Wellcare taxonomy code rejection - How to resolve it - paper and electronic claim

Taxonomy Guide

In accordance with SNIP level 4 edits, a valid taxonomy is a requirement for all providers when submitting both paper and electronic claims. This guide will provide basic information to further instruct and educate all providers in assistance with taxonomy submittals. Taxonomy code is constructed of 10 digits- numeric and alpha: (see example 1)

Example: 282N00000X


Electronic:

Billing- Loop 2000A-PRV01 “BI” PRV02 = “ZZ” qualifier PRV03 = 10 character
taxonomy
Rendering- Loop 2310B PRV01 “PE” = Referring PRV02 = “ZZ” qualifier PRV03
= 10 character taxonomy code
Referring- Loop 2310A PRV01 “RF” = Referring PRV02 = “ZZ” qualifier PRV03 =
10 character taxonomy code

Tips:
* Qualifiers are to be included on both paper and electronic claims for proper submission
of claim
* Provider should be billing with the taxonomy that is filled with DCH
*  See the following websites for additional information billing information:
www.NUCC.org and www.NUBC.org

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