May 23, 2008 is here! Are you using your registered NPI?
Claims submitted without a registered NPI after May 23, 2008, will reject. You must register your NPI with AmeriHealth prior to submitting claims. Register your NPI online with AmeriHealth now.
Claims submitted with invalid NPIs will be rejected
Each claim must pass an NPI check-digit validation to ensure that it has a valid NPI. To date, many claims are not passing this check-digit validation. Claims that fail the check-digit validation after May 23, 2008, will reject. The most common reasons why claims are not passing the NPI check-digit validation are:
- the wrong provider identifier is entered in an NPI field;
- the NPI is entered incorrectly;
- the number entered is not a valid NPI.
As of May 23, 2008, in accordance with the CMS mandate, providers must use the NPI as the primary identifier on the claims, and AmeriHealth will reject claims with invalid NPIs on or after this date.
General NPI Information
The NPI is a unique ten-digit identifier being issued to all health care providers by the CMS as mandated by the federal government via the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The NPI eliminates the need for multiple identifiers from different health plans. All covered entities under HIPAA must obtain an NPI. We began requiring participating providers to use their NPI in all electronic and paper health care transactions on May 23, 2008.
How to obtain an NPI
Providers who have not yet obtained their NPI may apply for it through an easy,
web-based application process that takes approximately 20 minutes to complete online.
You may also call the National Provider Identifier Enumerator call center at 1-800-465-3203 to request a paper application.
Please note: The most time-efficient way to obtain an NPI is to complete the web-based application process.
Once an NPI application has been successfully processed, the applicant will receive an NPI confirmation notice, including a ten-digit NPI issued by the Enumerator. Web applicants will receive confirmation via email; paper applicants will receive confirmation via standard mail.
How to Register your NPI with AmeriHealth
Registering your NPI with AmeriHealth is easy. Once you have obtained your NPIs, you may register online using our NPI Provider Registration Web Form. All providers (participating and nonparticipating) may register using the appropriate online form.
Participating providers may also register their NPIs with us by mailing their completed custom NPI Submission Form. This form has been included in mailings to participating provider offices.
Contact your network coordinator with questions regarding the new Provider Registration Web Form or your custom NPI Submission Form.
