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NPI Contingency Plan
The Centers for Medicare and Medicaid Services (CMS) have provided updated guidance regarding the implementation of NPI. As a result, health plans may develop contingency plans to ensure smooth provider payment cycles while working reasonably and diligently toward full compliance for up to 12 months after the May 23, 2007 NPI compliance date.
To avoid delays in claims payment and processing after May 23, 2007, CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc. (CareFirst BlueChoice) appreciate your cooperation in following our 3-step contingency plan as stated below.
1.) Submit Legacy IDs on 837 Electronic Claims after May 23, 2007
CareFirst and CareFirst BlueChoice will require that electronic claims contain the provider’s legacy ID number after May 23, 2007. (A legacy ID is your provider ID number assigned by CareFirst/CareFirst BlueChoice.) Providers may also submit both the legacy ID and the NPI using a “dual use” approach until further notice.
For more information about dual use, please refer to our NPI Dual Use Companion Guide.
2.) Submit Legacy IDs on Paper Claim Forms after May 23, 2007
Providers are encouraged to use the current CMS 1500 (12/90) version of the professional claim form and the UB-92 version of the institutional claim form. By doing so, you will submit paper claims with a legacy provider ID number, as you do today. We will accept the new CMS 1500 (08/05) and UB-04 versions of the forms, but they must include a legacy provider ID number. The use of NPI is optional.
3.) Continue to Use Legacy ID Numbers for Inquiries and Referrals
Providers must continue to use their legacy ID numbers when sending inquiries, writing referrals, and accessing the BlueLine and FirstLine Voice Response Units, CareFirst Direct, iEXCHANGE and IASH.
If you have any questions, please send an e-mail to NPI@carefirst.com or contact Provider Services.
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