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Fill and Sign the 2000 Instructions for W 2 and W 3 2000 Instructions for W 2 and W 3 Wage and Tax Statement Form

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Guidance on Obtaining the Best Results When Using NPIs for Organizations Transaction Type Scenario Aetna Processing Explanation Guidance Claims A health care provider has multiple Organizational (type 2) NPIs and uses one or more of them in claims. Aetna uses the tax ID number and provider name and address information to identify the billing provider. If needed, the NPI is also used to identify the billing provider. Use the most appropriate Organizational NPI for the billing provider on claims. Unless you have told Aetna that you want a particular NPI used on your electronic remittance advice (ERA), the billing provider NPI you use on the claim will be returned on your ERA. Claim Status Inquiry A health care provider has multiple Organizational (type 2) NPIs. The provider submits an Organizational NPI in a claim and later submits a claim status inquiry transaction using the same Organizational NPI and is unable to locate claims. Aetna may have selected a provider record associated with a different NPI. If no claim status inquiry requests are associated with that record, no claims will be found. For professional claims, submit claim status inquiry transactions using the provider’s Individual (type 1) NPI or use the NPI associated with the entire organization. Eligibility A health care provider organization, including individual providers with differing reimbursement levels, is enumerated with a single Organizational (type 2) NPI. That Organizational NPI is used in the eligibility transaction. Aetna’s response will not contain benefit detail levels specific to particular providers within the organization. For example, Aexcel®-designated providers will not receive Aexcel-designated benefit detail levels. Submit eligibility inquiry transactions using the provider’s Individual (type 1) NPI. Transaction Guidance When Using Organizational (type 2) NPIs Transaction Type Scenario Aetna Processing Guidance Precert Add The requesting provider shares a single NPI across multiple providers or specialties. Aetna must select one provider record for processing and response. The selected record may not be the intended facility, department or specialty, resulting in an unexpected provider name returned in the response. The requesting provider/facility name returned in the response will not affect the validity of the precert add request. The requesting facility shares a single Organizational (type 2) NPI across multiple facilities, departments or specialties. The admitting or attending provider or facility shares a single Organizational (type 2) NPI across multiple providers, specialties, departments or facilities. Precert Inquiry The inquiring entity shares a single Organizational (type 2) NPI across multiple facilities, departments or specialties. Use an Individual (type1) NPI, if available, for attending and admitting providers. Aetna must select one provider record from among those linked to the Organizational NPI to compare with the member’s precert history. The selected record may not be the intended facility, department or specialty, resulting in no matches being returned. Inquire using the Individual (type1) NPI, if available, of one of the attending, admitting or primary care providers. Or, use your Aetna provider ID number (PIN) if your system offers this option. Precertification inquiry transaction is not a HIPAA mandated transaction. It does not require an NPI for provider identification purposes. Transaction Guidance When Using Organizational (type 2) NPIs Transaction Type Scenario Aetna Processing Guidance Referral Add A referring provider shares a single NPI across multiple providers or specialties. Aetna must select one provider record for processing and response. The selected record may not be the intended facility, department or specialty, resulting in an unexpected provider name returned in the response. Use the Individual (type 1) NPI for the referring provider (PCP/Gyn.) Aetna must select one provider record from among those linked to the Organizational NPI, to compare with the member's referral history. The selected record may not be the intended facility, department or specialty, resulting in no matches being returned. Use the Individual (type 1) NPI of any provider in the appropriate specialty who is affiliated with the organization to which the patient was referred. Or, Use your Aetna provider ID number (PIN) if your system offers this option. The “referred to” organization shares a single Organizational (type 2) NPI across multiple departments or specialties. Referral Inquiry The inquiring entity shares a single Organizational (type 2) NPI across multiple facilities, departments or specialties. Use the Individual (type1) NPI of any provider in the appropriate specialty who is affiliated with the organization to which the member is being referred. Or, refer to a specialty/taxonomy code. Referral inquiry is not a HIPAA mandated transaction. It does not require an NPI for provider identification purposes.

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