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Dear Colleague,
The transition to National Provider Identifier (NPI) values has dominated the headlines for many months now – most recently with stories explaining the CMS decision to postpone its May 23, 2007, implementation deadline. While this announcement was welcome news to many providers and payers, it has nevertheless sparked a great deal of confusion. CMS moved the deadline back a year, allowing payers to adopt contingency plans to complete the transition to NPI anytime between now and May 23, 2008.
This approach has created a great deal of inconsistency from payer to payer – because each now has the leeway to establish different deadlines. Many Medicaid plans, for instance, adhered to the original May 23, 2007, deadline. One commercial payer, on the other hand, is making the change on September 1, 2007, while a second won’t require compliance until May 2008. Variations like these pose a complex problem for providers since they need to track which payer has adopted which deadline, in order to ensure their claims are paid promptly.
Navicure removes this “nuisance factor” through functionality within its revenue cycle management solution. During the contingency period, the Navicure system will automatically keep track of each payer’s requirements, providing either (or both) the NPI value and the legacy number as appropriate. This will virtually eliminate delays, rejections or other problems that may result from the wide-ranging NPI deadlines.
In order to ensure the transition to NPI is smooth, providers need to keep a few important facts in mind:
- It’s not enough simply to apply for and be assigned an NPI value. Providers must also register their NPI with each payer. Medicare automatically integrates the NPI value when it is reported on claims, but all other payers require registration as a separate step. If this has not been done, some payers will warn the provider that the NPI has not yet been registered, but process the claim anyway. Others will reject the claim out of hand, even if the legacy number appears on the claim. Navicure has integrated special edits, displaying these rejections and required corrective action on its scoreboard so providers can be sure they are in compliance with vital NPI registration requirements.
- NPI values are meant to be shared. Some providers mistakenly view the NPI as a billing identifier and refuse to furnish it to organizations other than payers. CMS has issued a dissemination policy clarifying the fact that NPI values must be shared with other providers, laboratories, radiology centers, etc. If an internist refers a patient to a cardiologist, for instance, the internist must provide his or her NPI to the cardiologist in order for the cardiologist to properly submit a claim. Beginning August 1, NPI values will be made publicly available at https://nppes.cms.hhs.gov through a UPIN-type directory. Providers will be able to withhold certain information (e.g., their street address), but their name, license number and NPI will be displayed.
- CMS is in the process of shutting down its UPIN database – obliging providers and payer to use only the NPI value. Already, new providers are being credentialed only with NPI values.
Navicure is committed to assisting clients during this period of transition. Once clients have received their NPI value and registered it with each insurer, Navicure removes the burden of tracking individual payer requirements. This ensures providers experience no disruption in service – or in cash flow. As always, we invite you to contact Navicure Client Services at 770-342-0800 if you have any questions or concerns about the NPI process.
Sincerely,
Jim Denny
President
jdenny@navicure.com
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Shortly after distribution, Navicure updated its web servers to provide you with enhanced access. During the conversion, some responses to this poll were lost, which meant those individuals missed an opportunity to provide feedback — and their chance to win an iPod!
Rest assured, no claims information was compromised. However, in fairness to those who answered the survey previously, we are distributing it again. Please take a moment to respond — even if you did so earlier. Thank you!
What’s the average amount of time you wait to get paid?
41%
0-15 days
42%
16-30 days
14%
31-45 days
3%
46-60 days
0%
61-90 days
0%
90+ days
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