Troubleshooting: NPI Numbers on Claim Forms or Superbills

Healthie's insurance billing makes it easy for you to create CMS 1500 claims and submit them (electronically or physically) to an insurance company for reimbursement for services. Claims can be created in Healthie and then downloaded as a txt file or exported directly to Office Ally. Alternatively, you can create a Superbill to send to your client for possible reimbursement. 

To save time when completing forms, information like NPI numbers for providers, referring providers, and billing providers auto-fill into a claim form. This prevents you from having to enter NPI numbers every time a Superbill or insurance claim is created. 

However, there may be instances where you find the wrong NPI number has populated into a field, and perhaps a claim has been denied. This articles walks through where/how NPI numbers are populated in Healthie. We recommend that you review your claim form or Superbill for each of these fields, to verify that the correct NPI number is being populated. 

NPI Numbers on Claim Forms 

Below are the sections of the Healthie claim form, and how the NPI number is populated onto the claim form. Please review each of these sections of your claim, and check that the NPI number in each of these sections is correct. If you create a claim and edit one of these NPI number fields, it will auto-fill into all subsequent claims as such. 

For example, if you put an individual provider's NPI number as the Billing Provider NPI spot when completing a claim for a client, Healthie will auto-fill that individual NPI on subsequent claims. Please use care when editing the NPI fields on a firm, knowing that it may affect future claims. 

Rendering Provider NPI > Box 24J and Box 31

Review Rendering Provider details here. 

Referring Provider NPI > Box 17a 

Review Referring Provider details here.

Billing Provider NPI > Box 25 and Box 33 

Review Billing Provider details here. 

Service Facility NPI > Box 32 

Review Service Facility details here (including how to remove and NPI number for a Service Facility) 

Verify Updates to Your Claim Form 

If you've followed the steps above, and checked that all of your NPI fields are correct, we suggest that you update the claim form and export it as a PDF. This will allow you to view the claim as it renders on the red-ink CMS 1500 claim form. You can review each field where an NPI number maps to ensure that the form is now correct, prior to submitting (or resubmitting) your claim. 

If you still are not seeing the proper NPI numbers population, please email hello@gethealthie.com with the following information: 

• Email address associated with your account 
• The client name that you've created a claim for
• The correct NPI number that you would like to populate, into which field (ie. Box 33) 
• Screenshots or PDF rendering of the claim (Claims > Actions (three dots) > Export as PDF) 

NPI Numbers on Superbills 

On a Superbill, a NPI number can be populated for the Provider, and the Referring Provider. 

If you have created a Superbill for this client in the past, the NPI number will auto-fill the next time you create a Superbill. 

We recommend that you pay extra attention to editing the NPI number or using an NPI number that is not this provider's individual NPI number. For example, if you use a group NPI number (NPI 2) in this field - the NPI 2 will auto-fill in the future, and may be associated as this providers NPI 1. 

If you'd like to add a second NPI number to a Superbill (ie NPI 2) please follow the steps here. 

When creating a Superbill, you have the option to select a referring provider. Referring Providers can also be managed in your Settings > Business > Referring Providers. When added here, Referring Providers will be available in the drop-down option of the Superbill. 

The NPI number that you've added to the Referring Provider details will automatically populate into the claim form. 

However, if you edit the NPI number for the Referring Provider directly on the Superbill, take note of the following: 

• On subsequent Superbills for this particular client the new NPI number for the Referring Provider will automatically populate 
• The Referring Provider details in your settings will not update with the new NPI. You will find that the original NPI number will populate in other client claims form. 

Remove NPI Number for Medicare Claims 

When adding a Service Facility, NPI number is a required field. However for Medicare billing, you may need to have NO NPI number associated with the facility. 

If this is the case, please send us an email to hello@gethealthie.com and request that a Service Facility be added to your account without an NPI number. Our support team will be able to add it on the back-end for you, and it will be rendered as a drop-down option for you to select. 

Please include the following Service Facility details in your email:

• Facility Name 
• Facility Address (Street, State, Zip) 
• Place of Service Code 

Additional Support

If you still are not seeing the correct NPI numbers populating, please email hello@gethealthie.com with the following information: 

• Email address associated with your account 
• The client name that you've created a claim or Superbill for
• The correct NPI number that you would like to populate, and into which field (ie. Box 33) 
• Screenshots or PDF rendering of the claim or Superbill