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Tax ID numbers

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ste:
I bill for a provider that has 5 or 6 patients covered by a specific insurance company. Claims for one of these patients are denied because the tax ID no. I am using (the one and only one I use for this provider) has been canceled and the provider has another one in use. The provider has no recollection of ever using another tax ID number. The insurance company will not tell me what the new Tax ID number is because it is a HIPAA violation, and they are reluctant to give me any information about the new number. Other patients with the same insurance are unaffected. From my perspective it seems like a problem the provider needs to work out with the insurance company. However, the provider gives me the “this is what I am paying you to do” or the “don’t bog me down with paperwork” routine. Any suggestions on how I should cautiously tread to solve this problem?
Steve   

Michele:
I would call the insurance carrier with the eob of the denial due to the tax ID#, and an eob from the same carrier for a patient that got paid.  When they say that the claim was denied due to the provider's tax ID, then I would provide them with the paid claim information and ask why that claim was paid since it had the same info on it.  Also, regarding HIPAA, you are not asking for anything regarding PHI, you are asking about the provider file for the provider you are working for.  I know they won't give you the EIN, but they should be able to explain why/when the info changed from the info you are providing them with.

Michele

dekenn:
Also, if it happens to be a secondary claim, it might be coming over (such as from medicare) with a different id number.  that's the problem I'm having.  Medicare uses his ssn, but all insurance companies have ein as id number. i'm in the process of correcting it (i think!), but i have one insurance company that repeatedly denies the claim when it comes with the other number, even though we have called and requested that they link the two together.

PMRNC:
The insurance company cannot and will not provide information on the EIN, it's an IRS violation and yes it is a HIPAA violation as well. What I would do is contact the IRS and yes the provider is going to have to get his hands dirty with this. Just explain this EIN was in existence prior to you taking over and he needs to get this taken care of with them. Deactivate the prior one if not being used and then you will need a W9 to the carriers to make sure the proper EIN is linked.

Lisa@srts-inc.com:
I have had this happen a few times, especially when the NPI's took effect.  One situation I was able to get the info from the insurance company when I gave them my client's ss# and date of birth, if that doesn't work your client will have to call,  but I would get every detail you could for them ahead of time.....the phone #, all the prompts they will need, all the patient info and exactly what they need to ask........make it as simple as possible.

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