This will be the address page
and will only contain the address for the window envelope
N eMwedical Assistance Claims Processing System
IMPORTANT INFORMATION!
PA PROMISeTM
Your Provider Identification Number Has Been Changed!
This mailing is to inform you of your new provider number under the Department of Public Welfare’s new claims processing system,
PROMISe™ (Provider Reimbursement and Operations Management Information System). You will need this information for future
communications with the Department and for submitting claims for payment. Please use the information to make necessary changes to
your billing practices. If you do not modify your billing practices to include your new number, you will not be paid. Your old
provider number will not be accepted in PROMISe™. Your new 13-digit PROMISe™ provider number reflects a 9-digit number, which is
based on your Federal Tax ID Number (Legal Entity) and a 4-digit number for each MAMIS address code. A separate service location (4digit number) is assigned for each unique provider type at a physical location.
New Provider Identification Number and Service Location Codes
The Department has converted your old provider number and address codes for you. Your new PROMISe™ provider number and
service location codes are listed on the attached Personalized Provider Cross Reference.
Questions & Answers
Also included in this correspondence is a list of PROMISe™ Provider Number Frequently Asked Questions and corresponding
answers. Watch your mail or the DPW OMAP website (www.dpw.state.pa.us/omap) for a schedule of informational sessions that will be
conducted to assist you with any questions you might have regarding this information.
Key Transition Dates
A summary of key PROMISe™ transition dates is attached. These dates are important as they dictate when you must stop using your
current provider number and start using the new provider number.
Provider Service Location Change Request
We have included a PROMISe™ Provider Service Location Change Request to use to notify us of any service locations that should
be closed. Reminder: Starting February 17, 2004, the PROMISe™ version of ePEAP will be available for registered providers to use
for both inquiry and changes.
PROMISe
™
Your Personalized Provider Cross Reference
You have been identified as associated with the following Legal Entity, which is the IRS name associated with your tax identification
number. Please make sure this information is correct.
Legal Entity Name:
Your Current (MAMIS) Provider Name:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
The chart below contains information from your current MAMIS file and the corresponding PROMISe™ enrollment information needed for billing.
Please note that in some cases more than one PROMISe™ provider number has been assigned for a single MAMIS Provider Number/Address code.
This was necessary to accommodate new features available in PROMISe™.
Please note: The address(es) that your payment is sent to has not been changed.
MAMIS
MA ID
Provider
Type
Provider
Number
XX
XXXXXXXX
XX (XXXXXX)
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX XX XXXXX
=
XX
XXXXXXXX
XX (XXXXXX)
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX XX XXXXX
XX
XXXXXXXX
XX
XXXXXXXX
PROMISe™ Provider ID
MAMIS Address Code and
Open/Close Indicator/Address
EQUALS
PROMISe™ Provider Type
and Description
MPI Provider
Number
Service
Location
XX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXX
XXXX
=
XX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXX
XXXX
XX (XXXXXX)
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX XX XXXXX
=
XX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXX
XXXX
XX (XXXXXX)
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX XX XXXXX
=
XX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXX
XXXX
The following pages contain frequently asked questions and corresponding answers regarding the new provider numbers and the Key
Transition Dates for claims processing. These dates are important as they dictate when you must stop using your current provider number
and start using the new PROMISe™ Provider ID. Also enclosed is a PROMISe™ Provider Service Location Change Request.
PROMISe
™
Provider Number Frequently Asked Questions
1. Why are new provider numbers being issued?
New provider numbers are being issued to support additional functionality and reporting with the implementation of the
Department of Public Welfare’s new claims processing system, PROMISe™, and the Master Provider Index (MPI). The new
numbers are based on your Federal Tax ID Number, your provider type and specialty(s), and the physical location where you
provide services. You must use your new number(s) when billing in PROMISe™ as the old provider numbers will not be
accepted and your claims will reject.
2. What is the Master Provider Index (MPI)?
MPI is a central repository of provider profiles and demographic information that registers and identifies providers uniquely within
the Department of Public Welfare regardless of the program/system for which they are registering.
3. Who needs to know this information?
Your provider number(s) is critical to successful billing. It is strongly recommended that you share this information with your
billing staff, information systems staff, software vendor, any group practice or entity to which you assign fees, and other
associated parties that need to be aware of the new provider number format in PROMISe™.
4. What does my new PROMISe™ provider number look like?
The new number is a 13-digit number. The first 9-digits are assigned by MPI for a given Federal Employer Identification Number
(FEIN) or Social Security Number (SSN). For example, if you and three other providers share the same Federal Tax ID number,
you will all share the same first 9-digits in MPI. The next four digits of the number reflect a Service Location Code that is based
on provider type, specialty, and physical location. It is the combination of the both of these that uniquely identifies you in
PROMISe™.
MPI Provider
Number
Service
Location
0123456780003
5. Do I continue to use address codes in PROMISe™?
No, service locations that are included as part of your 13-digit PROMISe™ provider number now indicate where the service is
being provided. Remember to use the correct 13-digit number based on the appropriate 4-digit service location when billing for
different locations.
PROMISe
™
Provider Number Frequently Asked Questions
6. Will all current information (banking, pay to addresses, etc.) be converted from MAMIS to PROMISe™ so I don't have to
update this information?
Yes, if you are currently an enrolled MA provider, your provider information will be converted for you.
7. My provider cross reference shows that I now have several different 13-digit provider numbers. How do I know which
13- digit number to use when submitting claims in PROMISe™?
