Question |
Response |
| Is there a designated contact for
National Provider Identifier (NPI) implementation
issues? |
For all Electronic Data Interchange
(EDI) inquiries regarding NPI, contact the EDI
Support Team:
- Email: EDIsupport@regence.com
- Fax: 1 (877) 329-3342
- Idaho and Oregon Submitters 1 (800) 713-1693
- Utah Trading Partners/Submitters 1 (888)
344-5583
- Washington Submitters 1 (877) 329-3342
|
| Have you implemented the NPI? |
Yes, as of March 1, 2008, you
are required to submit an NPI
on all electronic claims, with or without your
Regence provider number. We will notify you at
a later date when the Regence identifier will
no longer be accepted.
Note: Hospitals, other facilities and
medical groups submitting professional claims
either electronically or on a CMS-1500 should
continue submitting their Regence identifier
in addition to their NPI to facilitate proper
payment assignment. We will notify you at a later
date when this is no longer necessary. |
| How do you communicate information
about NPI? |
Regence publishes and distributes
NPI updates in our quarterly provider newsletters, The
ConnectionSM. NPI status and detailed information
is available on the Provider Web Site. Other
communication methods such as direct mailings and
voucher stuffers may also be used to share information
or request action from providers related to NPI. |
| Do I still need to include my tax
identification (ID) number on my claims submissions? |
Yes, the NPI does not replace the
tax ID number. Your tax ID number is a critical
element that helps us correctly process your payments. |
| Will NPIs be validated as part of
the adjudication process or claims submission process? |
Yes, for electronic claims submissions,
the NPI will be validated to ensure formatting
of the NPI is correct. For adjudication, the NPI
on the claim will be validated against the NPI
information submitted to Regence by the provider. |
| How can I be sure you have my correct
NPI? |
The NPI on file will be printed
on your payment voucher.
- Please verify now that the NPI on your
voucher is correct.
- If you do not see the NPI number or you
feel it is incorrect, please contact Provider
Services immediately.
|
| Will taxonomy codes be required
to adjudicate claims? |
Regence does not require the use
of taxonomy codes at this time. |
| How do you process same provider/multiple
locations claims/remittance advices? |
Regence continues to process and
distribute payments using processes currently in
place. |
| Do you have subpart requirements? |
No. See CMS
guidelines related to subparts (PDF) for
more information. |
| Do you require new Trading Partner
Agreements? |
No. |
| Do you require the NPI on paper-based
transactions? |
While we are not requiring the NPI
on paper-based transactions, we do recommend that
the NPI be included on all transactions whether
submitted electronically or on paper. |
| Do you require providers to update
you in addition to the Enumerator? |
Yes, at this time, the Enumerator
has not yet disclosed when it will be able to deliver
the NPI to payers. Until that process is defined,
we will continue to request that providers notify
us of their NPI prior to submission of claims-based
transactions. |
| What is the process? |
Regence offers three ways to
submit NPIs:
|
| Have your systems been updated to
accommodate the new UB-04, and the new CMS-1500 forms
in accordance with the NPI related changes? |
Yes. |
