NPIs required on ALL claims

Effective May 23, 2008, your NPI number is required on all electronic HIPAA transactions, including electronic claims, otherwise the transaction will be rejected. Additionally, if your legacy provider number (BCBSAZ assigned proprietary number) appears on an electronic transaction, even though your NPI is also present, the transaction will be rejected. This is consistent with CMS interpretation of the NPI Final Rule that CMS (Medicare) has published and CMS guidance.

Your NPI must also be used on all paper claims effective May 23, 2008. We have converted our claims processing system to utilize the NPI as the primary provider number. Lack of your NPI may delay claim processing and could result in a returned claim if BCBSAZ is unable to process the claim without your NPI. The NPI requirement does not apply to atypical¹ providers.

For Dental Providers: Effective Sept. 8, 2008, BCBSAZ will require the use of the new dental claim form (ADA version 2006). All paper claims received after that date that are on older versions of the form will be returned to the provider.

To learn about electronic claim solutions, please visit azblue.com/EDI or contact BCBSAZ eSolutions at (602) 864-4844 or (800) 650-5656.

If you have not done so already, please forward a copy of your NPI confirmation to BCBSAZ via mail or fax to the following:

Attn: Provider Network Administration
BCBSAZ
P.O. Box 13466
Phoenix, AZ 85002-3466
Fax: (602) 864-3142

¹Atypical Providers – Atypical providers, as defined by HIPAA, cannot obtain an NPI, therefore, BCBSAZ will assign a proprietary provider ID. This proprietary ID must be used when submitting CMS 1500 (08/05) claims in field 33b.