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The NPI is here. The NPI is now. Are you using it? Recent News: Transcript for April 17th NPI Roundtable Now Available – Click Medicare Implementation to the left of this screen for registration details. CMS Will Host National NPI Roundtable Q&A Session on May 19, 2008 – Click Medicare Implementation to the left of this screen for registration details. CMS Will Host National NPI Roundtable on May 14, 2008 – Click Medicare Implementation to the left of this screen for registration details. The NPI will be Required for all HIPAA Standard Transactions on May 23rd. This means: - For all primary and secondary provider fields, only the NPI will be accepted and sent on all HIPAA electronic transactions (837I, 837P, NCPDP, DDE, 276/277, 270/271 and 835), paper claims (UB-04 and CMS-1500) and SPR remittance advice.
- The reporting of Medicare legacy identifiers in any primary or secondary provider fields will result in the rejection of the transaction.
REMINDER: May 23rd is Only Two Months Away, Be Prepared! TEST NPI-only NOW Now that the NPI is required on all Medicare claims in the primary provider fields, if your claims are being successfully processed with NPI/legacy pairs (and most are) now is the time to begin testing claims using the NPI alone. If the Medicare NPI Crosswalk cannot match your NPI to your Medicare legacy number, the claim with an NPI-only will reject. You can and should do this test now! Stay up-to-date with the latest information from CMS – Click CMS Communications to the left of this screen. Overview The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. Beginning May 23, 2007 (May 23, 2008, for small health plans), the NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered entities may invoke contingency plans after May 23, 2007, and guidance about contingency plans may be found in the Downloads section below. If you are a health care provider who bills for services, you probably need an NPI. If you bill Medicare for services, you definitely need an NPI! Getting an NPI is easy. Getting an NPI is free. The first step is to get your NPI. If you delay applying for your NPI, you risk your cash flow and that of your health care partners as well. As outlined in the Federal Regulation, The Health Insurance Portability and Accountability Act of 1996 (HIPAA), covered providers must also share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes. More detailed information is available on the pages listed in the left hand column of this page. Getting an NPI is free - Not Having One Can Be Costly. NPI Frequently Asked Questions (FAQs) NPI FAQs are posted on the CMS website and continue to be updated as new information is available. To view these FAQs, see the "Related Links Inside CMS" section below. To find the latest FAQs, click on the arrows next to "Date Updated". NPI Question Resource Sheet Many NPI questions that providers and their staff may have can be answered by the resources provided here on the CMS NPI page. The "NPI Question Resource Sheet" points to specific resources that can help answer common questions (see Downloads below) Please note that CMS cannot respond individually to every question submitted as feedback via the website. However, be assured that we are reviewing all questions to determine if new educational products or "Frequently Asked Questions (FAQs)" are needed or if revisions to existing products or FAQs are warranted.
Page Last Modified: 05/12/2008 10:59:11 AM
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