How to Apply for NPI
If a claim is submitted without a valid, registered NPI, the claim will reject. In accordance with the reimbursement terms of your provider contract, you may continue to provide your digit legacy number. Only a valid NPI will be accepted by us as the primary identifier on the claim. Will Independence require NPIs on paper claims?
Paper claims must be submitted with an NPI as the primary identifier. Tax ID is required for all claims. Some of these providers may not have an NPI, and others we may not be able to obtain. Independence requires NPI identifiers in the following four provider fields:. Is Independence planning on requiring a nine-digit zip code on the claim form?
The nine-digit zip code is currently not required. If providers choose to enumerate their subparts further than they currently have today with payer legacy ID numbers, will Independence require enrollment of their additional subparts? No, Independence will not require enrollment of all subparts. However, Independence will not accept health care transactions using these NPIs if they are not registered with Independence.
Does Independence require different NPIs when there are currently different provider numbers? While keeping NPI enumeration requirements in mind, Independence strongly encourages providers to enumerate with NPIs in the same configuration in which they are now enumerated with Independence using corporate provider IDs. Otherwise, issues may occur with your claim payments and internal business and reporting procedures.
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Independence recommends that you take a close look at your current provider number configuration and plan wisely when obtaining your NPIs. How can hospitals notify Independence of their NPIs? Registering your NPIs with Independence is easy. However, unless we are percent sure of a provider match, we will not enter that NPI into our systems. To date, many claims are not passing this check-digit validation. The most common reasons why claims are not passing the NPI check-digit validation are:.
For single specialty groups, the taxonomy code is X. For multispecialty groups, the taxonomy code is X. You must notify the enumerator of any changes within 30 days of the change. Most changes will not change your NPI number. Only rare circumstances such as fraudulent use of your NPI number will require that you be issued a new number.
National Provider Identifier
You can change the information in your NPI file online nppes. You may either create a user ID or, if you have one already, log in and update your information. Download the form www. Like UPIN numbers that were used prior to the establishment of the NPI, other physicians and providers to whom you refer will need your NPI number in order to submit claims for services for patients you refer to them.
National Provider Identifier (NPI)
If another party does billing on your behalf, that party will need your NPI. You may also need NPI numbers from hospice and home health agencies and other physicians in order to bill for your services. What is the National Provider Identifier? Will my NPI information be available to others? Sole Proprietorships If you practice as a sole proprietorship, you must apply as a type I individual. How do I apply for my NPI?
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You can apply for an NPI in one of three ways: Apply online nppes. Mail in a written application. Through an electronic file interchange provided by a large organization. Online and Paper Applications The fastest and easiest way for most physicians will be completing the online application form. You will need: Legacy current provider identification numbers UPIN number Taxonomy codes License numbers Mailing address and practice address es Phone number and the name of the person who will serve as a contact should the enumerator need further information.
Health care providers who wish to obtain a copy of this form must contact the NPI Enumerator in any of these ways: Phone: or TTY Email: customerservice npienumerator. What is my taxonomy number? What happens with my NPI if my information changes or I quit practicing?
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