Tips for Proper Electronic and Paper Claims Submission
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1 National Provider Identifier (NPI) Toolkit Tips for Proper Electronic and Paper Claims Submission Inside this toolkit you fill find tips for submitting your National Provider Identifier (NPI) when submitting electronic and paper claims. Enclosed you will get the latest news on electronic and paper claim submissions, the CMS-1500 claim form, and loop and data elements, plus resources for where you can find additional information. Electronic Claim Submission AmeriHealth systems accept 837P (professional) and 837I (institutional) version 4010A1 electronic claims with an NPI. We will reject any electronic claim that does not have an NPI as a provider s primary identifier after the May 23, 2008, compliance date. AmeriHealth Dual Use Requirements Please see the information on the following pages regarding loop and data elements, which will assist you in entering in your NPI and optional submission of your legacy number when submitting electronic claims. This information was effective January 1, How to Obtain an NPI The National Plan and Provider Enumeration System (NPPES) is currently accepting applications for NPIs. Providers who have not yet obtained an NPI may apply for it in one of the following ways: Electronic u Complete the web-based application online at It takes approximately 20 minutes to complete and is the most time-efficient method of obtaining an NPI. Paper u Providers may wish to obtain a copy of the paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator. The form will be available only upon request through the NPI Enumerator. Providers who wish to obtain a copy of this form must contact the NPI Enumerator in any of the following ways: u Phone: (800) or TTY (800) u customerservice@npienumerator.com u Mail: NPI Enumerator P.O. Box 6059 Fargo, ND AmeriHealth HMO, Inc. QCC Insurance Company d/b/a AmeriHealth Insurance Company 1
2 Professional Loop and Data Elements Loop Data Element Industry Name Content 2000A 2010AA 2310A 2310B 2310D 2420A BILLING PROVIDER SPECIALTY INFORMATION PRV03 Provider Taxonomy Code Taxonomy BILLING PROVIDER NAME NM109 Billing Provider Primary Identifier NPI REF02 Billing Provider Secondary Identification Number Tax ID REF02 Billing Provider Secondary Identification Number Legacy REFERRING PROVIDER NAME NM109 Referring Provider Primary Identifier NPI PRV03 Referring Provider Taxonomy Code Taxonomy REF02 Referring Provider Secondary Identifier Tax ID REF02 Referring Provider Secondary Identifier Legacy RENDERING PROVIDER NAME NM109 Rendering Provider Primary Identifier NPI PRV03 Rendering Provider Taxonomy Code Taxonomy REF02 Rendering Provider Secondary Identifier Tax ID REF02 Rendering Provider Secondary Identifier Legacy SERVICE FACILITY LOCATION NM109 Laboratory or Facility Primary Identifier NPI REF02 Laboratory or Facility Secondary Identifier Legacy REF02 Laboratory or Facility Secondary Identifier Tax ID RENDERING PROVIDER NAME NM109 Rendering Provider Primary Identifier NPI PRV03 Rendering Provider Taxonomy Code Taxonomy REF02 Rendering Provider Secondary Identifier Tax ID REF02 Rendering Provider Secondary Identifier Legacy 2 2
3 Institutional Loop and Data Elements Loop Data Element Industry Name Content 2000A 2010AA 2310A 2310B 2310C 2310D BILLING PROVIDER SPECIALTY INFORMATION PRV03 Provider Taxonomy Code Taxonomy BILLING PROVIDER NAME NM109 Billing Provider Primary Identifier NPI REF02 Billing Provider Secondary Identification Number Tax ID REF02 Billing Provider Secondary Identification Number Legacy ATTENDING PHYSICIAN NAME NM109 Attending Physician Primary Identifier NPI PRV03 Attending Physician Taxonomy Code Taxonomy REF02 Attending Physician Secondary Identifier Tax ID REF02 Attending Physician Secondary Identifier Legacy OPERATING PHYSICIAN NAME NM109 Operating Physician Primary Identifier NPI PRV03 Operating Physician Taxonomy Code Taxonomy REF02 Operating Physician Secondary Identifier Tax ID REF02 Operating Physician Secondary Identifier Legacy OTHER PROVIDER NAME NM109 Other Provider Primary Identifier NPI PRV03 Other Provider Taxonomy Code Taxonomy REF02 Other Provider Secondary Identifier Tax ID REF02 Other Provider Secondary Identifier Legacy REFERRING PROVIDER NAME NM109 Referring Provider Primary Identifier NPI PRV03 Referring Provider Taxonomy Code Taxonomy REF02 Referring Provider