National Provider Identifier

BWC is planning a two-phased implementation approach that will allow providers to incorporate their National Provider Identifier (NPI) into their BWC billing processes. BWC does not view NPI as a replacement of the BWC provider number assigned, but as an alternate and additional identifier that providers can use in Ohio workers’ compensation billing.

BWC is not a covered entity under HIPAA and will continue to accept bills containing only BWC legacy (or current) numbers as well as bills containing both the legacy number and the NPI.

BWC is making changes to effectively add provider NPI data into its provider enrollment and eligibility database, in order to crosswalk the NPI information received on invoices to the BWC Provider ID. This approach permits BWC to continue to process bills in a way that is accurate and consistent with laws, rules and policies governing the payment of workers' compensation medical benefits.

Providers wishing to incorporate the use of their NPI into their Ohio workers' compensation billing must make sure that they have provided their information with verification to BWC provider enrollment in the BWC provider relations department. Providers should submit a copy of their NPI confirmation received from the Enumerator (Fox Systems Inc.) to the fax or address below.

Ohio BWC Provider Enrollment
FAX (614) 621-1333

Or mail to:

Ohio BWC Provider Enrollment
P.O. Box 182031
Columbus, OH 43218-2031.

Upon BWC’s successful entry of the NPI, providers may bill with their BWC Provider ID or their BWC Provider ID plus NPI (and taxonomy code if applicable). During Phase 1, as bills are processed with both the BWC and NPI identifiers, new explanation of benefit codes will be added to the provider remittance advice to give the provider information regarding the success of their enrollment and use of NPI data in the billing process.

Then, in Phase 2, the provider may, at his or her discretion, bill with the NPI in lieu of the BWC Provider ID. The planned beginning of phase 2 is May 23, 2007.

Revisions and updates to the line-by-line instructions for invoices (UB-04 and CMS-1500) are in BWC’s Billing and Reimbursement Manual available at www.ohiobwc.com/provider/PrvSectionMap.asp.

You may direct questions regarding submitting NPI information to BWC at 1-800-OHIOBWC, and listen to the options to reach BWC’s provider relations contact center between 7:30 a.m. and 5:30 p.m. weekdays.