The Return to Group Provider button displays at the top and bottom of the page. It returns the user to the NPI Reporting page for the group provider for this rendering provider. Any changes made to the page are retained for the duration of the session, however, they are not saved unless the Save Changes for this Provider button is used. For more information on the NPI Reporting page, see the NPI Reporting Page section of this manual.
Figure 4.1 – NPI Reporting – Rendering Provider Page, Upper Portion
Figure 4.2 – NPI Reporting – Rendering Provider Page, Lower Portion
Provider/NPI Information Section
In this section the user can perform several activities regarding each service location currently on file for the rendering provider.
Expand All Rendering Providers Button
This button expands the page to show all rendering providers currently on file for this group provider number.
Rendering Provider Subsections
In each rendering provider subsection, the rendering provider number (nine-digit number) and service location code (alpha character) displays in the green, red, or blue header (Figures 4.1 and 4.2) and the status of the rendering provider/NPI record. .Table 4.2 explains the colors and status.
NPI Reporting Tool User Guide Section 4: NPI Reporting – Rendering Providers
Table 4.2 – Rendering Provider Subsection Header Information
Color Explanation Status Error Messages
Green Indicates an active NPI reporting. Displays Active in the colored header. The provider number, service location, and NPI on file is unique. No conflict.
Active No error message or instructions display
Red Indicates a pending NPI reporting. Displays Pending in the colored header. The provider number, service location, and NPI is in conflict with another record currently on file.
Pending Error (conflict) message displays with instructions
Blue Indicates a provider that has not been reported. Displays Not Reported in the colored header. No provider number/service location/NPI record is on file for this provider.
Not Reported No error message or instructions display
Only rendering providers that are currently active display. All group providers must have at least one service location with at least one rendering provider. Billing providers, group providers, and dual providers are displayed and sorted by provider number.
Selected Taxonomy codes display for Active and Pending provider records.
Error Messages and Instructions
If a conflict exists (Pending), the error message, Conflicts Exist. See below, displays (Figure 3.2).
For each billing provider, group provider, or dual provider, the information that displays is read-only information. The user is given instructions to complete and mail a Provider Update Form to EDS at the address indicated on the form. This form is available on the IHCP Web site at
http://www.indianamedicaid.com/ihcp/ProviderServices/pdf/ProviderUpdate.pdf.
Conflict Error
For NPIs that are reported, but conflict with an identical NPI reported for other rendering provider(s), an error message displays describing the problem. The error message may contain references to one or more rendering providers that are in conflict with this provider’s reporting. Error messages only display for Pending records.
Each reference to a conflicting provider includes the following information:
• Provider Number and Service Location
• Rendering Provider Number, if applicable
• List of Taxonomy codes that are in conflict
The error message states that if the information reported is correct, and cannot be changed, the user must contact EDS Provider Enrollment (1-877-707-5750) for more options. By doing this, the conflict can be researched and resolved.
The following are the error messages that display for conflicts:
3. At this same address has already reported this NPI with Taxonomy code(s) 4. This NPI has been reported by another provider
Step 1) Enter NPI
Type in the NPI number to be associated with this rendering provider number/group provider number/service location combination. Entries in this field are only allowed for rendering provider records with a status of Not Reported (blue).
Users are not required to report every NPI for every provider the first time they access this page. Additional NPIs may be reported at a later time.
For rendering provider records with a status of Pending or Active, any change to the NPI must be done by contacting EDS Provider Enrollment at 1-877-707-5750.
Step 2) Select Taxonomy Codes Button
Clicking this button opens the NPI Reporting – Taxonomy Code Selection window (Figure 4.3). This window allows the user to select Taxonomy codes for the NPI that is being reported.
Taxonomy codes are selected by expanding the Taxonomy type by clicking on the ! (Expanded view) icon. The Taxonomy code specialty list displays and allows for selection of the appropriate Taxonomy codes by clicking on the corresponding checkboxes. One click to mark the box, a second click to remove the mark.
Once Taxonomy codes are chosen, click the Save and Close button to retain the choices or changes.
To reject the choices or changes made on this window, click the Cancel button. Upon returning to the Provider/NPI Information section, the Taxonomy codes are listed in the Taxonomy Codes area.
When the provider is a Waiver provider (Type = 32), a message displays: Waiver Provider – No Taxonomy Codes needed (Figure 4.2).
NPI Reporting Tool User Guide Section 4: NPI Reporting – Rendering Providers
Figure 4.3 – NPI Reporting – Rendering Provider – Taxonomy Code Selection Window
Step 3) Submit Changes for this Provider Button
Clicking this button opens a confirmation box that asks the user: Do you really want to continue with the submission of the reported NPI information? (Figure 4.4).
Selecting the Cancel button returns the user to the NPI Reporting – Rendering Provider page and does not submit the changes.
Selecting the OK button submits the reported NPI information to the NPI crosswalk to verify the uniqueness of the information being submitted.
Figure 4.4 – Submit Changes for this Provider, Response
The NPI information is sent to the server to be evaluated for possible conflicts with other rendering providers who might have submitted the same NPI.
For each Taxonomy code that is reported, the system returns an indicator as to whether or not there is a conflict. If there is a conflict, the system returns a list of the rendering providers involved in the conflict. Only providers under the same Tax ID display.
Add an NPI to the NPI Crosswalk Database
If the NPI does not have a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Active. The effective date is the current date and the end date is open.
If the NPI has a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Pending. The effective date is the current date and the end date is open.
The user is returned to the NPI Reporting page and the page is populated with all of the NPI information that is being stored in the database.
A confirmation message displays to inform the user about the status of the reported NPI(s). The confirmation message varies, based on the status of the reported NPI.
NPIs that are submitted and everything under the Tax ID is Active returns a message that states, The NPI information reported is now available for use.
NPIs that are submitted, but one or more recent reportings are in a Pending status returns a message that reads, The NPI information reported contains a conflict and needs to be resolved before the NPI can be used. Please review messages in red fonts for more information on a conflict restriction.
The generic message that informs the user who to contact with questions about the NPI information reported is displayed: For all questions concerning reported NPI information, please contact EDS Provider Enrollment (1-877-707-5750).
NPI Reporting Tool User Guide Section 4: NPI Reporting – Rendering Providers
Section 5: NPI Reporting History
Overview
The NPI Reporting History reports on provider history through the NPI Reporting History page. The NPI Reporting History page (Figure 5.1) is accessed from the NPI Reporting page by clicking on the View Reporting History button.