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Updated Article for National Provider Identifier (NPI) Special Bulletin, No. 205
Information posted July 23, 2007: TMHP has identified a correction to an article published in the June 2007 National Provider Identifier (NPI) Special Bulletin, No. 205, entitled “NPI Contingency Period Announced,” under the subheading “NPI-Only or Prior Submission Options Phase.” The subheading contained sections entitled “Remittance and Status (R&S) Reports” and “ER&S Reports” that incorrectly indicated August 3, 2007, as the date on which R&S and Electronic Remittance and Status (ER&S) reports will include NPIs and related data. The correct date on which the revised R&S and ER&S reports will be available is August 10, 2007. Click on the title to view the details.

Remittance and Status (R&S) Reports

Beginning with R&S reports dated August 10, 2007, TMHP will include a Texas Provider Identifier (TPI), NPI, taxonomy code, and benefit code for those providers who have completed attestation with TMHP. The Provider ID field located in the header of each page will be labeled “TPI,” with the newly added identifiers displayed below the TPI number. Providers who have not completed the attestation process will continue to receive a TPI-only.

A new column titled “Benefit” will be added in the claim detail sections of the R&S report. When applicable, this column will contain the three-character benefit code associated with a claim. (For additional information regarding benefit codes, refer to page 3 of the January 2007 National Provider Identifier (NPI) Special Bulletin, No. 202.)

ER&S Reports

Providers (excluding TDHconnect users) who wish to receive NPI and related data beginning with ER&S reports dated August 10, 2007, must contact the TMHP Electronic Data Interchange (EDI) Help Desk (1-888-863-3638) and have completed provider attestation. Providers may receive ER&S (835) responses in one of two ways:

·         NPI and TPI. Providers may call the TMHP EDI Help Desk to receive the ER&S with an NPI and TPI. The ER&S will also include the taxonomy code and benefit code.

·         NPI Only. Providers may call the TMHP EDI Help Desk to receive the ER&S in an NPI-Only format. The ER&S will include an NPI, taxonomy code, and benefit code.

Providers may also request to receive NPI and related data on pending ER&S (277P) reports beginning with reports dated August 10, 2007. The ER&S will include an NPI, taxonomy code, and benefit code.

Providers who have not completed the attestation process or do not wish to receive NPI data on their ER&S reports will continue to receive a TPI-only on ER&S reports. No action on the part of the provider is necessary to continue receiving the ER&S in a TPI-only format.

For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.
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