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evans1035:
Ok, so from what I could tell from Medicare's IVR system (when I could get a response and it didn't hang up on me), they say all the claims I resubmitted under her new group npi have been approved to pay and the amount, although it is apparently too soon for them to have actually sent the funds to her bank acct.
  Now my next problem is to figure out what needs to be done with the commercial carriers as far as her npi. I believe her indiv NPI is already attached to her tax ID #, since I was seeing both on some of the carrier eobs (like Aetna and United Beh Hlth), but then which npi needs to go in now on claims? Do both NPIs go in and if so, which one goes in which box?  I called United Beh to see where to send a notice of the new NPI and the person I spoke to told me that they will only go back to the beginning of the month they get the notification, so I called my clearinghouse and told them to send the 9/10 claims with the indiv npi on them when I resend them, so now I'm trying to make sure it goes to clearinghouse with correct npis in correct places.
I am going around in circles at this point, I think.

Michele:
It is really better to have all insurance carriers set up with the same info.  I would go for the individual NPI for the rendering provider (box 24J on the CMS) and the group npi & EIN for the billing provider info.  EIN in box 25, Group NPI in box 32A & 33A.  I would get all carriers set up that way ASAP, otherwise you are looking at a billing nightmare, especially on claims that are crossed over by Medicare.

evans1035:
Michele,
Thank you so much for the response. From everything I've been reading, I can see that's how it should be, but I'm still unclear as to if she needs a new indiv npi under her group npi, or can just use the one she's had all this time.
  For Medicare, my clearinghouse person said they sent the new claims in with both her individual NPI and new organizational NPI on them. I just checked the automated system again and they said all those claims are processing, and that approved amt is 64.41 and pd 51.53. I'm hoping the reason no funds have been disbursed yet is that it hasn't been 14 days yet.
  Also, when I checked on the automated system, I put in her group PTAN, not an individual PTAN. My clearinghouse said on the claims Medicare no longer wants to see PTANs anyway, so they were sending in both old indiv and new NPIs, so I'm worrying that since they deactivated her old indiv NPI they won't actually pay in spite of what the automated system said. Thanks for the help. Carol

Michele:
A provider can only ever get one individual NPI.  That stays with them for ever.  They would never have two individual NPI's.  It sounds like you should be fine from this point.

Michele

evans1035:
Thanks for the response Michele. It took a long time to sink into my head that the identifier is just that, and identifier, not a tax id. I've been calling my client's main carriers to see what they will require to add the org npi. Not only does every carrier give different answers, but the people don't seem to clearly know the answer either. I called BCBS of CO yesterday after looking on their website. There is a provider change form there and on there it says "You do not need to do a W-9 if the TIN is not changing." Well, it's not, and all the carriers with exception of Medicare had her TIN tied to her indiv NPI anyway, yet woman @BCBS says we have to fill out a w-9 and send a formal letter to add the org npi. I kept asking for clarification of why the website said one thing and she was telling me another, and she let me speak to the supv who also said we had to do the w-9. How do I straighten things out when the carriers' online info and prov svc reps don't say the same thing?
Carol

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