NPI Quantities and Legacy Numbers – New Guidelines As of May perhaps 23, 2008 For Billing Medical Coverage Statements
On May 23, 2008 coverage carriers were suppose to accept NPI only on all paper & electronic promises. Not only were you demanded to involve the NPI range, but you have been necessary to EXCLUDE the legacy quantities. Some insurance coverage carriers had been not ready for the deadline and utilized for an extension (like NYS Medicaid). But Medicare was prepared and if you include things like your PTAN (legacy) quantity on your claims they are getting rejected.
For the insurance carriers who were being completely ready for this deadline, you have to make absolutely sure you do not have the legacy range in the shaded region of box 24J or box 32A & 33A. If your computer software is set up to mechanically print the legacy quantity in this box you need to have to take out it. If you post claims electronically, make confident your vendor has it set up to exclude the legacy selection.
For the insurance carriers who were not all set and used for an extension, you will need to keep on like the legacy amount until eventually they have complied. This will make things a minimal messy. You want to make certain you are publishing the claims that require the legacy variety with it, and the types that do not allow for it, devoid of. Outrageous, but it is what we billing people today have to do to make positive the funds keeps coming in.
Another minor nuts point to worry about is the NPI range entered in 24J. If you are established up with Medicare as an specific company (not a group) and you only have a type I NPI, you should go away the NPI portion of box 24J blank. You cannot include the unique NPI amount below. If you are an particular person provider and you set your NPI range in 24J, Medicare may well reject your claims.
If you are a team with Medicare then you have to have to carry on putting the rendering providers individual NPI in box 24J and the group NPI (type II) in box 33A. If you are not guaranteed if you are an particular person or a team you can notify by your PTAN quantity. If you only have one particular PTAN variety then you are an specific. If you have a PTAN for the personal service provider and a different PTAN for the exercise title then you are a team. Just when you thought it could not get much much more perplexing!
If you want to continue to keep your money move constant it is important to make sure you are submitting the statements effectively. If you have any dilemma as to what a individual insurance coverage provider requires, give them a call. Greater to have it suitable the initially time than to have to resubmit!
Copyright 2008 – Michele Redmond