Rendering Provider NPI Reporting Requirement

Rendering Provider NPI Reporting Requirement 

December 17, 2015

Effective Jan. 1, 2016, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan will require you to report the rendering provider National Provider Identifier (NPI) on all claims if it is different from the billing provider NPI. Any claim we receive without the rendering provider’s information will result in a claim denial.

We will accept corrected claims if your office happens to omit the rendering provider information. We recommend you submit the claims electronically using My Insurance ManagerSM on our website at www.BlueChoiceSC.com for faster processing. Follow these directions to submit your corrected claim:

  1. Log in to My Insurance Manager. 
  2. Go to the Patient Care menu and select Professional Claim Entry, then the Plan Information page will appear. 
  3. Select a Plan and indicate whether the Plan is the primary payer. 
  4. Enter the Date of Service, then select Continue for the Provider Information page to appear. 
  5. Select the billing location, rendering provider and/or referring provider when prompted, then select Continue for the Patient Information page to appear.
  6. Manually enter the required patient information or select Choose a Patient to populate the fields, then select Continue.
  7. When the Claim Information page appears, use the Claim Type menu to select Replacement of Prior Claim.
  8. Enter the prior claim number in the required field, then select Continue for the Claim Line Information page to appear.
  9. Enter all of the required fields on each line, to include the rendering provider NPI in the Rendering Provider Information section, then select Continue.
  10. After reviewing your claim, select Submit to confirm the claim information you entered. 

You can submit hard copy corrected claims that include the rendering provider NPI as well by filing to the address on the back of the member’s ID card. This may, however, result in slower processing.  

If you file through a clearinghouse, please contact your vendor for additional information about submitting corrected claims.

Please contact your area Provider Education representative for information about this bulletin or the general Provider Education area at provider.education@bcbssc.com or by calling 803-264-4730

BlueCross® BlueShield® of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.