Tuesday, May 20, 2008

DHS/MediCal NPI Update

Beginning May 24, 2008, Medi-Cal and the Child Health and Disability Prevention (CHDP) program will no longer accept claims billed with a Medi-Cal legacy provider number. Providers who have registered their National Provider Identifiers (NPIs) but have not submitted claims using their NPI are strongly encouraged to start submitting NPI claims now to avoid interruption in claim payments. Providers who have not already registered their NPI with Medi-Cal may have their claims rejected.

Medi-Cal previously announced that providers would no longer need to use both sets of identifiers on claims because the Department of Health Care Services (DHCS) was able to accept an NPI only, effective December 17, 2007. Providers who were not ready to transition to the NPI were informed they could continue to submit their Medi-Cal provider number until instructed otherwise.

In February 2008, providers were reminded that once a claim was submitted with an NPI, the associated Medi-Cal “legacy” provider number(s) would be end-dated. In other words, effective for dates of service beyond the date of a claim submitted with an NPI, the Medi-Cal provider number would no longer be valid. Using the associated Medi-Cal provider number(s) following a claim submission with an NPI results in claim denials for subsequent dates of service.

DHCS plans to deactivate all Medi-Cal and CHDP legacy provider numbers as early as May 23, 2008. The only exception is atypical providers: Multipurpose Senior Services Program (MSSP), Christian Science Practitioners and blood banks. These providers may continue to use only their nine-digit Medi-Cal provider numbers.

This information is available on the Medi-Cal web site in the following link: http://files.medi-cal.ca.gov/pubsdoco/npi/articles/npi_9364.asp

Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the NPI page on the Medi-Cal Web site.

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