Author Topic: Confusion over NPI numbers  (Read 1210 times)

Michele

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Confusion over NPI numbers
« on: March 12, 2008, 06:02:36 AM »
Question

With the transition to the 1500-05...
My hospital has recently purchased a one physician family practice. We did the reassignment on her old Medicare and Medicaid numbers (still in processing) but I wonder if we should have applied for another NPI besides her individual one in order to bill for her services provided and that clinic and the hospital receive payment. We have been working on FL32 and 33 and I am having lots of trouble. Should as the rendering provider be in 32 with her individual NPI and the hospital as the "requesting Payment" provider in 33 with our hospital NPI? (This is where I am wondering about the group NPI issue)
Thanks for your help in advance.
Jamie E
Answer
Hi Jamie,
If you want the payment to come in the hospital name and under the hospital tax ID, then the hospital info (including the hospital NPI number should be what goes in box 33 on the CMS 1500. Then the individual Dr's name would go in box 31, the individual NPI would go in box 24J, and the address of the Dr's office (if the office is not located at the hospital, it would be different than box 33) would go in box 32. Basically, the NPI number in box 33 is the entity that is going to receive payment for the services.
You would only need another NPI number for the Dr if you wanted to bill under a different tax id than the hospital, and a different group name (not the hospital or the Dr's name).
I hope this is helpful.
Michele
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