NPI and taxonomy requirements
To improve payment accuracy and timeliness, bill with National Provider Identifier (NPIs) numbers and taxonomy codes wherever and whenever they apply.
At a minimum, include the following information on both electronic (837i) and paper (UB-04) claims:
- Billing provider NPI, the minimum information needed to process a claim
- Pay-to provider NPI, if different from the billing provider
- Service location NPI, if different from the billing address
In addition to the information applicable to all providers, hospitals are asked to include the following information on both electronic and paper claims:
- Billing provider taxonomy code, a combination of tax ID, NPI, and taxonomy code that replaces the Medicare facility number for hospital payment methodology
- Pay-to provider taxonomy code, if different from the billing provider
Kaiser Permanente's hospital billing requirements are in line with those of Medicare. Like Medicare, we will recognize the following taxonomy codes for hospital units:
Additional taxonomy codes and information can be found on the Washington Publishing Company website.
Electronic 835 remittance advices have been sorted by NPI since May 2008.
Paper remittance advices will include both the NPI and subprovider information in the header.
Checks and paper remittance advice statements will be sent to the billing provider NPI address or pay-to address when supplied. It is important to use the correct billing provider NPI when submitting claims.
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