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Provider Identification Numbers (PINS) To properly identify and verify the credentials of physicians and limited licensed practitioners Health insurance companies issue Provider Identification Numbers (PINs). Prior to billing for professional services each individual provider must be correctly credentialed and assigned PINs to ensure correct application of reimbursement. Filing a new application may not always be necessary. Many physicians may have been assigned a PIN while practicing at a different location within a carrier's geographical area. In this situation, only a change or addition to, the practice address location may be necessary. Each insurance company has specific policies regarding the activation date of the PIN. The Medicare carrier usually activates the PIN corresponding with the date of state licensure. Inquires to insurance companies may clarify the activation date of a PIN, and will assist in establishing the specific criteria for claims submission prior to the assignment of the PIN. In general, service claims for physicians without PINs should be held until the PIN is issued. Service claims should be submitted substituting one physician provider number for another. The correct provider of service should be identified for all claims. It is important to obtain PINs for limited licensed practitioners whether the non- physician practitioner plans to submit services independently or not. As reimbursement policies expand, and claim submission requirement change, all limited license practitioners must obtain PINs. Group numbers are issued to physicians who wish to receive payment under one tax identification number. The group number is issued separately over and above the individual PINs assigned to the physicians. Maintaining the group's membership is important to avoid potential billing and reimbursement errors. New members should be added, and past members should be deleted. In addition to obtaining PINs and group numbers, it is vital to enroll all new practitioners under the electronic submitter number for the group. Insurance companies will not accept electronic claims for unidentified physicians.
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