HNS Policy 

 

All claims submitted to HNS must include the name and the Type I NPI number of the provider that actually rendered the services reported on the claim form. Your signature on the healthcare claim form is an attestation that you provided the services.

 

The Type I NPI number of the rendering provider must be included on each service line in box 24J on the CMS 1500 claim form. If you have a Type II NPI number, place your Type II NPI number in boxes 32a and 33a of the CMS 1500 claim form.

 

Exception: If services were provided by a locum tenens ("fill-in") provider and all locum tenens requirements have been met, services provided by the "fill-in" provider may be submitted under the name/NPI number of the provider who contracted with the "fill-in" provider. For more information, please refer to the policy on Locum Tenens Providers for requirements regarding locum tenens billing.

 

If you are in a group practice or share call coverage with other providers or have an independent contractor working in your office, take special care to assure the accuracy of the rendering provider's name on each claim submitted.

 

If you discover that a claim (or claims) was submitted incorrectly with the wrong rendering provider's name, you must promptly file corrected claims to correct the error. Your prompt recognition of this and your immediate correction can reduce payor concerns of suspected fraud and abuse.