Hi Michelle, Per NHIC (the California Medicare Intermediary) and CMS, until the national standard for Health Plan ID (HPI) is effective, there is no national list for payer ID. Therefore, from a HIPAA compliance standpoint, providers can use any value including a provider-defined value in the HPI.
However, the HPI is used on the 837P claims by payers to identify routing. Medicare uses the HPI in the 2330B loop to identify the Medigap number, so it can electronically cross over its claims. Therefore, the 2330B loop must contain the Medigap number on Medicare claims if the secondary payer is Medigap. WebMD, a national clearinghouse, uses the payer ID in the 2010BB loop to identify the payer within its network to which the claim is routed. WebMD assigns these payer IDs. Per WebMD, in assigning payer ID, they use the NAIC code if the payer has one. However, most payers do not. If the payer does not have an NAIC code, WebMD creates a payer ID using an internal standard. Hope this helps. Thank you, Kathy Carlin, Principal Consultant Siemens Medical Solutions Voicemail 610-219-2067 [EMAIL PROTECTED] --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
