Managing NPI Numbers / Medicaid IDs / Tricare/Taxonomy Codes

Adding Provider Identifiers (NPI/Tricare/Medicaid/Referring Provider) and Taxonomy Codes

Adding Provider Identifiers

A NPI (National Provider Identifier) & Tricare number is a unique ID for covered health care providers. These numbers are used on the CMS 1500 form as a way to identify the health care provider(s) for HIPPA standard transactions. 

1. From the left navigation menu click the  icon and select Provider Identifier.
   
2. On this screen you will notice General, Tricare ID, Medicaid ID, and Referring Provider tabs along the top.
   
3. Select which tab you would like to add an ID for.
   
4. Only offices/staff who already have NPIs entered will show up.  Clear the filters to show all offices/staff.  
5. Use the search at the top to locate the staff then add their identifier on the right. 
   
6. On the General Tab, select whether the office/staff is a rendering provider, billing provider or service facility.

Typically, offices are billing providers and service facilities while individuals are rendering providers.  Make sure to check your credentialling and payer contracts to ensure you are billing the correct NPIs.

Adding Taxonomy Codes

A taxonomy code is a unique 10-character alphanumeric code that identifies a healthcare provider's type, classification and area of specialization.  Not all payers require taxonomy codes, but claims can get denied for a not including them if it is required.  Refer to the contract with your payer to see if they are required.

1.  To the right of the NPI number is a section to enter the taxonomy codes.  Make sure to use the taxonomy code that correlates with your NPI number from the NPI Registry.

2.  In order to ensure that taxonomy codes end up on your claims go to Payer > Payer Profile > Billing Rules and under claim settings you can select to "include billing provider taxonomy" and/or "include rendering provider taxonomy" on claims.

Completed appointments will not retroactively add the taxonomy codes.  However, taxonomy codes can be added to individual claims or bulk updated in the Billing Manager.

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