Thank you very much Jan. I really appreciate the follow-up. 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] ***Confidentiality Notice*** Proprietary/confidential information belonging to CGI (formerly IMRglobal) may be contained in this message. If you are not a recipient indicated in this message (or responsible for delivery of this message to such person), or you think for any reason that this message may have been addressed to you in error, you may not use or copy or deliver this message to anyone else. In such cases, you should destroy this message and kindly notify the sender by reply mail. >>> [EMAIL PROTECTED] 10/19/01 09:15AM >>> Yes, we are saying the same thing using different words. At least until the NPI comes out in final form (and there are seveal key unanswered questions at this point about the NPI), payers can mandate that providers send secondary identifiers beyond the tax ID. This is a business decision on the part of the payer. A business mandate means "I won't pay you unless you send this ID". And yes, a payer can mandate that a provider send a specific ID. It doesn't do United HealthCare much good to get a BC provider identifier, United doesn't keep track of BC's provider Ids. United want's its specific identifier. BC wants its identifier and so forth. j Paul Costello wrote: > I understand that the NPI will be the mandated data element for the primary >identifier for the billing provider, but until then, billing providers can use their >Employer Identification Number (Code = 24) or their social security number (Code = >34) as their primary identifier. > > The IG also requires a secondary identifier in those cases where "a secondary >identification number is necessary to identify the entity." > > Who makes that determination? > > To re-state my original question: since payers will either receive the billing >provider's EIN or SSN on an 837, can the payers also mandate that billing providers >send a secondary identifier? If so, can payers mandate which secondary identifier >must be sent (e.g. BC number , BS number, etc.)? > > Thanks Again, > Paul > > >>> [EMAIL PROTECTED] 10/18/01 02:58PM >>> > The use of the secondary identifier may continue even after the NPI is finalized. >I've brought this up with HHS, but until the NPI is published, they can't really >comment. As a payer, we have IRS responsibilities to report income on a 1099. In >the proposed NPI, there was a possibility that we would not be able to link the NPI >to a FEIN because we would have limited access to the information. We also need to >use the FEIN to match against provider contracts. We hope this is corrected in the >final rule to allow payers to get access to the FEIN, because if it isn't it >decreases the value of a NPI. But if it isn't, I would assume we could require that >the FEIN go in the secondary identifier? Any comments on how anyone is addressing >this? > > >>> [EMAIL PROTECTED] 10/18/01 01:42PM >>> > 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] > > ***Confidentiality Notice*** > Proprietary/confidential information belonging to CGI (formerly IMRglobal) > may be contained in this message. If you are not a recipient indicated in > this message (or responsible for delivery of this message to such person), > or you think for any reason that this message may have been addressed > to you in error, you may not use or copy or deliver this message to anyone > else. 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