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Medicare Advantage Outreach and Education Bulletin Anthem Blue Cross and Blue Shield Ordering/Referring NPI Requirements The Centers for Medicare & Medicaid Services (CMS) require that all physician

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How to fill out orderingreferring npi requirements

01

Gather all the necessary information such as name, address, and contact details of the ordering/referring provider.

02

Verify if the provider meets the eligibility requirements for obtaining an NPI.

03

Access the National Plan and Provider Enumeration System (NPPES) website.

04

Create an account or log in to the NPPES website.

05

Navigate to the 'Apply Online' section and select the 'NPI Application' option.

06

Choose the appropriate option for 'Individual' or 'Organization' based on the type of provider.

07

Fill out the required fields in the NPI application form.

08

Provide accurate and up-to-date information about the ordering/referring provider.

09

Double-check all the entered details for any errors or inaccuracies.

10

Submit the NPI application and wait for the confirmation.

11

Keep the NPI number on record for future reference and use in healthcare transactions.

Who needs orderingreferring npi requirements?

01

Ordering physicians

02

Referring physicians

03

Nurse practitioners

04

Physician assistants

05

Physical therapists

06

Occupational therapists

07

Speech-language pathologists

08

Clinical social workers

09

Clinical psychologists

10

Chiropractors

11

Podiatrists

12

Dentists

13

Optometrists

14

Osteopaths

15

Medical groups or practices

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What is ordering/referring NPI requirements?

Ordering/referring NPI requirements are guidelines set by the Centers for Medicare & Medicaid Services (CMS) that require healthcare providers to include the National Provider Identifier (NPI) of the ordering or referring provider on certain claims for services.

Who is required to file ordering/referring NPI requirements?

Healthcare providers who order or refer services for Medicare patients are required to file ordering/referring NPI requirements.

How to fill out ordering/referring NPI requirements?

Healthcare providers can fill out ordering/referring NPI requirements by entering the NPI of the ordering or referring provider in the appropriate field on the claim form.

What is the purpose of ordering/referring NPI requirements?

The purpose of ordering/referring NPI requirements is to ensure that claims for services are properly documented and that the ordering or referring provider can be identified.

What information must be reported on ordering/referring NPI requirements?

The ordering or referring provider's National Provider Identifier (NPI) must be reported on ordering/referring NPI requirements.

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