Print

NPI Edit Update Notification

March 2, 2009

The following NPI Submission Edit will be set to a Warning ("W") effective March 2, 2009. Effective April 6, 2009, the Warning ("W") be set to a Rejection ("R").

QGE - Billing Tax ID Not a Match to NPI

In order to avoid claim delay and payment, it is imperative that you include the corresponding Tax Identification Number or Social Security Number along with your assigned NPI.

The QGE message requires the "XX" qualifier in LOOP – 2010AA (Billing Provider Name) segment ID, NM108 and the National Provider Identifier in segment ID NM109. The "EI" qualifier requires the corresponding Tax Identification Number or the Social Security Number with "SY" qualifier in segment REFO2.


 
 

Example:

LOOP ID 2010AA – (Billing Provider Name)

NM1*85*1*LAST NAME*FIRST NAME*MIDDLE IN***XX*NPI NUMBER~
N3*BILLING ADDRESS~
N4*CITY*ST*ZIP~
REF*EI*TAX IDENTIFICATION~

     - IF THE NM102 IS AN ENTITY USE THE VALUE “2”.

 
 

The Tax ID or Social Security number on your electronic claim must match the Tax ID/SSN that is currently on our Provider File which should also correspond with your Enumerator letter.

Any Tax Identification updates must be coordinated through our Provider Services Department by submitting the following form:

http://www.bcbsok.com/forms/practice_change_form.pdf 

If you have any questions on these edits, please contact our E-Commerce Center at 1-800-746-4614 for assistance.



View 2009 e-Commerce Alerts