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NPI Numbers, the New CMS-1500 Claim Form and Practice Point Manager Versions 6.5 and 7.0

 Adding taxonomy codes (.pdf file)

Updated Taxonomy Code Listing (.pdf file)

NPI Number Information

Not sure what an NPI is and how you can get it, share it and use it?  As always, more information and education on the NPI can be found at the CMS NPI page http://www.cms.hhs.gov/NationalProvIdentStand/ on the CMS website.  The National Provider Identifier (NPI) is almost here - May 23, 2007 - the requirement that only NPI numbers be used for Medicare claims processing. Have you taken all the steps you should to make sure there is no interruption in your cash flow?

Make sure you have applied for your NPI number. Don't be caught without an NPI when the deadline arrives. Obtain your NPI by going on line to https://NPPES.cms.hhs.gov/NPPES/Welcome.do or calling them at 800-465-3203. Be sure to enter all of your Medicare legacy numbers to the NPPES Website to avoid further problems later.  We recommend you still use your Medicare legacy numbers in conjunction with the NPI, but give yourself plenty of time to make sure your NPI is correctly billed. Don't wait until the last minute then find you need programming changes.
Don't forget to put your NPI number on any forms you submit to the EDI area - NPI is a condition for EDI Enrollment. Make sure you see the NPI number that corresponds with your provider number.

Blue Cross\ Blue Shield is requiring that providers register the NPI numbers with them. 

 

For BCBS of Illinois online registration, go to http://www.bcbsil.com/provider/npi_registration.htm   or call   312-653-7954.                                                                                            

For Anthem BCBS online registration, go to https://npi.wellpoint.com or call 800-470-9630 for BCBS WI, OH, KY, IN, and MO.

 

 

Where to add the new CMS-1500 form information into Practice Point Manager 6.5 and 7.0

 

Under the Group, Provider, Referring Provider and Facility maintenance add the following for boxes 17, 24, 32 and 33 of the new CMS-1500. Some information listed is also for electronic claim submission.

 

Group Information

1.)                 PRACTICE ID in the Group is your Tax ID, with a G2 ID qualifier

2.)                 Complete all ID qualifiers under IDs for your Group for box 33B. See ID qualifier list below

3.)                 Add in NPI number for box 33A; taxonomy code, and specialty codes are for electronic claims

4.)                 Make sure the Entity Type is completed for electronic claims

 

Provider Information

1.)                 The PROV ID is your Tax ID with a G2 ID qualifier

2.)                 Complete all ID qualifiers under IDs for your providers for box 24J. See ID qualifier list below

3.)                 Add in NPI number for box 24J; taxonomy code, and specialty codes are for electronic claims

4.)                 Make sure the Entity Type is completed for electronic claims

 

Referring Provider Information

1.)                 The Provider ID is the Provider UPIN number with a 1G ID qualifier is for box 17B

2.)                 Add in NPI number for box 17A

 

Facility Information

1.)             Add in NPI number for box 32A

2.)             Add in the facility id and id qualifier of 0B (zero B) for box 32B in the Ids button, NOT the front screen

 

ID Qualifiers to Use:

 

1.)      G2 = Commercial ID, includes HMO plans or those plans you are unsure what type they are.

2.)      1B = Blue Cross ID qualifier, DO NOT USE 1A.  If submitting claims to Blue Cross Illinois (CPID   

1405), the Provider ID qualifier MUST BE 0B   

3.)      1C = Medicare ID qualifier (also applies to Railroad Medicare)

4.)      1D = Medicaid ID qualifier

 

  

Important Notice Regarding the Revised Form CMS-1500

 

The Form CMS-1500 (12-90) was revised by the National Uniform Claim Committee (NUCC) predominantly for the purpose of accommodating the National Provider Identifier. Since that time, the industry has been preparing for the implementation of the revised Form CMS-1500 (08-05). It has recently come to our attention that there are incorrectly formatted versions of the revised form being sold by print vendors, specifically the Government Printing Office (GPO). Given the circumstances, CMS has decided to extend the acceptance period of the Form CMS-1500 (12-90) version beyond the original April 1, 2007 deadline while this situation is resolved. Medicare contractors will be directed to continue to accept the Form CMS-1500 (12-90) until notified by CMS to cease. At present, we are targeting June 1, 2007 as that date. It is important to note that this issue involves the implementation of the new CMS-1500 (08-05) only and does not impact the May 23, 2007 implementation date of the NPI.

Please see the below link for the entire statement regarding the paper CMS-1500 form date change to June 1st 2007 posted on Medicare's website. http://www.cms.hhs.gov/ElectronicBillingEDITrans/Downloads/1500%20problems.pdf

 

General Information

 

High Call Volumes

 

Due to the high call volumes regarding NPI and new claim form questions, we thank you for your patience, as calls are being returned as quickly and timely as possible.

If you have the new claim form and are ready to use it please call Wendy to schedule an appointment. Please bill out all of your paper claims prior to adjusting the new claim form.

If you are getting a new printer, the claims, statements, and route slips will need to be adjusted. Please call to schedule an appointment for forms adjustments.

 

Internet Explorer Version 7.0

 

We are recommending that clients do not install Internet Explorer version 7.0. There have been numerous of instances of the new Internet Explorer version 7.0 conflicting various applications.

 

 

Error in Billing with Practice Point Manager version 7.0.6.9

 

There have been instances of an error while billing electronic and paper claims.

The error states "Error inserting record on Charges; Right String Truncation".  The claims are being generated correctly but the system is not changing the claim generated flag to N, therefore a patients' charge will possibly bill on an electronic claim and paper claim.