As per NPI regulations and BCBSNM billing instructions, providers belonging to a group must bill all claims with both rendering NPI and billing/group NPI. If both NPIs aren't received, your claims may be processed and paid incorrectly. To ensure the correct provider record is selected for processing claims, it is critical both NPIs appear on your claims. If one or the other is missing, claims will be rejected for incorrect claim submission.
Steps you can take to ensure correctly completed claims if you are a member of a group practice:
- Verify that your individual Type 1 NPI is in the rendering loop of the 837 electronic claim record (box 24J on a paper claim.)
- Verify that your billing or group type 2 NPI is in the billing loop of the 837 electronic claim record (box 33a on a paper claim).
- Verify the tax identification number is correct for the billing group.
