whole in the shaded area of box 24J or box 32A & 33A. If your software is set up to automatically print the inheritance whole in this box you need to take off it. If you submit claims electronically, make sure your seller has it set up to exclude the inheritance number.

For the assurance carriers who were not ready and applied for an extension, you will need to continue together with the inheritance whole until they have complied. This makes things a little messy. You need to make sure you are submitting the claims that wish the inheritance whole with it, and the ones that do not allow it, without. Crazy, but it is what we billing people have to do to make sure the money keeps coming in.

Another little crazy thing to worry about is the Npi whole entered in 24J. If you are set up with Medicare as an private supplier (not a group) and you only have a type I Npi, you must leave the Npi part of box 24J blank. You cannot contain the private Npi whole here. If you are an private supplier and you put your Npi whole in 24J, Medicare may reject your claims.

If you are a group with Medicare then you need to continue putting the rendering providers private Npi in box 24J and the group Npi (type Ii) in box 33A. If you are not sure if you are an private or a group you can tell by your Ptan number. If you only have one Ptan whole then you are an individual. If you have a Ptan for the private supplier and a detach Ptan for the practice name then you are a group. Just when you understanding it couldn't get much more confusing!

If you want to keep your cash flow steady it is foremost to make sure you are submitting the claims correctly. If you have any query as to what a singular assurance carrier requires, give them a call. Great to have it right the first time than to have to resubmit!

Copyright 2008 - Michele Redmond

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