NPI update: Changes you may see in the claims payment process
Since mid-November 2006, BCBSTX has been accepting NPI and BCBSTX provider numbers, or BCBSTX provider numbers only on electronic claims. This dual identifier submission period has enabled us to continue to validate and remediate our systems, while at the same time providing you with the opportunity to use and test any modifications made to your electronic claims submission process before the May 23, 2007 compliance date.

Your patience throughout this transition phase has been appreciated, and we would like to make sure you are prepared for the following upcoming changes:

• Beginning April 16, 2007, all checks, Electronic Funds Transfers (EFTs), and Provider Claims Summaries (PCSs) for all claims that were submitted using your NPI will reflect your NPI rather than your BCBSTX provider number.
• During the dual identifier submission phase, it is very important that you submit the appropriate combination of NPI plus BCBSTX provider number on all claims. During the transition to NPI compliance, each unique combination of NPI and existing BCBSTX number will result in a unique payment, payment voucher (PCS), and Electronic Remittance Advice (ERA).
• Some providers will receive multiple payments for the same NPI because, while they have only one NPI, they have multiple BCBSTX numbers. Additionally, multiple NPIs with a single BCBSTX number will yield multiple payments. In this scenario, multiple payments will continue even after you are submitting claims with NPI only if the claims remain mapped to multiple BCBSTX numbers.

All providers are encouraged to contact their local BCBSTX provider network representative prior to April 15, 2007, to ensure that their NPI billing structure will be recognized and their claims properly processed after the May 23, 2007 compliance date.