National Provider Identifier (NPI) valid for Medicare Advantage claims
A valid National Provider Identifier (NPI) number is required when submitting Medicare Advantage claims. CHPW previously suspended claims and searched our claims system for a valid NPI for your provider. If a valid NPI was found, the claims were released from hold and processed as usual.
CHPW received a notification that the Centers for Medicare & Medicaid Services (CMS) are implementing software changes to their systems to accept and process encounter data. CMS will validate the submitted billing provider NPI for all Durable Medical Equipment (DME), Institutional, and Professional Encounters submitted by Medicare Advantage Organizations (MAOs), including CHPW, for all Dates of Service (DOS) from 01 / 01/2011 onwards. Invalid NPI encounters will be rejected.