Author Topic: bcbs group npi  (Read 2207 times)

wharta

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bcbs group npi
« on: March 11, 2010, 01:19:00 PM »
HELPPPPPPP!
I keep getting these claims rejected for "billing tax id not a match to npi" and everybody keep giving me different info and sending me in circles.  I have tried this so many different ways its not funny. The doctor says he only uses his npi for this and he has a group npi but he doesnt use it. So i have been sending these claims recently with his npi only in 24j, 32 as his health group and personal npi and his group name and personal npi in 33a. When i contact bcbs this is the info they have on file , but they still are getting rejected electronically from them.
He is the only provider and the practice is his own- what should i do to get these paid??????

Pay_My_Claims

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Re: bcbs group npi
« Reply #1 on: March 11, 2010, 04:06:26 PM »
HELPPPPPPP!
I keep getting these claims rejected for "billing tax id not a match to npi" and everybody keep giving me different info and sending me in circles.  I have tried this so many different ways its not funny. The doctor says he only uses his npi for this and he has a group npi but he doesnt use it. So i have been sending these claims recently with his npi only in 24j, 32 as his health group and personal npi and his group name and personal npi in 33a. When i contact bcbs this is the info they have on file , but they still are getting rejected electronically from them.
He is the only provider and the practice is his own- what should i do to get these paid??????

have you verified that his tax id, and npi are correct, and that the tax id is linked to that npi

medauthor

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Re: bcbs group npi
« Reply #2 on: March 11, 2010, 10:54:02 PM »
Wharta,

If he is a solo provider and his 'billing entity' is NOT a type 2 NPI, you cannot put his individual NPI in 24J.  If services are provided in his office (not a satellite office), then blocks 32 and 33 should match EXACTLY, including the NPI in 32a and 33a.  What does he mean "He has a group NPI, but doesn't use it" ???

If he is a solo provider, but his 'billing entity' is registered as a Type 2 NPI, he MUST use the Billing Entity name and the Type 2 NPI in both 32a and 33a; the tax ID # in block 25 should match the billing entity in 33; if he has an EIN # linked to the 'group', then that is what belongs in 25.  Now, when I say 'group', I do not necessarily mean more than one; Even though his name may be John Doe, MD; if he registered himself as an LLC or INC whether using his name or a business name ( ABC Family Care), you must use THAT name and NPI in 32 and 33; hope this helps!!  Feel free to email me at michelle@pmbausa.com if I have confused you.
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

PMRNC

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Re: bcbs group npi
« Reply #3 on: March 12, 2010, 05:49:04 PM »
YES..

To simplify..  The NPI and Tax Info EIN  MUST MATCH EXACTLY.. even if there is an initial off, or anything off, it will reject! The two files MUST match EXACTLY!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

wharta

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Re: bcbs group npi
« Reply #4 on: March 13, 2010, 06:07:32 AM »
THANKS EVERYBODY , I AM GOING TO MAKE SOME CHANGES AND I HOPE THIS DOES IT! :D