Claim Denials for No Attending Provider on UB-04 and 837I Claims, CR 107682

Mar 18, 2022

Effective June 30, 2022, UB-04 and 837I claims submitted without an attending provider will deny.

Providers who bill on UB-04 or 837I claims must include an Attending Provider Name and National Provider Identifier (NPI), including secondary identifiers, when submitting claims in MIHMS. The Attending Provider information is a required field, and we will use it to validate that your attending provider is enrolled with MaineCare. The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment. There are only a few services that do not require an Attending Provider (NPI).

See the e-message from February 18, 2022 for the full list of services that require an NPI in the Attending Provider Field and details about entering the NPI to avoid claim denials.