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FAQs

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NPI, You & BCNEPA:
Frequently Asked Questions (FAQs)

  1. When can I begin submitting my NPI on my electronic claims submissions to BCNEPA?

You must first register your NPI with BCNEPA. A confirmation letter will be sent to you from BCNEPA. Once you receive the confirmation letter you may begin submitting your NPI.

For more information on how to register your NPI, please click on BCNEPA NPI Registration Info.

  1. Will BCNEPA accept my electronic claims after 5/23/07 if I do not submit an NPI?

Yes. We will continue to monitor provider claim submissions for NPI. In November 2007, we will determine the date in which we will no longer accept electronic claims with out NPI.

  1. Will BCNEPA accept my electronic claims after 5/23/07 if I continue to submit my BC/FPH Provider ID in addition to NPI?

Yes. We recommend using both numbers during your transition to NPI compliance.

  1. Will I be required to submit my NPI on paper claims submissions to BCNEPA?

Health plans may choose to require that paper claims include the same data elements, codes, and identifiers that are required by the HIPAA regulations for electronic transactions.

BCNEPA recommends providers submit their NPI when submitting paper claims.

  1. When can I begin submitting my NPI on my 1500 paper claims submissions to BCNEPA?

You must first register your NPI with BCNEPA. A confirmation letter will be sent to you from BCNEPA. Once you receive the confirmation letter you may begin submitting your NPI.

Please note: You must be using the new version of the 1500 claim form. The old version of this form does not allow for NPI.

BCNEPA strongly recommends you include your BCNEPA/FPH ID in addition to the NPI on all paper claim submissions.

For more information on how to register your NPI, please click on BCNEPA NPI Registration Info.

  1. When can I begin submitting my NPI on my 1450/UB paper claims submissions to BCNEPA?

You must first register your NPI with BCNEPA. A confirmation letter will be sent to you from BCNEPA. Once you receive the confirmation letter you may begin submitting your NPI.

Please note: You must be using the UB-04 claim form. The UB-92 version of this form does not allow for NPI.

BCNEPA strongly recommends you include your BCNEPA/FPH ID in addition to the NPI on all paper claim submissions.

  1. Will my NPI be on my paper Remittance Advice (RA) from BCNEPA?

The NPI will appear on your paper RA beginning 7/1/2007, if you have registered your NPI with BCNEPA.

  1. Will my NPI be on my 835 Remittance Advice (RA) from BCNEPA?

Your NPI will appear on your 835 Remittance Advice from BCNEPA, if you have registered your NPI with BCNEPA and submit your claims with your NPI.

  1. Will I be required to submit a taxonomy code to BCNEPA?

BCNEPA requires taxonomy codes on all claims. Please refer to the following BCNEPA Provider articles

Click here for more information.

Click here for more information.

  1. What taxonomy code should I submit to BCNEPA?

BCNEPA requires you to submit the taxonomy code(s) assigned to you by BCNEPA. The BCNEPA-assigned taxonomy code will be sent to you in your confirmation letter when you register your NPI with us.

Please also refer to question 9

  1. Where do I enter my taxonomy code on 1500 paper claim form submissions?

Click here for more information.

Where do I enter my taxonomy code on 1450 paper claim form submissions?

Click here for more information.

  1. What if my NPI confirmation letter shows two different taxonomy codes for one physician? Will I have to bill both?

If a provider holds multiple contracts and credentials with First Priority Health he/she is assigned taxonomy codes for each.

Providers are required to bill the specific taxonomy code from the confirmation letter on their claim indicating the specialty they are performing.

The taxonomy code helps BCNEPA determine which contract to apply to the claim. If the wrong taxonomy is submitted, your claim may not process correctly. How does BCNEPA get my NPI?

  1. Does registering my NPI with BCNEPA also register my NPI with other health plans?

BCNEPA's relationship with Highmark Blue Shield enables BCNEPA to register your NPI with Highmark. Registering your NPI with BCNEPA does not register your NPI with any health plan other than Highmark.

  1. Will I need to know the NPIs of other health care providers?

You may need to know the NPIs of other health care providers to fulfill billing requirements including, but not limited to, NPIs of attending physicians, referring physicians, prescribing physicians, operating physicians, and the facility where the service was rendered.

Please refer to your billing manual for the specific product for which you are billing. This manual will advise you if this information is required.

The billing manuals are available on-line at WWW.BCNEPA.COM

  1. Will my NPI appear in the BCNEPA Provider Directory?

BCNEPA will publish NPIs in the Provider Directory for PCPs only. The NPI will be published in addition to the FPH Provider number in our 2007 publication. In 2008 NPI will replace the currently published FPH number for PCP offices.

  1. Where do I enter my NPI on 1500 paper claim form submissions?

You must first register your NPI with BCNEPA. A confirmation letter will be sent to you from BCNEPA. Once you receive the confirmation letter you may begin submitting your NPI.

Please note: You must be using the new version of the 1500 claim form. The old version of this form does not allow for NPI.

BCNEPA strongly recommends you include your BCNEPA/FPH ID in addition to the NPI on all paper claim submissions.

For more information on paper/1500 claim form submissions, click here

  1. Where do I enter my NPI on 1450/UB paper claim form submissions?

You must first register your NPI with BCNEPA. A confirmation letter will be sent to you from BCNEPA. Once you receive the confirmation letter you may begin submitting your NPI.

Please note: You must be using the UB-04 claim form. The UB-92 version of this form does not allow for NPI.

BCNEPA strongly recommends you include your BCNEPA/FPH ID in addition to the NPI on all paper claim submissions.

Click here for more information. 

  1. Can I use my NPI when making inquiries to BCNEPA?

Yes, if you have registered your NPI with BCNEPA, you may use your NPI when making inquiries to BCNEPA.

  1. Will I receive a separate RA for each Subpart?

Yes, if the Subpart is registered with BCNEPA.

  1. Where can I find more NPI FAQ?

You can find additional NPI Frequently Asked Questions (FAQ) on the Centers for Medicare & Medicaid Services (CMS) web site. 

If you have questions that were not answered in this FAQs section, click here to submit your question.