If a trading partner sends a default value for the rendering bill provider state license number (DN643), can the trading partner send a default value for the taxonomy code as well? And how does a trading partner determine the taxonomy code?
No, a default value should not be sent for the taxonomy code. Two acceptable methods to determine taxonomy codes follow: one method is to build a bridge file between your existing provider taxonomy and the California-adopted AMA provider taxonomy. Another method is to follow the definitions of a medical provider contained in the WORKERS’ COMPENSATION LAWS OF CALIFORNIA DIVISION 4. WORKERS’ COMPENSATION AND INSURANCE, PART 1. SCOPE AND OPERATION, CHAPTER 1. GENERAL PROVISIONS, 3209.3 and 3209.5 to be sent in REF02 127 in the 2310B loop of the California-adopted IAIABC 837 transmission. Q: Currently, the rendering provider state license number is reported to the California Department of Consumer Affairs containing zeros, for example: PSY00009681. Is the current format acceptable to the WCIS, or must the zeroes be stripped out and only the “PSY9681” be reported? A: The suggested format is provided by the California Department of Consumer Affairs in the master file of all licensed medical
Related Questions
- My trading partner uses a Value Added Network (VAN) for communication – can we use Vantage Point EDI to connect directly to any network?
- If a provider has multiple NPIs or multiple provider ID’s, will they need multiple Trading Partner Agreements (TPA)?
- Does a billing agent have full access to all provider information under the Trading Partner Agreement?
