Our claims are being denied for missing or incomplete provider numbers. Where can I check to ensure our NPI matches our provider number (PTAN)?
A . Certain information you enter into the National Plan and Provider Enumeration System (NPPES) in order to obtain and maintain your National Provider Identifier (NPI) is used by Medicare in processing claims. If the information you entered in NPPES is not correct, your claims may reject. It is important to verify that information is entered correctly. Once the NPI application information has been submitted and the NPI assigned, NPPES will send the health care provider a notification that includes their NPI. Medicare Learning Network (MLN) Matters article, SE0725 addresses information regarding the NPPES errors and using the NPI on Medicare claims. You can view this article on the Centers for Medicare & Medicaid Services (CMS) web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0725.pdf. Also, you may wish to contact Customer Service to verify that your NPI information is being cross-walked correctly in our system.
Related Questions
- Since there is only one remittance per NPI, what happens if a provider obtained one NPI for several Medi-Cal group provider numbers and only submits a portion of claims electronically?
- If a provider chooses to obtain one NPI to replace multiple Medi-Cal provider numbers, which provider number must be reported on the UB-04 claim form?
- Does a clinic need to bill using different NPI numbers, depending on which provider rendered the service, or should a clinic use their own NPI number?
