As previously communicated, AmeriHealth requires the use of taxonomy codes to ensure proper claims processing. If a provider's group National Provider Identifier (NPI) is associated with more than one AmeriHealth specialty, the provider must include the appropriate provider taxonomy code in addition to the NPI on all claims. This allows the accurate matching of the provider's agreement(s) with AmeriHealth. Failure to submit claims with the applicable NPI and correct correlating taxonomy code may result in incorrect claims processing and/or payment delays.
The following examples illustrate how to correctly submit your taxonomy code:
Example 1
Incorrect billing practice |
---|
Billing NPI | Specialty description | Taxonomy code | Taxonomy description |
12345XXXXX | Durable medical equipment | 332B00000X | Durable medical equipment |
Rendering NPI | Specialty description | Taxonomy code | Taxonomy description |
11223XXXXX | Durable medical equipment | 333600000X | Pharmacy |
Correct billing practice |
---|
Billing NPI | Specialty description | Taxonomy code | Taxonomy description |
12345XXXXX | Durable medical equipment | 332B00000X | Durable medical equipment |
Rendering NPI | Specialty description | Taxonomy code | Taxonomy description |
11223XXXXX | Durable medical equipment | 332B00000X | Durable medical equipment |
Example 2
Incorrect billing practice |
---|
Billing NPI | Specialty description | Taxonomy code | Taxonomy description |
12345XXXXX | Home infusion/Durable medical equipment | 3336H0001X | Home infusion/Durable medical equipment |
Rendering NPI | Specialty description | Taxonomy code | Taxonomy description |
11223XXXXX | Home infusion/Durable medical equipment | 333600000X | Pharmacy |
Correct billing practice |
---|
Billing NPI | Specialty description | Taxonomy code | Taxonomy description |
12345XXXXX | Home infusion/Durable medical equipment | 3336H0001X | Home infusion/Durable medical equipment |
Rendering NPI | Specialty description | Taxonomy code | Taxonomy description |
11223XXXXX | Home infusion/Durable medical equipment | 3336H0001X | Home infusion/Durable medical equipment |
If you have additional questions on billing with taxonomy codes, please email us at
providercommunications@amerihealth.com.