![]() Q: I only provide EAP services and file for reimbursement using the EASI form. If you do not know your Magellan MIS number, contact the Provider Services Line at 1-80 to obtain it. The Magellan MIS number continues to be used (in most cases) as a provider's username when signing in to the Magellan website. Any HIPAA standard electronic transaction sent with a Magellan MIS number will be rejected. Q: Should I include my Magellan MIS number on HIPAA standard electronic transactions?Ī: No. All electronic claims submitted without an NPI are rejected. Magellan requires the NPI on HIPAA standard electronic transactions. Q: Does Magellan require NPIs on all HIPAA standard electronic transactions?Ī: Yes. Q: Where can I find more information about the NPI and CMS' guidance on compliance with the HIPAA NPI Rule?Ī: You can find more about the NPI, including compliance guidance and answers to frequently asked questions, by visiting the Centers for Medicare & Medicaid Services (CMS) website. Important – claims that do not include a TIN will reject. The NPI is for identification purposes, while the TIN is for tax purposes. TINs are required on all claims – paper and electronic. Q: Does my NPI replace my Taxpayer Identification Number (TIN)?Ī: No. Please note: some public sector plans include providers classified as “atypical,” who do not provide healthcare (e.g., transportation providers or non-licensed case management providers), as defined under HIPAA in Federal regulations at 45 CFR section 160.103 these providers are not eligible to receive NPIs. The NPI is required for all healthcare providers covered under HIPAA, including but not limited to Magellan individual practitioners, group members, and organizations. ![]() Magellan expects all providers submitting claims electronically to obtain and use an NPI. Q: Is the NPI required for all healthcare providers?Ī: Yes. The NPI was put in place so that each provider has one unique, government-issued identifier to be used in transactions with all health plans with which the provider conducts business. ![]() ![]() NPIs have replaced all separately issued identifiers, including Medicaid PINs, Medicare UPINs and health plan-assigned identifiers, on HIPAA standard electronic transactions. General InformationĪ: The National Provider Identifier (NPI) is a 10-digit number required on all HIPAA standard electronic transactions. IMPORTANT NOTE: All claims electronically submitted without an NPI will be rejected. ![]()
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