Will the NPI replace the primary physician’s Medi-Cal provider number on the new CHDP Confidential Screening/Billing Report (PM 160) form?
Yes. Effective December 17, 2007, the NPI is accepted on the PM 160 form, as well as all other claim forms. Providers who are not ready to transition to using the NPI may continue to submit their Medi-Cal provider number until instructed otherwise. • If an institution has obtained one NPI for multiple Medi-Cal provider numbers and is paid differently for each provider number, how does Medi-Cal determine payment after the institution’s Medi-Cal provider numbers are no longer valid? A: The claims payment system will use data contained on the claim to accurately adjudicate the claim. Also of importance is accuracy of provider location information contained on the Medi-Cal provider master file, as well as the service location submitted on the claim. Inaccurate service location information may lead to payment irregularities. Providers are encouraged to verify their service location information by calling the Telephone Service Center (TSC) at 1-800-541-5555.
