BWC’s National Provider Identifier implementation plan
BWC will allow providers to incorporate their National Provider Identifier (NPI) into the bureau’s billing processes. Providers may incorporate NPI at their own discretion if it fits their business processes.

The bureau does not view NPI as replacements for the BWC provider numbers already assigned. Instead, BWC views NPIs as alternates or additional identifiers providers can use in Ohio workers’ compensation billing.

The federal Health Insurance Portability and Accountability Act (HIPAA) protects the privacy of patients' medical records and other health information maintained by covered entities. BWC is not a covered entity under HIPAA. Therefore, the bureau will continue to accept bills containing only BWC legacy (or current) numbers, as well as bills with both the legacy number and the NPI.

The bureau is making changes to add NPI information to its database to cross-reference BWC provider numbers. This will permit BWC to continue processing bills in a way that is accurate and consistent with laws, rules and policies governing payment of workers' compensation medical benefits.

Providers wishing to incorporate NPI into their workers' compensation billing must provide and verify their information with BWC’s provider relations department. Providers should submit copies of their NPI confirmation from the enumerator (Fox Systems Inc.) along with their corresponding BWC provider number to the fax number or address below.

Fax to:
BWC Provider Enrollment
(614) 621-1333

Mail to:
Ohio BWC Provider Enrollment
P.O. Box 182031
Columbus, OH 43218-2031.

Once this process is complete, a provider may bill using either his or her BWC provider number or a combination of both the BWC provider number and NPI (and taxonomy code if applicable). Again, BWC does not require providers to use NPIs for billing.

Providers who wish to transition to billing BWC using their NPI information only should first bill using both identifiers (the BWC provider number plus the NPI). BWC will add new explanation of benefit codes to remittances to confirm it has added NPI data to a provider’s record. Once confirmed, the provider may choose to bill using the NPI rather than the BWC provider number. BWC plans to be able to handle either scenario by May 23, 2007.

You can find revisions and updates to the line-by-line instructions for invoices (UB-04 and CMS-1500) and new explanation of benefits related to NPI in chapter 4 of BWC’s Billing and Reimbursement Manual.

Any provider still needing to obtain an NPI may do so at https://nppes.cms.hhs.gov

Please be aware that BWC can only accommodate NPIs on forms for the billing processes noted above. The bureau is looking to accommodate future use of NPIs on other medical documents but is not set up to do so at this time. BWC has instructed managed care organizations to identify medical providers using NPIs on any form other than a bill, attempt to cross-reference their information, and then inform the provider to use its BWC provider number until the bureau can accommodate NPI in other processes.

You may direct questions about submitting NPI information by calling 1-800-OHIOBWC weekdays between 7:30 a.m. and 5:30 p.m. When you call, listen to the options to reach BWC’s provider relations contact center.