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Medicare/BCBS

Jill Benson 9 months ago in Billing/Electronic Modules updated by Tina B 9 months ago 2

Anyone know how to get a noncredentialed Medicare claim out of Procentive to get the denial from Medicare to submit to a secondary BCBS?   We have an interesting situation where Medicare is primary due to the size of the company but clinician is a clinical trainee so the claim will not get out of Procentive to Medicare without a credentialed provider NPI on it.  Trouble is, if it goes out with the credentialed provider's NPI, Medicare pays it.  Thanks.

Have the Clinical Trainee get a NPI:

The NPI is a unique identification number for covered health care providers. All health care providers are eligible for NPIs and may apply for them. Because medical students, interns, residents and fellow are health care providers, they are eligible for NPIs.

Send the claim with with a Medicare Provider as the supervisor and then add GY in place of the HN modifier