Important NPI Date is Here – May 23, 2008

 Physicians and office staff – remember that as of May 23rd old legacy numbers will not be accepted on any electronic claims. Claims will only be accepted with a National Provider Identification (NPI) number. That deadline applies to all payers. Physicians are strongly urged to test sending their claims with just their NPI as soon as possible to avert claims processing and cash flow interruptions that could occur after May 23. Physicians also should ensure that all of their information in the NPI database is up to date. Incorrect information in the NPI database can affect a payer’s ability to identify a physician and pay his or her claims.

To reiterate - starting May 23, physicians filing electronic claims with ANY PAYER – as well as paper claims with Medicare or some private payers – must be using only the NPI to identify themselves. CMS suggests the following be done in order to prepare for the deadline:

• Test a small batch of claims using the NPI only. If billing is done through a billing service or clearinghouse, work with them to arrange the test batch.
• If the claims go through, continue to increase the volume of NPI-only claims in advance of the deadline date.
• If the claims are rejected, call the National Plan and Provider Enumerator System (1-800-465-3203) to check if the information on the claims matches what is in the system. Update the system if needed and resend the rejected claims after three to four days.
• If the information matches, but the claim is not paid, call the appropriate carrier’s (PalmettoGBA in Ohio) customer service number to see if Medicare enrollment data needs to be changed to match the NPI.
• Obtain NPIs for all referring professionals for inclusion in the secondary provider identifier fields on claims. Starting May 23, if several attempts to obtain these numbers have failed, report the primary physician’s name and NPI to the secondary provider identifier field.

Physicians can change or update their information by visiting https://nppes.cms.hhs.gov/NPPES/Welcome.do
or calling (800) 465-3203. If AMCNO members experience problems with the implementation of the NPI, please contact our offices.