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Prospect FAQ's

Frequently Asked Questions Regarding Changes to CKHS TAX ID and NPI Numbers Effective July 1, 2016

With the transition of CKHS to Prospect Crozer, LLC effective 7/1/16, our Tax IDs and NPIs are changing.

Which Tax ID and NPI Numbers should be used to verify Eligibility or request Authorizations / Referrals as of 7/1/16?

Some payers are ready to use our new Tax IDs and NPIs to verify Eligibility or request Authorizations / Referrals as of 7/1/16, however some payers are still loading our new numbers into their claims and eligibility systems and need us to continue to use the old CKHS Tax IDs and NPIs to verify eligibility and request referrals and authorizations until their work is completed. If we try to look up using our new numbers for payers still loading our new information, Crozer-Keystone providers will incorrectly appear to be non-participating providers.

Status of whether to use old vs new Tax ID/NPI for referrals, authorizations and eligibility as of 8/3/16:

Payer

Use OLD CKHS Tax ID and NPIs

Use NEW CKHS Tax ID and NPIs

Aetna Better Health

HAN, hospitals, home health, hospice and ambulance - use new

Cigna Commercial

hospitals, home health, hospice, ambulance, HAN and urgent - use new

Gateway Medicare

hospice and ambulance - use old

hospitals, home health and HAN - use new

Health Partners Plans

use new for all hospital, HAN and urgent

Highmark BS of PA

use old for all hospital and urgent

HAN - use new

Highmark Delaware

use old for all hospital and urgent

HAN - use new

Horizon (BCBSNJ)

HAN, urgent - use old

hospitals, home health, hospice and ambulance - use new

IBC

home health and hospice - use old

HAN, hospitals and ambulence - use new

Keystone First / VIP

use old for all HAN and urgent

hospitals, home health, hospice and ambulance - use new for KeystoneFirst (not VIP)

Magellan

N/A

hospitals use new

Medicaid - FFS

N/A

Medicare FFS

use old for all hospital and urgent

HAN - use new

United and UHCP

use old for all hospital, HAN and urgent

For all payers not listed above,  use CKHS’ new Tax IDs and NPIs as of 7/1/16 to verify eligibility and to request authorizations / referrals.

As each payer completes loading of each of our new TINs/NPIs, they will notify our Managed Care department, who will then email updates to internal contacts; we will also post updates on this page and notify referring providers via email and/or fax.

Billing areas have received their own instructions regarding how to correctly bill each payer using our new numbers.

During this time of transition, most managed care payers will automatically cross walk our authorizations and referrals from our old Tax IDs and NPIs to our new Tax IDs and NPIs – if you experience problems please call the command center!

How will we know when to use the new Tax ID and NPI to verify eligibility and obtain Authorizations / Referrals?

The Managed Care Department has set up email chains to communicate to the department heads or their designee to distribute to all staff members as each payer notifies us it is ready to use our new Tax IDs and NPIs. Updates will also be posted on the Crozer-Keystone website. There may be daily updates, so it is very important that all staff check their emails and that managers communicate updates to all staff as needed.

When will all payers complete the change of Tax ID and NPI numbers in their system?

We anticipate most payers will have completed loading our new Tax ID s and NPIs soon. As each payer notifies us they are ready they will let us know; managed care will email and post updates as they arrive. 

Will this information be provided to all HAN practices and to our medical staff and referring physicians?

Yes - Communications are being sent to all HAN providers, medical staff and referring physicians.  

Will there be any noticeable changes such as increased co-payments? How will patients be impacted by this transition?

There is no change for patient copays, deductible and coinsurance and as Prospect Crozer we are participating with the same payers we had as CKHS. 

What do we do if a referring physician’s office is unaware of the change to our Tax IDs and NPIs or is having difficulty?

If a practice is having difficulty using Navinet, needs a list of our New Tax ID, NPI numbers or cannot obtain eligibility, authorizations/referrals or has other questions please call or email the Command Center. We have representatives to assist by phone or email, or to make an onsite visit to provider offices if needed. If you are unsure of the correct answer, please make a referral to the Command Center!

Please note: Prospect Crozer LLC is a new legal name. As previously communicated, the names of the health system, hospitals and physician network will not change from an external perspective. Our patients will not see any difference in these names found on our signage, publications, marketing materials, etc.

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