Paper Claims

Effective August 1, 2008, Wellmark will require a National Provider Identifier (NPI) on paper claims. Claims received after July 31, 2008, using legacy provider number(s) only, will reject.

Wellmark will validate the NPI by matching the billing and rendering provider numbers, the first date of service or admit date, and the provider tax identification number. If this claim information does not match information previously reported to Wellmark, the claim will reject.

Paper Submitters: Rejected claims and reject messages will be found on the provider remittance. The claims will reject with the message X249: ‘Provider/attending physician information is missing/invalid. Please correct and submit new.

Starting November 15, 2008, Wellmark will reject claims that are submitted with both the NPI and legacy provider numbers.

CMS-1500
The CMS-1500 has been revised from version 12/90 to version 08/05 to accommodate the NPI.

UB04 (revised UB92)
The UB04 replaces the UB92. In addition to other changes, the UB04 form enables hospitals and other institutional providers to submit their NPI.

Copyright© 2008 Wellmark, Inc. All Rights Reserved.
Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.