NPI Numbers and Legacy Numbers – New Rules As of May 23, 2008 For Billing Medical Insurance Claims

On Might 23, 2008 marketing carriers have been suppose to just accept NPI solely on all paper & digital claims. Not solely have been you required to incorporate the NPI quantity, however you have been required to EXCLUDE the legacy numbers. Some marketing carriers weren’t prepared for the deadline and utilized for an extension (like NYS Medicaid). However Medicare was prepared and if you happen to embrace your PTAN (legacy) quantity in your claims they’re being rejected.

For the marketing carriers who have been prepared for this deadline, you could be sure to do not need the legacy quantity within the shaded space of field 24J or field 32A & 33A. In case your software program is ready as much as robotically print the legacy quantity on this field it’s essential take away it. In the event you submit claims electronically, be sure that your vendor has it set as much as exclude the legacy quantity.

For the marketing carriers who weren’t prepared and utilized for an extension, you have to to proceed together with the legacy quantity till they’ve complied. This makes issues a bit of messy. You’ll want to be sure to are submitting the claims that require the legacy quantity with it, and those that don’t permit it, with out. Loopy, however it’s what we billing individuals must do to ensure the cash retains coming in.

One other little loopy factor to fret about is the NPI quantity entered in 24J. If you’re arrange with Medicare as a person supplier (not a gaggle) and also you solely have a kind I NPI, you could go away the NPI a part of field 24J clean. You can’t embrace the person NPI quantity right here. If you’re a person supplier and you place your NPI quantity in 24J, Medicare might reject your claims.

If you’re a gaggle with Medicare then it’s essential proceed placing the rendering suppliers particular person NPI in field 24J and the group NPI (sort II) in field 33A. If you’re unsure if you’re a person or a gaggle you may inform by your PTAN quantity. In the event you solely have one PTAN quantity then you might be a person. In case you have a PTAN for the person supplier and a separate PTAN for the apply title then you’re a group. Simply if you thought it could not get way more complicated!

If you wish to hold your money circulate regular it is very important be sure to are submitting the claims appropriately. In case you have any query as to what a selected marketing provider requires, give them a name. Higher to have it proper the primary time than to must resubmit!

Copyright 2008 – Michele Redmond

Source by Michele Redmond

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