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May 7 is "Legacy Free" Day - An Opportunity to Check Your NPI Readiness! (GEN)
Posted April 30, 2008
The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Healthcare Information and Management Systems Society (HIMSS), has requested clearinghouses that submit claims to Fee-for-Service (FFS) Medicare to participate in a one day National Provider Identifier (NPI) preparation exercise. Specifically, on Wednesday, May 7, 2008, participating clearinghouses should submit Medicare claims with NPI-only in all provider identifier fields for which a provider uses NPI/legacy pairs. On May 8th, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs as received from the providers.
Through its monthly NPI messages, CMS has been requesting providers to begin testing NPI-only by sending a group of claims with NPI alone in primary provider fields. This "exercise" will result in feedback from your Medicare contractor on your readiness as it pertains to your NPI.
On May 7, 2008, participating clearinghouses will send Medicare claims with NPI-only in provider fields which originally contain NPI/legacy pairs from the provider. In other words, clearinghouses will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. Of course, fields already containing NPI-only will be sent to Medicare, as usual, and secondary provider identifier fields containing legacy-only will be sent to Medicare, as usual.
This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008, deadline.
The outcomes of this exercise are described below:
- Claims are processed and paid by Medicare. Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23rd implementation date.
Or
- Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23rd. Resolution might include changes to the National Plan and Provider Enumeration System (NPPES) data or to the 855 enrollment record.
Again, on May 8, 2008, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs, if sent to them by the provider.
Participating clearinghouses will be soon notifying provider clients about details, so pay close attention to clearinghouse communications.
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 Web site. 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 800-465-3203.
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 Web page. |
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