Traditional MedicareAdministrativeHigh impact
BadgerCare Plus Requirement for Automatic Institutional Crossover Claims for Dual Eligibles
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jan 1, 2008
We identified it
Jun 20, 2026
Summary
BadgerCare Plus requires institutional providers to include both National Provider Identifiers (NPIs) and Medicaid provider numbers on 837I claims for dual eligible patients to ensure successful automatic crossover from Medicare. Medicare will reject 837I claims without NPIs starting January 1, 2008.
Action Required
By January 1, 2008: Billing team must ensure all 837I institutional claims submitted to Medicare include both the NPI in billing/pay-to provider fields AND the Medicaid provider number for dual eligible patients. Obtain NPIs for all certified providers and report them to BadgerCare Plus. Update billing system to require both identifiers on crossover claims to prevent rejections and processing errors.