Jul 2, 2019

Did you know that timely filing limits vary based on your state and contract? Find your specific claim timely filing limits in your Provider Agreement.

Did you know that timely fi...
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National Provider Identification (NPI) - Chapter 9, 2019 UnitedHealthcare Administrative Guide

National Provider Identification (NPI)

HIPAA, federal Medicare regulations, and many state Medicaid agencies require health care professionals to obtain and use a standardized NPI. You are required to use an NPI as identification on electronic transactions as outlined in the instructions for HIPAA electronic transaction x12N Implementation Guides. 

State-specific regulations may also require you to submit your NPI on paper claims.

  • To avoid payment delays or denials, you must submit a valid billing NPI, rendering NPI and relevant taxonomy code(s) on all claims and encounters. In addition, we encourage you to submit the referring care provider’s NPI.

The NPI information you report on your claims and encounters helps us to efficiently process claims and encounters and to avoid delays or denials. 

We accept NPIs submitted through: 

  • Link: using the My Practice Profile tool for providers; UnitedHealthcare Facility Demographic Updates tool for facilities. 
  • UHCprovider.com: Sign in and go to “Practice/Facility Profile” and select the TIN. Click “Continue”, select the “View/Update NPI Information” tab. 
  • Fax: Using the fax form on My Practice Profile tool
  • Phone: United Voice Portal (UVP) at 877-842-3210. Select the “Health Care Professional Services” prompt. Say “Demographic changes” and your call goes to the Service Center to collect your NPI, Health Care Provider Taxonomy Codes, other NPI related information. 
  • Credentialing/Contracting: NPI and National Uniform Claim Committee (NUCC) taxonomy indicator(s) are collected as part of credentialing, recredentialing, new provider contracting and re-contracting efforts.

How to Submit NPI, TIN and Taxonomy on a Claim or Encounter

Information is provided for the location of NPI, TIN and Taxonomy on paper and electronic claims on My Practice Profile tool.