HF Logo HF Logo Provider Portal Login
Provider Home

Important Update: NPI and TIN Requirements for Claims Submission

Posted Oct 22, 2026

In the coming months, we will be rolling out changes that may affect you and your practice.

A printable PDF is available here.

 

As previously shared in our Upcoming Healthfirst Systems Enhancements provider alert, Healthfirst is updating several internal systems and processes with the goal of modernizing provider data maintenance, claims processing, and benefits administration.

What is Changing?

Effective December 1, 2026, Healthfirst is updating the following claims processing logic for all lines of business:

  • The NPI submitted on the claim must match the provider’s enrollment information and the required NPI type. Use a Type 1 NPI for an individual provider and a Type 2 NPI for an organization, as applicable.
    • To avoid claim rejections, ensure the submitted NPI matches the provider’s enrollment record and required NPI type (Type 1 or Type 2)
  • Healthfirst will no longer accept SSN in place of the TIN. Provider must submit the claim with the appropriate TIN.
Action Required for Providers

If rejected: Claims will need to be corrected and resubmitted with the appropriate information.

Questions?

If you have any questions, please contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).

Released October 2026

You are now navigating away from the Healthfirst website.

Links to non-Healthfirst websites are provided for your convenience only. Healthfirst is not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.