The Department has used your old MA ID provider numbers and address codes to create your new numbers. You should bill the
same way you have billed in the past, but use the PROMISe™ provider number cross reference to determine what the
comparable number is in PROMISe™. For example, if your old MA ID provider number was 02345678 and you used address
code 02 on your claim, and the provider crosswalk you received shows this is now equal to 0023456780004, that is the number
you should use in PROMISe™. See the examples below.
For a physician with two office locations:
MPI Number: 002345678
Service Location: 0001 (123 Main Street)
Service Location: 0002 (9876 Home Avenue)
PROMISe™ Provider ID: 0023456780001
PROMISe™ Provider ID: 0023456780002
For a corporation that has multiple MA ID numbers today. The corporation owns a hospital, a long-term care facility, and a
home health agency all under one Federal Employer Identification Number (FEIN):
MPI Number: 103456789
Hospital
Service Location: 0001
(453 High Street)
Long Term Care Facility
Service Location: 0002
(453 High Street)
Home Health Agency
Service Location: 0003
(453 High Street)
PROMISe™ Provider ID:
1034567890001
PROMISe™ Provider ID:
1034567890002
PROMISe™ Provider ID:
1034567890003
8. With the implementation of PROMISe™, will all PROMISe™ providers be able to use ePEAP to update their provider
information electronically or just MA providers?
In PROMISe™, ePEAP will be available to all providers. Please note that if you are not currently registered to use ePEAP, you
will need to register via the PROMISe™ Internet screens (promise.dpw.state.pa.us) initially to establish your logon ID and
password.
PROMISe
™
Provider Number Frequently Asked Questions
9. Two of the four address codes on my provider cross reference are no longer used. What should I do?
To ensure that all providers were notified of this important change, the Department sent this information to active (open)
providers as well as those providers or address codes that have been closed within the past 24 months. Using Your
Personalized Provider Cross Reference, check the MAMIS address code to determine if an address code is open or closed. If
you wish to make a change and you are a registered user of ePEAP, the Department’s Internet solution that allows updates to
your provider information, you can make updates directly online after February 17, 2004, when the new PROMISe™ ePEAP
website (promise.dpw.state.pa.us) is available. Also enclosed with this mailing is a Provider Service Location Change Request
that you can use to close an existing service location.
10. My Personalized Provider Cross Reference shows service locations that are not where I perform services. Why were
they converted into service locations and do I need to request changes?
To ensure that all of your service locations were captured during conversion, all existing address codes, including mail to only
and pay to only addresses, were converted to service locations. While this should not impact your billing, you may request that a
service location be closed via ePEAP (after February 17, 2004) or use the enclosed Provider Service Location Change Request.
11. Why was my provider type changed during conversion?
PROMISe™ is the Department’s claims processing system for multiple programs. New provider types are being implemented
within PROMISe™ to accommodate additional functionality and reporting. Please note that provider types are no longer
required for claims submission. Additionally, specialties will be maintained in your provider record to further distinguish the
services you provide. A cross reference of old MAMIS provider types and specialties is available on the Department OMAP
website at www.dpw.state.pa.us/omap.
12. I was not able to attend a PROMISe™provider training session. How can I find out what information was shared at the
session.
The information presented in the PROMISe™ Provider Awareness Training sessions is also available as an Internet accessible
e-Learning course. The e-Learning course is available at promise.dpw.state.pa.us.
13. Is there more information available on PROMISe™?
The Department’s OMAP website, www.dpw.state.pa.us/omap, contains the latest information and updates on the PROMISe™
transition. Watch your mail or this website for a schedule of informational sessions that will be conducted to assist you with any
questions you might have regarding your new provider number(s). We recommend you check the website frequently.
PROMISe
™
Provider Claims Processing Transition Schedule
The schedule below summarizes the critical dates related to the change over from the old formats to the new formats. For more
detailed information related to specific format changes and your new provider numbers, please see www.dpw.state.pa.us/omap, click
on the PROMISeTM information.
For Most Providers
(Excluding only Long Term Care & Pharmacy Providers)
Paper Claims
Electronic Claims
Last Date
First Date
Last Date
First Date
To Submit Claims in Old Format
To Submit Claims in New Format
To Submit Claims in Old Format
To Submit Claims in
TM 1
New Format (PROMISe )
Feb 12, 20042 (noon)
March 1, 20042
TM
(PROMISe )
Feb 2, 20042
4
Feb 9, 20042
For Long Term Care Providers
Paper Claims
Electronic Claims
Last Date
First Date
Last Date
First Date
To Submit Claims in Old Format
To Submit Claims in New Format
To Submit Claims in Old Format
To Submit Claims in
TM 1
New Format (PROMISe )
Feb 12, 20042 (noon)
March 1, 20042
TM
(PROMISe )
Feb 6, 20042
4
Feb 9, 20042
For Pharmaceutical Providers
Paper Claims
Electronic Claims
Online Pharmacy
POS Claims
Last Date
First Date
Last Date
First Date
Last Date
First Date
to Submit Claims in Old
Format
to Submit Claims in New
TM
Format (PROMISe )
to Submit Claims in Old
Format
to Submit Claims in
TM 1
New Format (PROMISe )
to Submit Claims in Old
Format
to Submit Claims in
TM 1
New Format (PROMISe )
Feb 2, 20042
N/A3
Feb 12, 20042 (noon)
March 1, 20042
Feb 18, 20042
Feb 19, 20042
1.
2.
3.
4.
TM
All electronic claims submitted in new format (PROMISe ) must be HIPAA Compliant.
Dates reflect receipt of claim as opposed to date of mailing.
In PROMISe™, all pharmacy claims must be submitted electronically.
The Department requires the use of HIPAA compliant code sets for paper claims submitted to PROMISe™.