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Thursday, July 1, 2010

Insurance deny the claim - PROVIDER NUMBER IS MISSING OR INCOMPLETE

PROVIDER NUMBER IS MISSING OR INCOMPLETE

Description:


CMS1500 form Items/Box #24K and #33 are filled out incorrectly, with the UPIN (unique provider identification number) or information is missing, thus causing a denial of the claim.

Action :

 For item 24K, enter the personal identification number (PIN) or national provider identifier (NPI) of the performing provider of service/supplier if you are a member of a group practice. When several different providers of service or suppliers within a group are billing on the same form CMS-1500, show the individual PIN or NPI in the corresponding line item.

For item #33, enter the provider of service/supplier's billing name, address, ZIP code, and telephone number. These are required fields. Enter the PIN (or NPI when implemented), for the performing provider of service/supplier who is a member of a group practice. Suppliers billing the DMERC should use the National Supplier Clearinghouse (NSC) number in this item. Enter the group UPIN, including the two-digit location identifier, for the performing practitioner/supplier who is a member of a group practice.

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