Corporate

Reopenings Rendering NPI (National Provider Identifier) Adjustment Request Form (RNP 237)

Form RNP 237PDF (Reopenings Rendering NPI Adjustment Request Form) will allow you to change the rendering practitioner's National Provider Identifier (NPI) on a line item of a previously processed claim. This form is to change only the performing physician/practitioner NPI and not the billing NPI. To change the billing NPI, please submit Form GRF 679PDF (Reopenings Adjustment Request Form). If the change results in lower payment amount, please submit a request to Overpayment Recovery (OPR).

Only one claim can be corrected per form; up to 12 line items per claim.

NOTE: In order to complete the form accurately, you must have access to your Remittance Advice (RA). If you download your RA from a billing service or clearinghouse, the line items may be in a different sequence, which will affect the processing on this form. We suggest accessing your RA directly from the myCGS Web Portal.

Also, to avoid issues with legibility, we encourage you to complete the form online, and then print it.

Automated Reopenings Rendering NPI Adjustment Request Form Instructions

  1. Complete the Header of the form:

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    • Select the State
    • Enter the date the form is completed
    • Enter a contact person's name and telephone number
      • NOTE: This information is important should we need to contact you with a question regarding your Reopening request.

  2. Complete the Provider Information section:

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    • Enter the Provider's Name
    • Identify the last 5 digits of Tax ID number
    • Enter the Billing PTAN
      • Individual physicians/practitioners who reassign benefits to a group, enter the Group PTAN
      • Solo physicians/practitioners, enter the Individual PTAN.

  3. Complete the Beneficiary Information section:

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    • Enter the Beneficiary's Name
    • Enter the Beneficiary's Medicare ID
      • To avoid processing delays, please verify that the Medicare ID is correct.

  4. Identify the claim information:

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    • Enter the first Date of Service from the claim (this is for internal use only).

      • Enter the first HCPCS/CPT code (procedure code) from the claim (this is for internal use only).
      • Enter the Internal Control Number (ICN) of the claim, which is located on the RA.
        • Verify that the ICN is accurate. Incorrect, incomplete, or invalid ICNs will result in increased processing time (up to 60 days).
  5. Complete the Adjustment Details section:

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    • Identify the Line you wish to have corrected.
      • For example, if the RA shows the claim submitted with nine line items, and the correction is needed on line six of the claim, enter "6"(A value of 1-13 may be entered in this field) in the line details.  If correction is for all lines of the claim enter each line number in the line details section and the new NPI number in each line of the new value rendering NPI section.

    • Identify the 10-digit New Value Rendering NPI in the second column. 
      • Be sure to enter the practitioner's NPI and not the group NPI.

    Please pay special attention to the Adjustment Details section. Forms submitted with inaccurate, incomplete, or missing Line and Position fields may result in increased processing time of up to 60 days.

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