Read Microsoft Word - BUG_676_NPI Regional Fields Update 6 7 07.doc text version

June 7, 2007

NPI ­ CMS 1500 Claims Filing Update

Providers should use the following guidelines when utilizing the new paper CMS 1500 Claim Forms for filing claims with Anthem Blue Cross and Blue Shield. CMS1500 Filing Guidelines

Field 19

Required or Content Example Recommended Recommended Qualifier and ZZ207Q00000X Taxonomy

Notes If you are currently using field 19 for NOC codes, please move those to field 24.

24I

24J shaded

Required if 2 digit qualifier 1B000000123456 If you are filing paper claims you must use the two Provider is using digit qualifier 1B which will be required effective Rendering 8/1/07. Provider 12 digit Anthem PIN Recommended 12 digit 000000123456 Until January 25, 2008, we are recommending Anthem PIN that you continue to file your claims with the Anthem 12 digit PIN in this field as you did in the past. You may not be able to enter this PIN if your software only allows 11 digits. We recommend you contact your software vendor to see if this field can be expanded. If 24J is used, 33a and /or b must also be completed. Recommended NPI 1234567890 The Billing Provider NPI is required (33a and/or 33b). The Rendering Provider NPI is required only if different than the Billing Provider. Whether you use NPI Type I or Type II depends on your organizational structure Please check the appropriate box for employer identification number (EIN) or social security number (SSN).

24J unshaded

25

Required

32A

Federal Tax ID Provider of Number service or supplier federal tax ID number. Recommended Service 1234567890 Provider Location NPI (physician office, hospital, etc)

Visit us online at www.anthem.com

In Indiana: Anthem Blue Cross and Blue Shield is a trade name of Anthem Insurance Companies, Inc. In Kentucky: Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. In Missouri: Anthem Blue Cross and Blue Shield is the trade name RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC) and HMO Missouri, Inc. use to do business in most of Missouri. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. Life and disability products are underwritten by Anthem Life Insurance Company (ALIC). RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® Registered marks Blue Cross and Blue Shield Association. .

32B

Recommended 1B qualifier then 12 digit Anthem PIN

33

Required

33A

Required

33B

Required

1B000000123456 Until January 25, 2008, we are recommending you continue to file your claims with the Anthem 12 digit PIN in this field as you filed in the past. If you are filing paper claims you must use the two digit qualifier 1B which will be required effective 8/1/07. Provider Billing Phone number, Phone number Information Name and 1st line ­ Name address 2nd line ­ Address 3rd line ­ City, State and Zip Group Type II 1234567890 The Billing Provider Anthem 12 digit PIN and/or NPI for NPI is required. Servicing Provider (if applicable) 1B qualifier 1B000000123456 Until January 25, 2008, we are recommending then 12 digit you continue to file your claims with the Anthem Anthem PIN 12 digit PIN in this field as you filed in the past. If you are filing paper claims you must use the two digit qualifier 1B which will be required effective 8/1/07.

We apologize for any confusion on the use of the above fields. We also apologize if you experienced an error message regarding your NPI not being on file. This error message has been corrected and if your NPI is registered in our system, you should no longer see this message. If you have any questions on NPI, please contact your local Provider Relations representative.

Visit us online at www.anthem.com

In Indiana: Anthem Blue Cross and Blue Shield is a trade name of Anthem Insurance Companies, Inc. In Kentucky: Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. In Missouri: Anthem Blue Cross and Blue Shield is the trade name RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC) and HMO Missouri, Inc. use to do business in most of Missouri. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. Life and disability products are underwritten by Anthem Life Insurance Company (ALIC). RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® Registered marks Blue Cross and Blue Shield Association. .

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Microsoft Word - BUG_676_NPI Regional Fields Update 6 7 07.doc