Blue Shield of Illinois requires NPI in all provider loops

As of March 28th 2008 Blue Shield of Illinois is requiring the NPI number to be sent on eClaims in all provider loops. If the provider does not submit electronic claims with this NPI format you may get the following claim rejections:

Exclusion Examples

HU 0019C:INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE EQUAL TO XX
HU 0020C:INVALID PAY-TO PROVIDER ID QUAL - IN LOOP 2010AB, NM108 MUST BE EQUAL TO XX
HU 0021C:INVALID CLAIM REF PROV ID QUAL - IN LOOP 2310A(PROF), NM108 MUST BE EQUAL TO XX
HU 0022C:INVALID CLAIM REND PRV ID QUAL - IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE EQUAL TO XX
HU 0023C:INVALID CLAIM PUR SRV ID QUAL - IN LOOP 2310C(PROF), NM108 MUST BE EQUAL TO XX
HU 0024C:INVALID CLAIM SRV FAC ID QUAL - IN LOOP 2310D(PROF)/2310E(INST), NM108 MUST BE EQUAL TO XX
HU 0025C:INVALID CLAIM SUP PROV ID QUAL - IN LOOP 2310E(PROF), NM108 MUST BE EQUAL TO XX
HU 0026C:INVALID CLAIM ATTEND PHY ID QUAL - IN LOOP 2310A(INST), NM108 MUST BE EQUAL TO XX
HU 0027C:INVALID CLAIM OPERATE PHY ID QUAL - IN LOOP 2310B(INST), NM108 MUST BE EQUAL TO XX
HU 0028D:INVALID SRV LINE REND PRV ID QUAL - IN LOOP 2420A(PROF)/2420C(INST), NM108 MUST BE EQUAL TO XX
HU 0029D:INVALID SRV LINE PUR SRV ID QUAL - IN LOOP 2420B(PROF), NM108 MUST BE EQUAL TO XX
HU 0030D:INVALID SRV LINE SRV FAC ID QUAL - IN LOOP 2420C(PROF), NM108 MUST BE EQUAL TO XX
HU 0031D:INVALID SRV LINE SUP PROV ID QUAL - IN LOOP 2420D(PROF), NM108 MUST BE EQUAL TO XX
HU 0032D:INVALID ORDERING PROVIDER ID QUAL - IN LOOP 2420E(PROF), NM108 MUST BE EQUAL TO XX
HU 0033D:INVALID SRV LINE REF PROV ID QUAL - IN LOOP 2420F(PROF), NM108 MUST BE EQUAL TO XX

If you get these rejections call your medical billing software vendor immediatly to identify where to place your Blue Shield of Illinois Provider NPI number correctly. Rebill all claims from the time you started getting these Blue Shield of Illinois NPI rejections.

To read more about Medicare updates including Billing Health Insurance Information check out Medicare Medical Coding and Billing Courses

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