Which should I use in transactions? View this document for help on submitting transactions with NPIs for organizations. Has the NPI changed the way Aetna pays claims and to whom? The NPI will now also be used to identify the appropriate provider. Does Aetna require the NPI on paper claims?
The rules only require the use of NPIs on electronic transactions. But we recommend that you send NPIs on paper claims. Should I make the same change in my Aetna claims submissions? Some providers have multiple tax ID numbers. We're aware that other payers, such as Medicare, have asked some providers to submit claims with a different tax ID number than they used in the past.
Utility Navigation Links
But if you make changes to the tax ID number on your Aetna claims, it may affect our ability to process your claims in a timely manner. If you want to change your tax ID number for Aetna, you can notify us as you do with any other demographic update.
You can:. What action do I need to take on these claims to have them processed? Use only the NPI for eligibility, claim status inquiry, referral and precertification. But first you need to send us your NPI. What error codes will I see if my claim submissions are rejected due to lack of an NPI? Depending on the format of your vendor's claim status report, you may see the codes below:. The ERA implementation guide states the following about the CLP "This data element is the primary key for posting the remittance information into the provider's database.
We also recommend that it be used for that purpose rather than matching by provider IDs. Is the NPI from the claim included on the payee's electronic remittance advice, or does Aetna derive the NPI from its internal database?
Provider | Blue Shield of CA
Does the NPI replace the tax ID number on eligibility, claim status inquiry, referral and precertification transactions? Federal rules require submission of the provider's NPI number for eligibility, referral and precertification transactions.
For claim status inquiry, NPI is required in the servicing provider field it should be the same NPI that was submitted on the claim you are inquiring about. What should I do if I get an error message when I try to transmit my NPI in an eligibility, claim status inquiry, referral or precertification transaction?
You can do this by logging in to our secure provider website and selecting "Update Profiles. Other resources for participating providers We post information in our dentist newsletter, Dental Dialog. We also provide information through outreach and industry events. If you have questions, call our National Dentist Line at Links to various non-Aetna sites are provided for your convenience only.
Aetna Inc. Links to ClaimConnect and its content are provided for your convenience. EHG independently develops and maintains its own privacy policies and practices. New User? Dental Providers: Register now for AetnaDental. Submit Search. Join The Network.
National Provider Identifier FAQ
Apply for Participation. Working with Us. Dental Clinical Policy Bulletins. Electronic Transaction Solutions. Linking Dental Care to Overall Health. Insurance Regulations by State. Helpful Links.
Secure Provider Website Link leads to secure site. Update Office Information Link leads to secure site. The NPI is the health care provider identification system adopted by the U. All health care providers that are considered covered entities under HIPAA, and those who file claims electronically or use a clearinghouse to bill insurance, are required to apply for an NPI.
All other health care providers are eligible to receive an NPI if they desire. The NPI will eliminate the need for health care providers to use different identification numbers when conducting business with multiple health plans. Many health plans, including Medicare, Medicaid, and private health insurance plans, and all health care clearinghouses are now required to accept and use NPIs.
- How to do it: Apply for NPI [National Provider Identifier Number].
- Why NPI Numbers are Required.
- free access to birth certificates.
- National Provider Identifier (NPI) Numbers.
- National Provider Identifier.
- Log in to:!
- National Provider Identifier (NPI) | NATA?
Even if you do not bill for services, you may need to disclose your NPI to those providers who do e. Without the NPI, claims may be adversely affected, with payment delayed or possibly denied. There is no charge to get an NPI.
Audiologists and speech-language pathologists can apply online for their NPI, free of charge, by applying online or by contacting the NPI Enumerator to request a paper application. It takes less than 5 minutes to apply online and the number is issued within a few minutes.
Related find a national provider identifier
Copyright 2019 - All Right Reserved