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Npi Numbers and patrimony Numbers - New Rules As of May 23, 2008 For Billing healing insurance Claims

Insurance Claims - Npi Numbers and patrimony Numbers - New Rules As of May 23, 2008 For Billing healing insurance Claims

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On May 23, 2008 guarnatee 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 legacy numbers. Some guarnatee 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) estimate on your claims they are being rejected.

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Insurance Claims

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

For the guarnatee carriers who were not ready and applied for an extension, you will need to continue along with the legacy estimate until they have complied. This makes things a itsybitsy messy. You need to make sure you are submitting the claims that require the legacy estimate 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 arrival in.

Another itsybitsy crazy thing to worry about is the Npi estimate entered in 24J. If you are set up with Medicare as an individual 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 individual Npi estimate here. If you are an individual supplier and you put your Npi estimate in 24J, Medicare may reject your claims.

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

If you want to keep your cash flow steady it is leading to make sure you are submitting the claims correctly. If you have any interrogate as to what a single guarnatee carrier requires, give them a call. Best to have it right the first time than to have to resubmit!

Copyright 2008 - Michele Redmond

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