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If you have questions regarding NPI, please view the NPPES NPI Registry, or call the NPI hotline at (800)465-3203, which is a government organization that assigns the NPI numbers.
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Disclaimer: MacPractice cannot be held responsible for any claim rejections you receive as the result of our recommendations and suggestions. It is your responsibility to be aware of the exact requirements for each of your insurance carriers and to set the software up accordingly. It is advisable to contact your carriers before you make any of the changes recommended in this documentation. |
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Facility NPI Number
The Facility NPI Number is entered in the Facility Reference. To enter this information, go to the References ability > Facility node in the sidebar. Click the triangle to the left of this to expand the node, then select the facility record. The National Provider ID (NPI) field is located at the bottom of the record.
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The Facility NPI number will appear in Box 32a on the CMS 1500 Claim Forms.
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Referral NPI Number
The Referral NPI can be entered in the Referrers Reference. Go to the References ability, select and click on the triangle to the left of the Referrers node to view your referrals. Select the referral, and the NPI field will be in the top portion of the window in the second row.
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The Referring Provider NPI number will appear in Box 17b on the CMS 1500 Claim Forms.
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Individual NPI Number
There are two types of NPI numbers: Type 1, which are used for individuals; and type 2, which are used for groups. Which number you use will depend on whether you have credentialed as an individual or a group with your insurance payers. MacPractice Support will not have this information.
The Individual NPI number will be entered in the Users Reference. Go to the References ability > Select the Users node in the sidebar on the left, then expand this node to view the list of Users. Select the Provider user, and go to the Provider tab > Claim Credentials sub-tab. Enter the NPI number into the National Provider ID (NPI) field.
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The Individual NPI will appear in Box 24j and Box 33a on the CMS 1500 Claim Forms.
The Individual NPI will also appear in Box 49 and Box 54 on the ADA Claim Form.
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Group NPI Number
Generally, the Group NPI number will be entered in the Offices Reference. Go to the References ability > Select Offices in the sidebar, then expand this node to view your office record. The Group National Provider ID Number field is located in the lower right corner.
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If you have multiple groups within your office, this group NPI can be overridden on a per-provider basis. In the provider's User Reference under the Provider tab > Claim Credentials sub-tab, the Group National Provider ID (NPI) field below the individual field.
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The Group NPI will appear in Box 33a on the CMS 1500 Claim Forms.
The Group NPI will also appear in Box 49 on the ADA Claim Form.
Medicare and Other Insurance Requirements
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If you have many carriers now accept NPI Only claims, you can set the CMS-1500 (02/12) NPI Only form as the Default Insurance Claim Form by going to the Forms Preference.
Other Insurance Requirements
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This can be done through the Insurance Companies Reference's Claims tabTab, then update the Default Form drop down menu to the required claim form.
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