NPI - Will You Be Ready?
The compliance date, May 23, 2007, is only 8 months away. It's every provider's responsibility to make sure that an NPI is obtained if the provider is required to do so. If you're not sure, it's time to investigate. Get your NPI now so you have time to prepare before the compliance date. This includes sharing your NPI and appropriately testing it with payers to avoid a disruption in cash flow. To learn more on how to apply visit
www.cms.hhs.gov/NationalProvIdentStand/ 
on the CMS website.
SHARE IT.
Have your NPI and don't know what to do with it? Share it. Share it with health plans you bill and the colleagues who rely on having your NPI to submit their claims (e.g. those who bill for ordered or referred services). You should also share it with your billing service, vendor, or clearinghouse, if you have any of them as business associates. Find out when and how the health plans with which you do business will begin accepting the NPI in claims and other standard transactions.
USE IT.
Once your health plans have informed you that they are ready to accept NPIs, begin the testing process. It is important to test before May 23, 2007 to avoid a disruption in your cash flow. Consider sending only a few claims at first as you test the ability of plans to accept the NPI. Fewer claims will make it easier to keep track of status and payment, as well as troubleshooting any potential problems that may arise during the testing process.
CMS NPI Roundtable - September 26, 2006
CMS will host a national NPI Roundtable, open to all health care professionals, on Tuesday, September 26th from 2:00-3:30PM ET. To participate, you may call 1-877-203-0044, pass code 4795739
Information on Covered Entities Under HIPAA
CMS has posted a new "Frequently Asked Question" to the CMS website that addresses whether a health care provider is a covered entity under HIPAA if they receive health information electronically (e.g. an electronic remittance advice), but do not transmit any health information electronically. The link is listed below or you can go to the CMS.gov website and select "Questions" in the blue banner.
New NPI Information for Medicare Providers
Clarification of the Taxonomy Requirement Outlined in CR5243 Effective January 1, 2007, institutional Medicare providers who submit claims for their primary facility and its subparts (such as psychiatric unit, rehabilitation unit, etc.) must report a taxonomy code on all claims submitted to their Fiscal Intermediary. CMS posted a FAQ that clarifies this requirement. The link is listed below or you can go to the CMS website and select on "Questions" in the blue banner.
Reminder to Supply Legacy Identifiers on NPI Application
CMS continues to urge providers to include legacy identifiers on their NPI applications. This will help all health plans, including Medicare, to get ready for May 23, 2007. If reporting a Medicaid legacy number, include the associated State name. If providers have already been assigned NPIs, CMS asks them to consider going back into the NPPES and updating their information with their legacy identifiers if they did not include those identifiers when they applied for NPIs. This information is critical for health plans and health care clearinghouses in the development of crosswalks to aid in the transition to the NPI.
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New WEDI Early Adopters Series
The Workgroup for Electronic Data Interchange (WEDI) has developed a series of monthly 90-minute audio casts that highlight the NPI related planning, management, communication and implementation activities. The first audio cast is scheduled for Wednesday, October 4, 2006 from 2-3:30 PM ET. Visit the WEDI website for more information and to register for this audio cast at http://www.wedi.org/npioi/index.shtml on the web. Please note that there is a cost to register for this WEDI event.
Getting an NPI is free - not having one can be costly.
Page Last Updated: Thursday, 04-Mar-2010 10:30:08 CST
