The National Provider Identifier (NPI) is expected to become the identifier for  
health care providers.  It has not yet been adopted as the standard (that is, the 
Final Rule has not yet been published).  Therefore, implementation of the NPI is down 
the road.  In the meantime, until there is a standard provider identifier in place, a 
"secondary" identifier is required in order to identify the billing provider (as well 
as other providers on the claims).  Most likely the identifier currently used to 
identify the billing provider (UPIN, BC or BS Number, PPO number, etc.) when billing a 
particular health plan is what would be used.

>>> [EMAIL PROTECTED] 10/18/01 01:55PM >>>
Group,

I have a question relating to the Billing Provider Secondary Identification data 
element on the 837 Institutional transaction:

Within the notes section (page 82 of 837 - Institutional Implementation Guide) there 
is a statement that reads:

"[the billing provider secondary identification] is required when a secondary 
identification number is necessary to identify the entity."

My question is this:

Who makes that determination?  What dictates that a secondary identification number 
must be sent?

Any insight is appreciated.

Thanks,
Paul

__________________________
Paul V. Costello
Senior Consultant
CGI (formerly IMRglobal Corp.)
3100 Zinfandel Drive, Suite #250
Rancho Cordova, CA  95670
Phone: (916) 631-7645 ext. 30
Fax: (916) 631-7647
E-Mail: [EMAIL PROTECTED] 

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