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Chill74

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Good morning ! I am fairly new to billing, have not even completed class for certification. I am currently training for a billing position in an Orthopedic office. I have several claims on hold because of referring provider's Work Comp Tx number. I called about 5 different referring providers to obtain this and not one of them even knew what it was. Upon doing some research I discovered that it is also called PTAN but unfortunately none of the referring providers I called even knew what their provider's TPAN is. Does someone know a way for me to look that up, similar to how we can look up NPI?? Any guidance would be appreciated.
Cari
 
PTAN is basically a provider's MEDICARE number. While I don't bill for worker's comp, it seems odd that a worker's comp carrier would want the referring provider's Medicare number. At least for commercial insurances, basically everyone uses NPI now. I would confirm they really want the PTAN.
 
Workers compensation varies from state to state - I would suggest putting your state in the thread title to increase the chance that you'll catch the eye of another biller in your area.

It looks like you're in Texas, so I checked the Texas Workers Compensation Billing Procedures. (This is accessible in the Texas Administrative code, link provided below)


What I'm seeing is that you need the referring provider's state license number in field 17a and the referring provider's NPI number in field 17B.

Here's a screenshot of the section about referring providers - you can find the entire text at the link above.

txwc.JPG

Good luck. Hope this helps!

I would think that your referring provider's staff should know their state license number. However, there is a lookup function on the Texas Medical Board's website that may help you find the information you're looking for as well:

 
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