NPI Deadline draws near

Beginning May 23, physicians who bill electronically, as required under the Health Insurance Portability and Accountability Act, are required to use their new NPI number instead of their old identifier numbers on claims and other transactions. And even though it is not required by law, Medicare has decided to require physicians who bill on paper to obtain and use their NPI as well. Physicians who do not have an NPI prior to the May 23 deadline could risk compliance issues. While the Centers for Medicare & Medicaid Services (CMS)-the agency charged with NPI enforcement-will permit payers to implement "contingency plans" that allow for the continued use of old identifiers for 12 months after the deadline (through May 23, 2008) where "good faith" compliance efforts have been made, Medicare, the nation's largest payer, has not announced any contingency plans yet. In considering whether a physician has made a "reasonable and diligent" effort in complying with the NPI requirement, CMS will be looking at whether that physician obtained his or her NPI prior to the deadline. Therefore, physicians are strongly encouraged to do the following:

1. Get an NPI prior to May 23.

2. Contact each of their payers to determine what, if any, NPI "contingency plan" they may have

3. Establish a line of credit that can be used to avert unanticipated cash flow interruptions beginning May 23 during the transition to use of the NPI.

Visit http://www.cms.hhs.gov/NationalProvIdentStand/  to learn more about NPIs