Monday, August 13, 2007

Medicare NPI numbers and Clearinghouses

Medicare has identified that some clearinghouses are stripping NPI numbers when forwarding the claims on to Medicare. This of course has a huge consequence to the providers including a false sense of security that your claims are actually going to the carrier correctly and without the NPI these claims will not count towards PQRI participation for eligible professionals (losing your Bonus potential).

If you are using ERA (electronic remittance advice) through your clearinghouse don't be fooled just because you see the NPI number on the ERA form. They have also identified that clearinghouses are "adding" these to the ERA even if the claim wasn't transmitted with them.

Medicare of course can not tell you "which" clearinghouses are doing this so they recommend you call your clearinghouse and ask them. Of coure, are clearinghouses going to actually tell us the truth????

Well, for those who may care I use McKesson and I am getting my Medicare payments with using my NPI number on my claims. If you are looking to switch to another clearinghouse McKesson is really good at what they do. Great support, great knowledge and quick turn around on cases. I do trust McKesson with my claims and ERA's.

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