Medical Billing Forum

NPI Numbers => NPI Numbers => Topic started by: PsychBiller on November 15, 2016, 11:35:04 AM

Title: Claim denials "NPI is not registered with the state"
Post by: PsychBiller on November 15, 2016, 11:35:04 AM
I currently bill for a provider who has relocated from Georgia to Virginia.  He is currently practicing in both states (Georgia clients are seen via telemedicine).  I updated his NPI profile to reflect Virginia as his primary practice location (as that is the state that he is residing in), but also kept his Georgia address in the profile as a secondary location.

I am now getting denials from Cenpatico, Georgia which say "NPI is not registered with the state"...has anyone encountered denials for this reason? if so, any idea how I resolve it?

Many Thanks!
Title: Re: Claim denials "NPI is not registered with the state"
Post by: kristin on November 15, 2016, 06:49:55 PM
Could it be that you need to update everything individually with various carriers? I know that when our office moved many years back(after NPI's were in use), we literally had to phone, fax, or fill out paperwork(sometimes all three) for every single insurance company letting them know our new address. Simply updating things at the NPPES website was not enough.
Title: Re: Claim denials "NPI is not registered with the state"
Post by: PMRNC on November 15, 2016, 07:01:12 PM
Yes, agree with Kristen, W9's might be needed so make sure his tax id's match up with the NPI numbers.
Title: Re: Claim denials "NPI is not registered with the state"
Post by: Michele on November 16, 2016, 09:50:31 AM
Kristin and Linda are right.  Just updating NPPES is not enough.  When a provider moves they need to update their address with each insurance carrier.  They may need to enroll with the insurance carriers, if they intend to be in network.  Moving to a different state means a different MAC and different BCBS.  Again, it will depend on if they are participating or not.