Edit 02056


Invalid NPI and MMIS Supervising Provider ID Combination

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N297
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: N/A

Potential Causes:
The submitted Supervising Provider NPI is not on the New York State NPI registration file as belonging to the same provider as the submitted Supervising Provider MMIS Provider ID.

Solution:
Check to ensure the submitted NPI and MMIS Provider ID are correct for the Supervising Provider. If the NPI and MMIS ID are correct, then the state registration file is incorrect. The provider must contact the NYS Medicaid Enrollment Unit at 518-402-7032.

837 Professional

Loop 2310E NM1 (Supervising Provider Name) NM109 (Supervising Provider Primary Identifier) REF (Supervising Provider Secondary Identification) REF02 (Supervising Provider Additional Identifier) - or - Loop 2420D NM1 (Supervising Provider Name) NM109 (Supervising Provider Primary Identifier) REF (Supervising Provider Secondary Identification) REF02 (Supervising Provider Additional Identifier)