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. |
