Starting May 23, all claims for reimbursement must carry your national provider identifier (NPI), or the claims will be rejected. This includes claims for Medicare, Medicaid, or any commercial health insurance plan.
The American Medical Association , some 35 national specialty societies, the National Uniform Claim Committee [ PDF ], and the National Uniform Billing Committee [ PDF ] have asked the Centers for Medicare & Medicaid Services (CMS) to give physicians six more months to prepare for the change. However, TMA has been told CMS is not inclined to do so.
What do you do now? CMS says you must:
- Apply for an NPI if you haven't already done so.
- Share your NPI with electronic trading partners (billing services, clearinghouses, and software vendors) and all health plans and other payers.
- Test your NPI before May 23. Begin submitting at least a portion of claims using only your NPI.
CMS will conduct a conference call on NPI implementation from 1 to 2:30 pm CDT on Monday, May 19. The agency says you must register by 1 pm CDT on Sunday, May 18, to receive the information you need to participate in the call.
"It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation," a CMS statement said.
For physicians or their staff members who cannot participate in the live call, it will be replayed between 2:30 pm CDT on May 19 and 10:59 pm CDT on May 24. Call (800) 642-1687 and enter 46175614.
CMS posted answers to frequently asked questions on its Web site. TrailBlazer Health Enterprises, the Texas Medicare carrier, also has posted information on using NPIs for Medicare claims on its Web site.
More information on the NPI is available at on the TMA Web site .
Action , May 16, 2008