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Credentialing

Enrolment, revalidation, NPI and exclusion screening.

7 min read

What OIG Exclusion Screening Actually Requires

You will read a lot of content telling you that monthly exclusion screening is federally required. That is not quite true, and the real answer is more useful. What is mandated, what OIG recommends, and what actually determines your exposure are three different things. Plus the three lists you need rather than one, and why the penalty figure in every article you read is already wrong.

5 min read

NPI Type 1 vs Type 2: Which Number Goes Where on a Claim

Type 1 belongs to a person, Type 2 belongs to a business. Easy enough until you hit the sole proprietor question, where being incorporated changes which number goes in Box 33a. Box 24J is always the individual, and Medicare will reject a group NPI there. Here is where each number belongs, on paper and in the 837P, and the rejections you get when it is wrong.