PROVIDER T.I.N. NOT ON FILE

Background

Most insurance companies are going to require that they have your Tax ID on file.  Your Tax ID that you have on file with the payer may be your Employee Identification Number (EIN) or your Social Security Number (SSN).   When you submit a claim to an insurance company that has your Tax ID on file with them, you need to submit the claim using the same Tax ID in Box 25 of the CMS-1500.  In Therabill, this is referred to as your billing provider Tax ID.

Cause of Error and How To Fix

If you receive this electronic claim rejection from a payer then you either have not yet shared your Tax ID with the payer or you submitted the claim with the wrong Tax ID (not the Tax ID that you have on file with them).

If you have not shared your Tax ID with the payer:  You should call the phone number on the insurance card for the payer.  Ask them how you can get your NPI and Tax ID on file with them.  You should do this right away as it may take them some time to process it (some payers may take a very long time).

If you have shared your Tax ID with the payer: You want to make sure you are sending your claims to this payer using the same billing provider NPI and Tax ID that you have on file with them.  This is true for every insurance company and government payer.  Therefore, there may be a couple of scenarios to follow based on what billing provider information you have on file with your other payers. 

• You have the same Tax ID on file with all payers: Simply enter your billing Tax ID under Admin in  Therabill.   If you are on the electronic error page in Therabill, then you can simply click the edit icon  next to the billing provider name on the error page.  Otherwise, click Admin in the top navigation bar of Therabill.  You will now see your member (or billing provider) information.  Click the Edit button at the top right to change your Tax ID.   The Tax ID that you have entered here will go out in Box 25 of the CMS-1500 by default on all of your claims (if not instructed otherwise through Groups or Insurance Company Specific Billing Provider Information).  Remember to Save your changes.
• You need a different Tax ID going out to this payer than your other payers: This can be done through Insurance Company Specific Billing Provider Information.  For instructions please see our knowledge base on Insurance Company Specific Billing Provider Information.

Final Note

It is important that you submit your billing provider information the same way that the insurance company (payer) has it on file for you.  This error refers to the Tax ID, however, it is just as important that you submit using the same billing NPI that you have on file with them.