Traditional MedicareAdministrativeHigh impact
BadgerCare Plus Requirement for Automatic Professional Crossover Claims for Dual Eligibles
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Mar 1, 2008
We identified it
Jun 20, 2026
Summary
BadgerCare Plus now requires providers to include both National Provider Identifiers (NPIs) and Medicaid provider numbers on Medicare crossover claims for dual eligible patients. Medicare will reject claims without NPIs starting March 1, 2008, and BadgerCare Plus crossover claims may be denied without the Medicaid provider number.
Action Required
By March 1, 2008: Billing team must ensure all 837P electronic claims submitted to Medicare include both NPI numbers in billing/pay-to provider fields AND Medicaid provider numbers in the appropriate loops (2000B/2010AA for billing provider, 2320/2330E for rendering provider). Contact BadgerCare Plus at (800) 947-9627 to report NPIs if not already done. Claims without both identifiers will be rejected by Medicare or denied by BadgerCare Plus.