| Q: |
What type of NPI does HealthPlus require? |
| A: |
Type I NPI: for ALL individual providers Type II NPI: for ALL ancillary (hospital, clinics etc) providers |
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| Q: |
In what fields do I place my NPI? |
| A: |
Billing field= NPI of the CONTRACTED physician (NO PA’s, NP’s etc)
Rendering field= NPI of who actually performed the service (this could be the NPI of a PA, NP or like provider). |
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| Q: |
Can I submit my HealthPlus number on my claim, with my NPI? |
| A: |
Yes, you can, but it is not necessary. Claims are paid from the NPI. |
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| Q: |
Do I have to bill HealthPlus electronically? |
| A: |
No. At this time, HealthPlus has not gone paperless, however electronic claims submission is the most efficient and timely way to submit and process claims. |
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| Q: |
If I bill paper claims, do I have to use a NPI? |
| A: |
No. At this time, NPI numbers are only required on electronic claims, however, if you are billing on paper, your claims MUST include your HealthPlus number or you claims will be rejected. |
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| Q: |
You have the wrong NPI number for me…how do I change it? |
| A: |
You may submit corrected NPI information (in writing), by faxing
(810) 230-2081. Please mark your fax with URGENT NPI INFORMAITON. A representative will contact you within 48 business hours, to confirm receipt and resolution. |
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| Q: |
I submitted the correct NPI information on my claim, but HealthPlus changed it. |
| A: |
HealthPlus will never change or alter claims. If you use a claim vendor, you should contact the vendor to ensure what you submitted to them, is what they submitted, on your behalf, to HealthPlus. If you submit directly to HealthPlus, please provide a copy of what you submitted to us and we will research the issue and get back with you. |
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| Q: |
Where did HealthPlus obtain my NPI? |
| A: |
NPI’s were received or collected from: PHO’s, written confirmation from the provider, NPPES website (this is the government website, where ALL provider NPI’s are listed) and new provider contracts. |
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| Q: |
What is a taxonomy code? Do I need one? |
| A: |
A taxonomy code is assigned to a provider, based upon the specialty information provided, at the time they applied for their NPI number. ALL providers have one, HOWEVER you do not need to use your taxonomy number on HealthPlus claims unless you were contacted directly by HealthPlus and asked to utilize your taxonomy. |
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| Q: |
Why do I have to bill with a NPI and taxonomy code? |
| A: |
One of the purposes of a taxonomy number was, to assist in the configuration and mapping of providers with unique contract or billing arrangements. If you were contacted, by HealthPlus, and asked to include your taxonomy code on your claims, it is essential that you bill claims with BOTH your NPI and your taxonomy. Without BOTH components, your claims with reject. |
