NPI Quantities and Legacy Numbers – New Rules As of May well 23, 2008 For Billing Healthcare Insurance policy Claims

On Might 23, 2008 coverage carriers were being suppose to acknowledge NPI only on all paper & electronic claims. Not only were being you required to incorporate the NPI range, but you ended up required to EXCLUDE the legacy quantities. Some insurance coverage carriers ended up not ready for the deadline and utilized for an extension (like NYS Medicaid). But Medicare was completely ready and if you consist of your PTAN (legacy) variety on your claims they are becoming turned down.

For the insurance policy carriers who were being prepared for this deadline, you have to make confident you do not have the legacy amount in the shaded location of box 24J or box 32A & 33A. If your software is set up to immediately print the legacy variety in this box you want to get rid of it. If you submit claims electronically, make certain your seller has it set up to exclude the legacy variety.

For the coverage carriers who had been not ready and applied for an extension, you will require to go on which includes the legacy amount right up until they have complied. This can make items a minor messy. You require to make positive you are publishing the promises that have to have the legacy quantity with it, and the kinds that do not make it possible for it, with no. Ridiculous, but it is what we billing individuals have to do to make certain the revenue retains coming in.

One more tiny ridiculous point to stress about is the NPI quantity entered in 24J. If you are established up with Medicare as an individual company (not a group) and you only have a variety I NPI, you ought to go away the NPI portion of box 24J blank. You can not contain the personal NPI number listed here. If you are an individual provider and you place your NPI selection in 24J, Medicare may perhaps reject your promises.

If you are a group with Medicare then you have to have to carry on putting the rendering providers specific NPI in box 24J and the group NPI (type II) in box 33A. If you are not confident if you are an personal or a team you can notify by your PTAN range. If you only have one PTAN quantity then you are an person. If you have a PTAN for the specific service provider and a separate PTAN for the follow title then you are a team. Just when you believed it couldn’t get significantly much more baffling!

If you want to preserve your cash move continuous it is essential to make certain you are publishing the statements accurately. If you have any query as to what a certain insurance policies carrier calls for, give them a simply call. Far better to have it ideal the initially time than to have to resubmit!

Copyright 2008 – Michele Redmond

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