Secondary Identifier Tax ID REF02 Referring Provider Secondary Identifier Legacy 2310E SERVICE FACILITY NAME NM109 Facility Primary Identifier NPI PRV03 Facility Provider Taxonomy Code Taxonomy REF02 Facility Secondary Identifier Tax ID REF02 Facility Secondary Identifier Legacy 2420A ATTENDING PHYSICIAN NAME NM109 Attending Physician Primary Identifier NPI PRV03 Attending Physician Taxonomy Code Taxonomy REF02 Attending Physician Secondary Identifier Tax ID REF02 Attending Physician Secondary Identifier Legacy 2420B OPERATING PHYSICIAN NAME NM109 Operating Physician Primary Identifier NPI PRV03 Operating Physician Taxonomy Code Taxonomy REF02 Operating Physician Secondary Identifier Tax ID REF02 Operating Physician Secondary Identifier Legacy 33
4 Paper Claim Submission The CMS-1500 (08/05) Claim Form and NPI NPIs are required as of May 23, 2008, when submitting a CMS-1500 (08/05) claim form. A sample CMS-1500 (08/05) claim form can be found on the next page. Though the form accommodates NPI, you may continue to report current provider identification numbers in the appropriate shaded areas of the form (17a, 24J, 32b, and 33b) until otherwise notified. Current provider identification numbers must be preceded by a two-character qualifier ID. This qualifier ID is the same as the qualifier ID used when billing electronically. If you do not currently bill electronically, please use the following ID: G2. Please note the NPI-specific areas circled in green on the CMS-1500 claim form. If you have obtained your NPI(s) and submitted them to us, you must begin to report them as of May 23, In addition, you may continue to use your current provider identification numbers on the CMS-1500 (08/05) claim form. If you have any questions regarding the NPI, the application process, or reporting your NPI to us, please contact your Network Coordinator or Provider Services. Instructions for filling out the CMS-1500 (08/05) claim form can be found at /providers/ npi/forms.html. Tips for Proper Paper Submission Tax ID is REQUIRED Legacy ID is OPTIONAL - Legacy ID is prefixed with G2 The following identifiers are not valid in the NPI fields: Tax ID number, Social Security Number, Corporate ID number The NPI is a unique 10-digit identification number. There are no dashes in the NPI. There is NO PREFIX on the NPI. Boxes 17b, 32a, 33a are for the NPI only Box 24J (shaded) is the rendering provider ID number Box 24J (unshaded) is the rendering provider NPI ºº NPI for a physician cannot be used for a billing NPI unless the physician is a solo practitioner PIN and GROUP numbers have been eliminated from the new form Boxes 17a, 32b, 33b require the prefix: G2 Box 19 requires a ZZ prefix for the Taxonomy Code 4 4
5 - CMS 1500 (08/05) ABC Doe, John B Main Street Doe, John B Main Street Anytown NJ Anytown NJ Doe, Mary self-employed Watch Repair, Inc. AmeriHealth PPO HMO, Inc. Referring Provider s two-character qualifier ID Referring Provider s Current Provider ID Josephine Smith, M.D. ZZ207LP2900X ZZ qualifier ID and Billing Provider s Primary Taxonomy Code G Referring Provider s NPI $ G $ Two-character qualifier ID of the Rendering Provider /5/06 Service Facility NPI ABC Hospital 123 Street Anytown, NJ Service Facility two-character qualifier and Current Provider ID number G Billing Provider NPI ABC Medical Group 8 North American Street Anytown, NJ G Billing Provider two-character qualifier ID and current provider identification number Red items are required by AmeriHealth for payment. Blue items are required for payment when applicable to the patient s condition/situation. Black items are optional. Indicates new field and/or requirement. Circled items are NPI-specific. 55
6 Important NPI Resources Please visit the following websites for additional information: AmeriHealth Provider NPI website: /providers/npi Contains NPI background, FAQs, Submission Instructions, web links, and other information. CMS Main NPI website: Contains NPI Final Rule, FAQs, Fact Sheets, Tip Sheets, NPI Viewlet, Medicare MedLearn Articles, Enumeration Statistics. NPI Enumerator website: Main site to enter an NPI application. WEDI NPI White Papers: Industry NPI papers, including NPI Impact on Providers, NPI Dual Use Strategy, NPI and Subparts, etc. WEDI NPI Outreach Initiative: NPI Resource Center with information resources, Industry readiness assessment survey, etc. 6 6
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