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Medical Directors name on all claim forms

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Michele:
First I'd like to say that in the 20 + years I've been billing I've always used the name of the rendering provider in 31.  It's not really an option.  PMS systems automatically put the name of the rendering provider in that field.  But when I tried to get proof this is what I found on the NUCC website:

DESCRIPTION: The “Signature of the Physician or Supplier Including Degrees or Credentials” refers to the authorized or accountable person and the degree, credentials, or title.

So that doesn't really clearly state that it must be the person whose NPI is in 24J

 ???

PMRNC:
I echo what Michele said here:
--- Quote ---The rendering provider's individual NPI goes in 24J and their name goes in 31.  The name in 31 should match the NPI in 24J.  The medical director should not be on the claim unless they were the rendering provider.  The only reason it would be different were if it were some specific rule for a specific carrier.
--- End quote ---

It also depends on how the NPI is setup and that needs to match IRS records.. EXACTLY!!!  I had a provider who had all kinds of problems because his IRS record was not an exact match.. was missing an ' (apostrophe) in the name!! was 6 week PIA to fix. THEY MUST MATCH!!

RichardP:
Search on "Item Number 31" (without the quotes) here:

http://www.nucc.org/%5Cimages%5Cstories%5CPDF%5C1500_claim_form_instruction_manual_2012_02.pdf

Enter the legal signature of the practitioner or supplier, signature of the practitioner or supplier representative, “Signature on File,” or “SOF.”

Search on "31" (without the quotes) here:

http://www.anthem.com/provider/me/f5/s2/t0/pw_041940.pdf

Signature of Physician or Supplier Including Degrees or Credentials
The signature of the physician or clinician who performed the services on the claim.

• If a group practice name appears in Box 33, the name of the physician who
   performed the services must appear in Box 31.
• If the clinician who performed the services is a non-recognized professional (not
   eligible to contract with us directly, i.e., physician’s assistant or certified nurse
   anesthetist), the name of the attending, supervising or medically directing
   physician must be entered here. The credentials must be included along with the
   clinician’s name.
• Do not enter the name of a billing clerk or supervisor.

Note: It is appropriate to indicate the names of PAFAs or RNFAs in Box 31 as they
are eligible to contract with us.

Michele:
AHHHH!  Thanks Richard!  I knew it had to be the same but wasn't finding that documentation.

RichardP:
You're welcome.

For those who may not have noticed, that first link is the instructions for filling out the new CMS 1500 (2-12) form.

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