Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 50

Reporting Requirements and Specifications

Last amended: 2006Year: 2006Length: 211 wordsOfficial source
50 - Reporting Requirements and Specifications (Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06) In order to facilitate report generation and data collection regarding IHS physicians, practitioners and services, the designated A/B MAC (B) shall assign PINs to each IHS physician and practitioner in a manner that will allow the designated A/B MAC (B) to ascertain which facilities are IHS, Indian tribe or tribal organization. For example, the designated A/B MAC (B) may establish PINs that will allow the identification of each IHS facility, Indian tribe, and tribal organization facility. Providers request Unique Physician Identification Numbers (UPINs) from the registry. PIN assignments will allow the identification of each IHS, Indian tribe, or tribal entity and the generation of the following reports from the PINs: • Names, locations and number of IHS entity enrollments; • Names, locations and number of Indian tribe or tribal entity enrollments; • Names, locations and number of individual practitioner enrollments; • Names and number of reassignments; • Receipt, pending and processing times for all applicants; and • Allowed charges and allowed frequencies, per quarter, by Current Procedural Terminology (CPT) code and modifier, for each provider. NOTE: Beginning May 23, 2007, it is mandatory that the National Provider Identifier (NPI) be used in place of UPINs and PINs.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 50: Reporting Requirements and Specifications | Justis AI