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Questions asked about NPI
All answers below pertain to L&I. If you have questions about other insurers' use of NPI, call them directly.
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Are you currently accepting the new CMS 1500 and UB-04 paper claim forms?
Yes. - When will you stop accepting the old HCFA 1500 and UB-92 paper claim forms?
As of May, 2007, L&I no longer accepts these forms.
- Do you require the health plan's qualifier on the paper claim forms?
No. The X5 qualifier is not required on paper claims. However, we strongly recommend you include it on your bills. Use the following format to submit the qualifier and the health plan's ID for the provider: X5####### (# = your L&I provider number).
- How do I correct previously submitted NPIs?
L&I: For individual providers or bulk updates, call Provider Accounts at 360-902-5140.
CVC: Call CVC Provider Accounts at 360-902-5386.
Self-insurers: To submit or change your NPI with self-insurers, call them directly. - What are the specific identifiers and taxonomy codes required on transactions?
Please see our table under the Billing info tab.
- In what loops will L&I be populating the NPI on the 835 Remittance Advice?
It does not report the provider's NPI unless you have made prior arrangements with the Electronic Billing Unit at 360-902-6511 or ebulni@Lni.wa.gov. The legacy ID is the default.
- On what types of bills can I choose to submit only my NPI?
On paper bills: After you register your NPI, you have the option to submit only the NPI.
On electronic transactions: After you register your NPI and possibly after you have tested with us. See our table under the Billing info tab to determine if you need to test with L&I before you use only your NPI to bill electronically. - Will L&I and CVC stop accepting Legacy IDs?
No.
L&I: Will accept Legacy IDs on both paper bills and electronic transactions.
CVC: Will accept Legacy IDs on paper bills. - When will L&I and CVC require the NPI?
L&I and CVC: will not require the NPI as long as the Legacy ID is submitted on the bill. After you register your NPI, you have the option to submit only that number.
- How does L&I use the taxonomy code?
Taxonomy codes can assist us to correctly pay providers who have more than one Legacy ID.
- Can you handle different taxonomy codes for the same provider?
No, if for multiple services on the same claim.
Yes, if across multiple claims. - How do I correct a taxonomy code submitted to L&I or CVC in error on a bill?
Because we do not accept electronic corrections or adjustments you would need to submit a Provider Request for Adjustment form (245-183-000).
- Does L&I comply with best practices for electronic processing of corrections to claims?
No. Because we do not accept electronic corrections or adjustments, we're not in total compliance with these best practices. For more information on these best practices see the Best Practice Recommendations for HIPAA Transaction Exchange site.
