tci Medicare Compliance & Reimbursement - 2023 Issue Q2

Clip And Save: Update Medicare Provider Enrollment to Avoid PTAN and NPI Issues

Critical: Ensure your PTAN hasn’t been deactivated due to inactivity. If your Medicare Part B claims keep getting rejected due to too many Provider Transaction Access Numbers (PTANs) being attached to one National Provider Identifier (NPI), you may need to check your billing records and enrollment. According to one Medicare Administrative Contractor (MAC), providers continue to have claims denied for PTAN/NPI incompatibility. “Medicare requires claims to contain NPIs to be accepted for adjudication,” explains Part B MAC First Coast Service Options (FCSO) in a release. “NPIs reported on the claims are cross walked to the...

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