|
5.10.2 Banner Pages
Banner pages serve two purposes. First, they print the provider's name and address in a location that appears in the window of the envelope. Second, they are used to inform providers of new policies and procedures. The title pages include the following information:
• TMHP address for submitting paper appeals.
•Provider's name, address, and telephone number.
•Unique R&S report number specific to each report.
•Provider identifier (TPI, NPI, and Atypical Provider Identifier [API]).
•Report sequence number (indicates the week number of the year).
•Date of the week being reported on the R&S report.
•TIN.
•Page number (R&S report begins with page 1).
•AIS telephone number.
•Taxonomy code.
|
