RCD Tip: Using the Correct Provider Transaction Access Number (PTAN)

Published 01/20/2021

If you are a part of a home health agency (HHA) with more than one location and multiple PTANs, please make sure you are using the correct PTAN when submitting pre-claim review (PCR) requests. The patient’s service location is key when selecting the appropriate PTAN.

If our Medical Review (MR) Team can easily determine the PTAN is incorrect (e.g., different states), the request will be non-affirmed. You will not be able to resubmit and will have to complete a new initial submission.

Additionally, if our MR Team is unable to determine the PTAN is correct, and you potentially file the claim using the UTN associated with the incorrect PTAN, this will result in a 25 percent reduction with an ADR.

Using the correct PTAN will prevent non-affirmations and reduce provider frustration.

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