For full NPI compliance, remember that legacy identifiers, UPINs, state license IDs, rendering provider tax IDs, etc., are no longer allowed on claim submissions. Including identifiers can cause your claims to be delayed or even rejected. Please check with your vendors to ensure these are not being submitted on our electronic claims.
Use of NPI is mandatory
Humana enforces the use of NPI only on HIPAA standard transactions. HIPAA electronic transactions included under the mandate require use of an NPI. Provider claims (HIPAA 837 I, P and D) must contain an NPI, or they will be rejected by the clearinghouses with which Humana has contracted.
Providers are strongly encouraged to obtain an NPI if they have not already done so and to begin using their NPI on all electronically submitted claims to avoid disruption in cash flow. Please ensure that your practice management system or billing service has your NPI(s) implemented for use on electronic claims.
For providers receiving the electronic remittance advice (HIPAA 835 ERA), Humana is including the NPI with the ERA data once Humana has received the NPI on claims submitted. In the spirit of administrative simplification, and in conjunction with CMS recommendations, providers submitting paper claims are also encouraged to use their NPI.
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