09/11/12 Ask-the-Contractor Teleconference (ACT ... - WPS Medicare

and the doctor was listed. We know this doctor by her published name at the
university but http://www.wpsmedicare.com
she’s in the PECOS or the NPPES with her maiden name and
her last name there. When we searched for her last name, it didn’t come up
because it was in there as her maiden name. And sometimes if you have MD,
that doesn’t work. And sometimes it does work and maybe you know about
these problems or don’t know about these problems, but those are the types
of reasons why we can’t find the referring doctor even in the NPPES because
the names and the search engines don’t work right.
Mary Muchow:
Richard Farley:
Mary Muchow:
Richard Farley:
Mary Muchow:
Richard Farley:
Mary Muchow:
Operator:
I would pick up the phone and call that physician and ask them for that
information. If that physician is referring patients to your office and doing
business with you, then he or she should be providing that information for you
or make it readily available for you.
OK. I don’t want to say their name but it’s like McDonalds kind of name where
– do you put a space between the C and the D or do you not And it’s really
hard sometimes so if you could find where the official list is because we found
several lists in Medicare and NPPES. Is it with the space, without the space,
with the period, without the period
Unfortunately, a lot of that is going to depend on how they fill out the
paperwork when they request their National Provider Identifier. The NPI
contractor does have a searchable database. But again, depending on how
that individual or healthcare provider or entity has gone to the NPI contractor
and filled out paperwork and how, someone from that contractor indeed
entered it into their database it might vary. The best bet is to go to that
provider that you’re doing business with and ask them for their NPI. Tell them
that you need that information to support the claim for the service that they
referred to your office.
OK. Yes, I mean, we have the NPI. It’s just that you also have to put in the
name just right. But in any event, OK, we’ll look for that.
Well, on the claim form, it’s going to be driven by the NPI that you entered
into the appropriate item number on a paper claim or the corresponding
electronic field for an electronic formatted claim.
OK. Thanks.
You’re welcome.
Your next question comes from the line of Colleen Kelleher.
Colleen Kelleher: Hi, I have just one question. Are remittance advices sent to providers who do
not accept assignment and if so, how often
Mary Muchow:
We’re going to follow up on that one, Colleen. If you can give your telephone
number, please.
Colleen Kelleher: Sure. Area code (515) 226-7423. I have asked this at customer service and
I’ve received conflicting information, so I’d just like the straight answer.
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