NPI - Get Ready for March 1, 2008

CMS has announced that full National Provider Identifier (NPI) compliance will be enforced starting March 1, 2008. This means submitting claims with only your NPI and not your legacy numbers. CMS has posted a fact sheet outlining what you probably already know about the NPI system.

Trailblazer Health Enterprises has recommended implementing this process in your office in steps which will ensure that you are prepared come March. If you have been successfully submitting claims with both your NPI and legacy numbers, you might want to try a few claims with just your NPI. If you are having difficulties with the crosswalk and you are having claims denied, go back to using just your legacy numbers until the problem is fixed.

Troubleshooting the issue:
-Verify that the NPI is correct (I know, this ranks up there with, "make sure the device is plugged in and powered on" - but it could be the problem)
-Check that the correct legacy numbers are linked to your correct NPI in the NPPES database.
-If all numbers are correct, and you are still having claims denied, you might need to fill out a Medicare CMS-855 enrollment form. If you have already done so, submit the form again with "NPI MISMATCH" written in red ink on the front. This will expidite the process.

Make sure you fill out the correct form:
CMS-855B for a group/organization
CMS-855 for an individual physician/practitioner

If you have only been using legacy numbers, start including your NPI on claims as well. If you don't have your NPI, go to NPPES to register. Not having an NPI is not an option.