Blue Cross and Blue of Illinois

The following BCBSIL NPI Submission Edit will be set to a Warning ("W") effective March 2, 2009.  Effective April 6, 2009, the Warning (“W”) be set to a Rejection (“R”).

QGE - Billing Tax ID Not a Match to NPI

The QGE message requires the “XX” qualifier in LOOP – 2010AA (Billing Provider Name) segment ID, NM108 and the National Provider Identifier in segment ID NM109.  The “EI” qualifier requires the corresponding Tax Identification Number (TIN) or the Social Security Number (SSN) with “SY” qualifier in segment REFO2.

Example:

LOOP ID 2010AA – (Billing Provider Name)

NM1*85*1*LAST NAME*FIRST NAME*MIDDLE IN***XX*NPI NUMBER~
N3*BILLING ADDRESS~
N4*CITY*ST*ZIP~
REF*EI*TAX IDENTIFICATION~

- IF THE NM102 IS AN ENTITY USE THE VALUE “2”.

In order to avoid claim delay and payment, it is imperative that you include the corresponding TIN or SSN along with your assigned NPI.  The TIN or SSN on your electronic claim must match the TIN/SSN currently on our Provider File, as well as correspond with your Enumerator letter.

Any Tax Identification updates must be coordinated through our Provider Services Department and may be submitted on-line.

Make your tax indentification updates.

If you have any questions on these edits, please contact our E-Commerce Center at (800) 746-4614 for assistance.