ANSI 837 - Florida Blue - BCBSF

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Florida Blue 837 P Companion Guide 2012NPI Attributes Technical Information837 Professional NPI Taxonomy Zip + 4 DigitPROVIDER TYPE IG BC Loop SegmentDataElement IG BC Loop SegmentDataElement IG BC Loop SegmentDataElementBilling Provider R R 2010AA NM1 09 S R 2000A PRV 03 S R2010AA N4 03Pay To Provider S S2010AB N4 03Rendering Provider S R2310B2420A NM1 09 S S2310AReferring Provider S S* 2420F NM1 09Ordering Provider S S* 2420E NM1 09SupervisingProvider S R2310D2420D NM1 092310B2420A PRV 03Purchase ServiceProvider S S 2420B NM1 09Service Facility S S2310C2420C NM1 09 S RLegend:R - RequiredS - SituationalBlank – N/A *Important Note: For Ancillary Providers, see Billing Requirements pg. 19IG - Implementation GuideBC - Blue Cross2310C2420C N4 03241 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012
Florida Blue 837P Companion Guide 2012IX.Helpful Tips: How to Avoid Provider Identification Errors for Claimsinvolving National Provider Identifier (NPI) and Tax ID number.Below are reminders to help you reduce the number of WEBV040 and WEBV042 claimserrors displayed when claim data (or information) does not match informationregistered with Florida Blue.A. Billing Provider SectionThis section is used to provide information regarding the billing provider for servicesrendered. It should match the name written on the check or electronic funds transferfrom Florida Blue.i. OPTION 1: If you are registered as a group provider (PA, LLC, etc.) with FloridaBlue and you want to bill as a group provider, enter the appropriate group name,Tax ID number and the group NPI (type 2).0. THE MATCH: Group Name matches Group NPI matches Group Tax IDii. OPTION 2: If you are registered as an individual provider with Florida Blue andyou are billing as an individual provider, please enter your name, Social SecurityNumber and your individual NPI (type 1).0. THE MATCH: Individual Name matches Individual NPI matches IndividualSocial Security NumberB. Rendering Provider SectionThis section is used to provide information regarding who performed the services. It isthe provider who actually sees the patient.iii. OPTION 1: If you billed as an organization (PA, LLC, etc.) list the name of therendering individual provider and the rendering individual NPI.iv. OPTION 2: If you billed as an individual, do not list a rendering provider. Thiswould be redundant as the billing individual would be the same as the renderingindividual. Submitting redundant information can cause a different providercorrectable error.Below is an example to assist you in understanding the appropriate entry of billing andrendering provider information to reduce the number of returned claims.25900-3398-1112005010X222A1Florida Blue December 2012
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ANSI 837 - Florida Blue - BCBSF

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