New Provider/Medicare Denial

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ltamulynas
Posts: 14
Joined: Thu Mar 01, 2012 3:36 pm

New Provider/Medicare Denial

Post by ltamulynas » Mon Aug 05, 2013 4:14 pm

Hi,

I recently added a new provider and finally after some months all of her claims are getting paid. I originally had her under 'Individual' instead of filing her claims under group and her NPI/Tax Id was coming up unrecognized from most insurance carriers. I have since changed that and most of the claims have gone through. Except for Medicare they keep denying my claims for missing/invalid NPI. How exactly should I have the new provider set up in Medisoft so that all of her claims get paid under our group name and group NPI. I am not sure if I am missing any codes or ID's that have to go in the provider section. It seems as if they all want to go to her as an individual provider, however she is an associate.

Any help would be great.

Thanks!

:D

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Gavin Walker
Posts: 4139
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: New Provider/Medicare Denial

Post by Gavin Walker » Mon Aug 05, 2013 7:56 pm

First you need to check with Medicare and see how the provider is enrolled. As a group or individual? Then go to the NPI registry on the Internet and make sure and make sure everything is registered out there correctly. Then setup Medisoft to match what Medicare has registered.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777

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