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Industry News

NPI



Wednesday, February 03, 2010


Providers and suppliers may now apply for their NPI on the National Plan and Provider Enumeration System (NPPES) web site, https://nppes.cms.hhs.gov. The NPPES is the only source for NPI assignment.

The NPI will replace healthcare provider identifiers in use today in standard healthcare transactions by the above dates. The application and request for an NPI does not replace the enrollment process for health plans. Enrolling in health plans authorizes you to bill and be paid for services.

Healthcare providers should apply for their NPIs as soon as it is practicable for them to do so. This will facilitate the testing and transition processes and will also decrease the possibility of any interruption in claims payment. Providers may apply for an NPI in one of three ways:

  • An easy web-based application process is available here
  • A paper application may be submitted to an entity that assigns the NPI (the Enumerator). A copy of the application, including the Enumerator’s mailing address, is available here. A copy of the paper application may also be obtained by calling the Enumerator at 1-800-465-3203 or TTY 1-800-692-2326
  • With provider permission, an organization may submit a request for an NPI on behalf of a provider via an electronic file

Providers should be aware of the NPI readiness schedule for each of the health plans with which they do business, as well as any practice management system companies or billing companies (if used). They should determine when each health plan intends to implement the NPI in standard transactions and keep in mind that each health plan will have its own schedule for this implementation. Your other health plans may provide guidance to you regarding the need to submit both legacy numbers and NPIs. Providers should submit their NPI(s) on standard transactions only when the health plan has indicated that they are ready to accept the NPI. Providers should also ensure that any vendors they use will be able to implement the NPI in time to meet the compliance date.



CMS

Additional Information: Source


Wednesday, February 03, 2010