The National Provider Identifier (NPI) is the 10-digit identification number issued to providers by the Centers for Medicare and Medicaid Services (CMS). The Administrative Simplification portion of the Health Insurance Portability and Accountability Act (HIPAA) mandated the transition from Unique Provider Identifiers (UPINs) to NPIs.
Three Ways to Apply for Your NPI
Updating Your NPI
Wellmark requires an NPI for all claims. Wellmark validates the NPI by comparing:
Wellmark rejects claims that don't match the NPI information captured during the provider enrollment process.
If your Organizational NPI changes, notify Wellmark using our Provider Change Form to ensure more timely and accurate claims processing.
Blue DentalSM Claims
To report your NPI to Blue Dental, please call 877-258-3685 or 515-558-7744.
When someone in the member's family has other dental coverage, send the claim for service to both the primary and secondary insurance plans. Blue Dental will coordinate benefits if a member has coverage under more than one dental plan.
Medicare Crossover Claims
If Wellmark cannot verify your NPI:
Please Note: Adjusted Medicare claims will not cross over to a secondary payer if the original claim was submitted to Medicare without a valid NPI.