According to the latest publication from Medicare, as of March 1, 2008 all FFS 837P and CMS-1500 claims will be required to have primary provider NPI numbers.  Claims will reject if NPI numbers are not included  on the claims.  For more information visit the Medicare web site.

As insurance carriers move towards their NPI only deadlines, providers may begin to receive informational or warning edits regarding the providers secondary (Legacy) ID numbers. For EZClaim users, these ‘Legacy’ ID numbers are stored in the Tools>Physician/Facility library under Additional ID Numbers. As your insurance carriers start requesting NPI only data in your claim files, you may delete “DEL” these additional ID numbers. Once a library entry has been edited and saved it will update all records using the Physician Library entry.

In speaking with the Texas Workers’ Compensation EDI department, they stated that the Workers Compensation rule stipulates that providers must have the ‘ability’ to submit their claims electronically. They also stated that providers should ‘enroll with some clearinghouse’ as soon as possible in order to show they have the ‘ability’ to submit claims electronically. Once enrolled with the clearinghouse the provider can begin to submit their claims, both WC and non-WC, that are accepted by the clearinghouse. Until the clearinghouse is able to accept specific WC carriers, the provider may continue to submit workers’ compensation paper claims and documentation.The EDI department said they are aware that at this time providers are not able to submit all of their claims to one clearinghouse which is why the carriers should be continuing to process paper claims.The Workers’ Compensation Board’s goal is to eventually have the all providers submitting their workers’ compensation claims electronically.Although EZClaim does offer clearinghouse services, it is not necessary to use the EZClaim clearinghouse in order to utilize our EZClaim medical billing software. EZClaim offers both the Print Image and the ANSI 837 file format for submitting your electronic claims. Visit our web site at www.ezclaim.com, or contact EZClaim for additional product and electronic billing information. Providers may still apply for a Financial Burden waiver by going to the Workers’ Compensation web site at www.tdi.state.tx.us/wc/ebill/ and filling out the necessary paperwork. (Contact Workers Compensation for any questions regarding waivers or billing requirements.)

Medicare has released a notice stating when NPI numbers must be included on claims. As of March 1, 2008 Medicare claims must include an NPI in the primary billing fields such as the Billing Provider data (Box 33) and the Rendering Provider data (box 24J). Medicare states that the provider may continue to submit NPI and Legacy ID numbers or just the NPI. Claims without NPI numbers in these fields will reject.

Provider’s may continue to submit Legacy identifiers without the NPI numbers in secondary fields until May 23rd, 2008.

After May 23rd, 2008, Medicare claims should include only NPI numbers for both primary and secondary fields.

For further information or updates regarding Medicare NPI compliance dates, visit the CMS web site at www.cms.hhs.gov

The start of the BCBS NPI Required phase has been changed to January 7, 2008. Continue to submit claims using dual identifiers (your BCBSIL provider number and your NPI). Claims submitted to BCBSIL without an NPI as of January 7, 2008, will be rejected. If you have any questions, contact Availity at 877.334.8446. www.availity.com

Effective immediately MI Medicaid is requiring that all electronic claims be submitted with an NPI number. Claims received after 12/20/07 without an NPI number will reject.

Ready to send claims to Availity? Migrating from THIN to Availity?

EZClaim has been an Availity software vendor since 2004 and has many customers successfully sending their electronic claims to Availity.

For additional information on using EZClaim Medical Billing software with Availity go to www.ezclaim.com and click on ‘Availity/THIN Information’. Information will include EZClaim pricing, User Guides, and links to the Availity web site.

Welcome to the new EZClaim Blog. EZClaim is a medical billing program used by our customers to fill out their CMS 1500 forms and submit claims to insurance companies either by paper or electronically. EZClaim will be using this blog to provide updated medical billing information such as NPI Crosswalk error information, the latest on electronic billing and many more topics. We will invite users, (and not just EZClaim customers) to share their information and to possibly answer questions posted by other interested parties. Check back as we begin to set up this blog.

The first article EZClaim is posting provides information on NPI Crosswalk guidelines and Medicare error messages. See link below.

NPI Crosswalk Information and Error Messages (PDF)