Blue Cross Blue Shield of North Dakota (BCBSND) had previously informed providers of an upcoming claim requirement regarding the provider Medicaid identification (ID) number. After further review and consideration, we are going to allow additional implementation time for providers to make system updates.
We will hold off on applying any front-end rejections for Medicaid Expansion 837P or 837I claim(s) submitted without the required provider Medicaid ID number at this time. Please look for an additional Healthcare News article when a new implementation date is determined.
The provider Medicaid ID number will be required on Medicaid Expansion claims in addition to the National Provider Identifier (NPI). A loop and segment should be available to enter the Medicaid ID number along with the correlating G2 qualifier, anywhere the NPI is required. This notice is to provide time for you to work with your clearinghouse, billing service and/or vendor to ensure you meet the requirements. The Availity Essentials provider portal has already been updated with the additional fields for those who need to key a claim.
While we understand this is a change to provider processes and may include provider system updates, we are confident this will help ensure claim accuracy in provider data matching, which in turn helps with timely processing. The NPI is a crucial piece of matching a provider record in our system, the addition of the Medicaid ID will help ensure all additional pieces of data are linked correctly with the files at the (Department of Health and Human Services (DHHS).
Below are the loops that may be applicable when entering in your provider NPI and Medicaid ID information.
The REF segment is used as a secondary identification number other than the NPI which can be necessary for the receiver to identify the provider in some cases.
Example: REF*G2*PROVIDER MEDICAID ID
2010BB – Billing Provider
2310A – Referring Provider
2310B – Rendering Provider
2420A – Rendering Provider
2420F – Referring Provider
2010BB – Billing Provider
2310A – Attending Provider
2310D – Rendering Provider
2310F – Referring Provider
2420C – Rendering Provider
2420D – Referring Provider
For additional questions on Availity Essentials submission fields contact Availity Essentials Client Services at 1-800-282-4548.
Your Medicaid ID number should have been provided to you via a letter from the Department of Health and Human Services (DHHS). If you are unsure what your provider Medicaid ID number is, please contact the DHHS at (701) 277-6999 for assistance.