Fri, 9 May 2008 16:15:41 -0400
=01=01
The NPI is here. The NPI is now. Are you using it? Important Information=
for Medicare FFS Providers Additional Guidance and Clarification for=
Identifying Secondary Providers in Medicare ClaimsIn accordance with the=
NPI final rule, when an identifier is reported on a paper or electronically=
submitted claim for ordering/referring=
/attending/operating/supervising/purchased service/other/service facility=
provider (in the x12N 837 claims transactions) or for prescriber (in the=
NCPDP 5.1 retail drug claim transaction), that identifier must be an NPI. =
For Medicare purposes, this requirement is effective May 23, 2008. If the=
entity to be identified as the=
ordering/referring/attending/operating/supervising/purchased=
service/other/service facility provider or prescriber does not furnish an=
NPI at the time of the order/referral/purchase or time of service, the=
billing provider must attempt to obtain that NPI in order to use it in the=
claim. The billing provider may use the NPI Registry or may need to=
contact the ordering/referring/ attending/operating/supervising/purchased=
service/other/service facility or presciber in order to obtain the NPI.=
While the Implementation guides for the X12N claims transactions permit the=
reporting of the Social Security Number (SSN) for some secondary providers=
if there is no NPI, we do not believe the billing provider will be=
successful in the obtaining the SSN. =
=
=B7 If unable to obtain the NPI of the entity to=
be identified in the service facility location loop, no identifier should=
be reported in that loop. =B7 If unable to obtain the NPI of the=
ordering/referring/attending/operating/supervising/purchased service/other=
or prescriber, the billing provider (in the X12N 837 transactions) or the=
service provider (in the NCPDP 5.1 transaction) shall use its own NPI to=
identify those secondary providers. Medicare will not pay these claims if=
these secondary providers are not identified by NPIs. CMS will Host NPI=
National Roundtable Q&A Session on May 19, 2008CMS will host a national NPI=
Roundtable Q&A session to address questions from the Medicare provider=
community prior to May 23rd. This Roundtable will be on May 19th from=
2-3:30PM EDT. Questions will not be collected during the registration=
process for this call. There will be no presentations during this call; we=
will open the lines to take questions following a brief introduction. For=
registration details, visit=
http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/listserv_wording_5-= 19-08_call.pdf on the CMS website. REMINDER: CMS will Host NPI National=
Roundtable on May 14, 2008Registration is still open for the Roundtable to=
be held on May 14th from 2-3:30PM EDT. Providers will be able to submit=
questions through the online registration system at the time of sign up for=
this call. Similar to the most recent NPI Roundtable, Subject Matter=
Experts will create presentations based on the questions submitted. For=
registration details, visit=
http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/listserv_wording_5-= 14-08_call.pdf on the CMS website. Need More Information?Still not sure=
what an NPI is and how you can get it, share it and use it? As always,=
more information and education on the NPI can be found through the CMS NPI=
page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers=
can apply for an NPI online at https://nppes.cms.hhs.gov or can call the=
NPI enumerator to request a paper application at 1-800-465-3203. Having=
trouble viewing any of the URLs in this message? If so, try to cut and=
paste any URL in this message into your web browser to view the intended=
information. Note: All current and past CMS NPI communications are=
available by clicking "CMS Communications" in the left column of the=
www.cms.hhs.gov/NationalProvIdentStand CMS webpage. =01
Remember! National Government Services' EDI List Serve is for out going=
messages only. Please do not respond back to messages as your response will=
not be answered, as this is not an authorized mode of communication at this=
time, Thank you! CONFIDENTIALITY NOTICE: This E-mail message, including any=
attachments, is for the sole use of the intended recipient(s) and may=
contain confidential and privileged information. Any unauthorized review,=
use, disclosure or distribution is prohibited. If you are not the intended=
recipient, please contact the sender by reply E-mail and destroy all copies=
of the original message. =01 To unsubscribe/change profile: click here.
=01Email list management powered by http://MailerMailer.com