NPI: Get It. Share It. Use It.

August 23^rd marks 9 months remaining until the National Provider Identifier (NPI) compliance date.  Over 1 million NPIs have been issued so far --- do you have your NPI yet?  At this 9-month mark, the Centers for Medicare & Medicaid Services (CMS) would like to announce the following:

CMS NPI Roundtable September 26, 2006

§         CMS will host a national NPI Roundtable, open to all health care professionals, on Tuesday, September 26^th from 2:00-3:30PM ET. 

§         To participate, you may call 1-877-203-0044, pass code 4795739

§         CMS will address common questions related to Medicares guidance on Subparts.  While CMS will only address questions from a Medicare perspective, this information may be helpful to all providers.  Medicare providers, who have questions, should select the appropriate email below and send in questions by Friday, September 8^th.  Questions received after this date will not be considered. 

       Medicare providers who bill a Fiscal Intermediary should send questions to:  NPIQuestionsfromFIBillers@cms.hhs.gov

1       Medicare providers who bill a Carrier should send questions to: 

      NPIQuestionsfromCarrierBillers@cms.hhs.gov

       Medicare providers who bill a Durable Medical Equipment Regional Carrier (DMERC) should send questions to:  NPIQuestionsfromDMERCBillers@cms.hhs.gov

Think You Don't Need an NPI?  Think Again.

§         Even those providers who do not bill for services may need to disclose their NPIs to those providers who do (e.g.,  physicians who order lab tests or refer patients for diagnostic testing must be identified on the labs or testing facilitys claims).

§         Even if you plan to retire in April, but know that some of your claims will not be submitted until after the May 23^rd compliance date, you still need an NPI.  Without the NPI, those claims may be adversely affected, with payment delayed or possibly even denied.  

What does this mean for Medisoft users?

In order to submit claims electronically after May 23, 2007 and in order to generate CMS 1500 printed claims, Medisoft customers must upgrade to Medisoft Version 11.  Although Medisoft Versions 9 and 10 include a field that can store an NPI, these versions, along with prior Medisoft versions, do not include software that enables electronic claims submission with the required NPI nor will they be able to produce paper claims using the new required form.  The NPI-ready features will be available to providers using Medisoft Version 11 via a Service Pack we will release during Q4 2006. 

Sunrise has a limited number of upgrades available at the pre-release discounted pricing that was available in March of 2006 for early purchases of V11.  Call today and take advantage of this opportunity to save hundreds of dollars on your upgrade. 

§         888-880-0384

§         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.

New NPI Slogans and Partnership with WEDI

§         Recently, CMS and the Workgroup for Electronic Data Interchange (WEDI) agreed to common NPI slogans for use in outreach campaigns.  These slogans appear at the beginning and end of this listserv message, and will continue to appear on our messages and products.  A recent WEDI press release, found at http://www.getresponse.com/t/3012122/, discusses the slogans and partnership in more detail. 

Special Information for Medicare Providers

       Designation of Subparts
       CMS reminds Medicare providers to visit Medicares Subparts Expectation Paper (located at http://www.getresponse.com/t/3012123/ on the CMS NPI web page) for more suggestions on how to determine their subparts.  Remember, no health plan, not even Medicare, can instruct a provider on how to enumerate subparts.  This is a business decision that the organization provider must make considering its unique business operations. 

       Medicare Provider Enrollment and NPIs
       CMS requires that providers and suppliers obtain their NPIs prior to enrolling in Medicare or updating their Medicare enrollment information.  Providers and suppliers must enter their NPIs on the CMS-855 Medicare provider enrollment applications and submit a copy of their NPI notifications with each CMS-855 application that they submit. 

       Required Use of NPI on Medicare Paper Claim Forms
       Medicare will require the NPI on its paper claim forms.  To learn more visit a recent MLN Matters article on this topic at http://www.getresponse.com/t/3012124/ on the CMS website. 

       Medicare DME Suppliers and NPIs
       CMS issued a special communication regarding DME suppliers and the NPI which can be viewed at http://www.getresponse.com/t/3012125/ on the CMS website. 

       Medicare to Require Taxonomy Codes on Institutional Claims
       Effective January 1, 2007, institutional Medicare providers (e.g., hospitals, HHAs, SNFs) who submit claims for their primary facility and its subparts must report a taxonomy code on all claims submitted to their Fiscal Intermediary.  To learn more, visit a recent MLN Matters article at http://www.getresponse.com/t/3012126/ on the CMS website. 

       Use of NPI on Medicare Claims on October 1^st   
       Beginning October 1^st, Medicare can accept claims that only have an NPI on them, however, to facilitate further testing, Medicare strongly encourages its providers to submit both legacy identifiers and their NPI on claims. 

As always, more information and education on the NPI can be found at the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website.  Providers can apply for an NPI online at http://www.getresponse.com/t/3012129/ or can call the NPI enumerator to request a paper application at 1-800-465-3203.

Getting an NPI is free - not having one can be costly.