Providers are reminded that once a claim is submitted with a National Provider Identifier (NPI), the associated Medi-Cal “legacy” provider number(s) will be end-dated. In other words, effective for dates of service beyond the date of a claim submitted with an NPI, the Medi-Cal provider number will no longer be valid.

Using the associated Medi-Cal provider number(s) following a claim submission with an NPI will result in claim denials for subsequent dates of service. Once providers begin using their NPI on claim submissions, they are strongly encouraged to continue using the NPI to prevent claim payment interruption.

Note:

Providers defined by the HIPAA final rule and Medi-Cal/CHDP policy as “atypical” will continue to use only their nine-digit Medi-Cal/CHDP provider numbers.

Test NPI-Only NOW
Providers who have been submitting claims successfully during the “dual-use” period with both an NPI and a Medi-Cal legacy provider number are strongly recommended to test the new NPI-only claims process by initially submitting only one or two claims. If these claims are processed successfully, providers are then strongly urged to submit all subsequent claims using only the NPI. The absolute end-dating of the Medi-Cal legacy numbers is May 23, 2008.

Cut-Off Date for Old Proprietary Forms
Medi-Cal proprietary forms were updated to accommodate the 10-digit NPI. Providers have until April 14, 2008 to use up their old proprietary forms. Beginning April 15, 2008, only the updated proprietary forms will be accepted for claims processing. Since July 2007, the updated proprietary forms have been available for ordering from Medi-Cal.