Blue Cross Blue Shield of North Dakota (BCBSND) has noticed a discrepancy in how the National Provider Identifier (NPI) is being used and would like to ask providers to check their National Plan and Provider Enumeration System (NPPES) registration to ensure they are registered with the correct NPI type.
There are two “types” of NPI’s that apply. They can be defined as below:
- Type 1 NPI is reserved for an individual practitioner
- If a business is registered with the IRS as a sole proprietorship, that Type 1 NPI can also be used as the billing NPI
- Type 2 are reserved for group practices (more than one practitioner) as well as hospitals and suppliers. Businesses must register a Type 2 NPI through NPPES.
- The group would need to communicate that new NPI to BCBSND as well as using it as the billing NPI on claims
If you are not set up properly or need to be set up with a different provider type, you will need to update your information with NPPES. Once all steps are completed within NPPES, fill out the “Update Provider Information" form by logging into Availity Essentials, and clicking on Resources in Payer Spaces.
If you have additional questions, please email email@example.com.