Blue Cross Newsletter
 

 

April 17, 2008

 

BC-08-08
HP-08-04
SA-08-04




 

HHA-08-04
DC-08-05

To: All Blue Cross Contracting Providers
From: Julie Hatesohl, Education Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association
Subject:

National Provider Identifier – Implementation Complete May 23, 2008


On May 23, 2008, Blue Cross and Blue Shield of Kansas will complete the implementation process for national provider identifier.  Starting on this date, the only health care provider identifier that will be allowed on electronic or paper transactions to BCBSKS will be the national provider identifier (NPI).  Other types of identifiers (legacy numbers, UPINs, etc.) will no longer be accepted.  

  • NPIs will be required on all claims received by BCBSKS starting May 23, 2008.  Service date is not a factor.
  • This includes all new and corrected claims, electronic and paper.
  • Applies to all provider fields that are part of either the 837P/CMS 1500 or 837I/UB-04 billing formats.
    • primary provider fields are billing, pay-to and rendering;
    • secondary provider fields (applicable to 837I/UB-04 billing only) include attending provider, operating physician and other provider.  (UPINs will no longer be accepted.) 
  • Electronic inquiry transactions (270/271 eligibility and benefit inquiry or 276/277 claim status inquiry) must reflect the NPI.
  • NPIs must be used on any BCBSKS online Web functions (i.e. online precertification, etc.) that require a provider identifier. Other identifiers such as UPIN or legacy numbers will no longer be accepted.
  • Data that BCBSKS returns to the provider will also identify health care providers with an NPI.  This includes remittance advices (electronic and paper), Web functions, etc.  

Blue Cross and Blue Shield of Kansas appreciate your efforts and cooperation throughout this successful implementation process for national provider identifier.