Performing Provider Number Not Identified as Part of the Group Billing Number

Rejection Message

PERFORMING PROVIDER NUMBER NOT IDENTIFIED AS PART OF THE GROUP BILLING NUMBER

Rejection Details

This rejection indicates that the rendering provider NPI is not linked to the group NPI in the payer's
system.

Resolution

Please contact the payer to link the rendering provider to the group NPI or determine if the provider should be billing as an individual.

When all corrective actions are completed, rebill and resubmit all affected claims.

If necessary, follow the instructions below to set up a claim override for the provider in order to bill to the payer as individual:

1. Click Settings > Providers. The Find Provider window opens.
2. Look for and open the provider record. The Edit Provider window opens.
3. Click on the Claim Settings tab.
4. Click Add. The Override Claim Setting window opens.
5. Click Insurance Company. The Select Insurance Company window opens.
6. Look for and select the insurance company.
7. Change the NPI drop-down to Bill with Individual NPI Only.
8. (If necessary) Click “Override NPI” if a different Individual NPI needs to be entered.
9. Click Save all the way out (multiple saves may be required).

Then, rebill and resubmit all affected claims.