BILLING PROVIDER TAXONOMY CODE: REQUIRED; MUST BE ENTERED FOR PAYER

The insurance company is saying that your billing provider taxonomy code is not valid or does not match what they have on file for your clinic.   A taxonomy code is from a standard code set and indicates your profession.

The Billing Provider Taxonomy in Therabill

When Therabill creates your electronic claims, it first looks if you have a taxonomy code entered under Admin (Member Info) in Therabill.  If you have a taxonomy code entered there, then it will use that as your billing provider taxonomy code.  If you do not have a taxonomy code entered under Admin in Therabill and the payer is known to require a billing provider taxonomy code, then Therabill will use the rendering providers taxonomy code as the billing provider taxonomy code.

Therabill will also use the rendering provider taxonomy code in the cases where the setting for the insurance company indicates to use the rendering provider as the billing provider or if the rendering provider NPI is the same as the billing provider NPI.

How to Fix

It is usually best to enter a taxonomy code under Admin (Member Info) in Therabill.  This way, you know exactly where it is coming from.  Make sure the taxonomy code that you have entered under Admin (Member Info) is present and matches what the insurance companies have on file for  you.

It is very common for the insurance companies to use the taxonomy code that you supplied when getting your NPI.  To find out what taxonomy code you supplied when registering for your NPI, please follow these instructions.

1. Go to NPPES at https://nppes.cms.hhs.gov/NPPESRegistry/NPIRegistrySearch.do?subAction=reset&searchType=ind
2. In the search form, enter your NPI (your billing NPI) and then click Search at the bottom.

You should see yourself in the results.  Click on the result to open up the record.  In the record, you should see your taxonomy code listed.