Reminder: Mid-level practitioners are required to file using their NPI
HealthKeepers, Inc. provides benefits for covered Anthem HealthKeepers Plus services rendered by nurse practitioners (NPs) and physician assistants (PAs) when operating within the scope of their license. Our policy states that these mid-level practitioners are required to file claims using their specific NPI number — not that of the medical physician.
We will continue to monitor this area of concern through medical chart review and data analysis. Billing noncompliance can be considered a contract breach.
HealthKeepers, Inc. recognizes the quality of care delivered to our members can be improved by the proper use of NPs and PAs. This notice is in no way intended to discourage their proper use, but rather to clearly define how services should be appropriately billed.
Thank you for your continued participation. If you have any questions about this communication, call Provider Services at 1‑800‑901‑0020 or Anthem CCC Plus Provider Services at 1‑855‑323‑4687.
March 2020 Anthem Provider News - Virginia