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National Government Services, Inc.
 Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter
MMR-2008 03B, October 2008

Attention National Government Services Medicare Electronic Submitters Part B New York New Provider Numbering Format

As a result of the EDI Gateway Migration for Medicare Part B NY electronic submitters, there will be a change to the format for entering of provider numbers for both individual providers and group practices.

All electronic submitters were required to migrate to the new EDI Gateway using their new M2 Submitter Number by December 31, 2007 or your claims would no longer be accepted. For more information about the EDI Gateway Migration to the M2 translator, visit our Web site at http://www.empiremedicare.com/edi/index.htm.

New Format
Individual providers/solo practitioners will enter either their six-digit Medicare Legacy Provider Identification Number (PIN) (e.g., #123451), or their ten-digit NPI number in the 2010AA loop segment (billing provider field). Group practices will enter either their six-digit Medicare Legacy Group Number (#W12341), or their ten-digit NPI group number in the 2010AA loop segment (billing provider field).

Rendering/performing providers within the group will enter either their ten-digit PIN from their Provider Enrollment Welcome Letter or their ten-digit NPI individual number into the 2310B loop segment (rendering provider field). The Provider Enrollment Welcome Letter combines both the individual’s number and the group number (e.g., individual #123451 billing in group #W12341 would be entered as 1234512341).

These changes can be put into effect immediately; however, once you migrate to the M2 Gateway, if your claims are submitted with the older format, the files will be returned to you. Please make sure that these changes are contained within the 837P claim submission transaction set before you send the file. If you have additional questions please call the National Government Services Medicare EDI Help Desk at 877-273-4334 or send e-mail to:
NGS.EDI.A@Anthem.com for Medicare Part A
NGS.EDI.B@Anthem.com for Medicare Part B
NOTE: We recommend that all Medicare providers use there NPI number(s) for submission of claims

Part B New York and New Jersey Providers