Wednesday, February 24, 2016

Billing NPI and Rendering NPI in ADA form

Your NPI and Tax ID are required on all claims, in addition to your provider taxonomy and specialty type codes (CMHCs, FQHCs, RHCs and PCCs) using the required claim type format (CMS – 1500, UB-04 or Dental ADA) for the services rendered. Please note, for Community Mental Health Centers (CMHCs) billing on a CMS 1500, the rendering and billing NPI information cannot match. As of October 1, 2013, Kentucky Department for Medicaid Services (KDMS) requires that all NPIs, billing and rendering addresses and taxonomy codes be registered and appear on their master provider list (MPL). Claims submitted without these numbers or information that is not consistent with the MPL will be rejected.

To avoid delay or disruption of claims payments, please share this information with individuals involved in claims and billing for your organization, billing vendors and/or electronic claims clearinghouses. When submitting an electronic claim to one of our clearinghouses, be sure to include the Humana – CareSource electronic payer ID number KYCS1.

To submit a paper claim, please mail a completed form to:
Humana – CareSource Claim Submissions
P.O. Box 824
Dayton, OH 45401-0824

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