Industry Note:
Beware Group NPIs On Your HHA Claims
Published on Thu Jul 26, 2012
If you're using the wrong physician NPI on your claims, expect some communication from your MAC.Wrong way: "Regional Home Health Inter-mediaries (RHHIs) and A/B MACS with home health workloads will be contacting home health agencies (HHAs) that submitted claims using both a group name and national provider identifier (NPI) as the attending NPI for ordered or referred services," the Centers for Medicare & Medicaid Services says in an e-mail message to providers.Right way: "The physician's name and NPI, not a group name and NPI, must be used as the attending name and NPI on the claim," CMS stresses. CMS recently sent a message urging physicians to provide their individual NPI to HHAs upon request (see Eli's HCW, Vol. XXI, No. 25, p. 202).Watch out: "Once CMS turns on the edits for ordering/referring services, claims using a group NPI will be denied," the agency warns. Despite high speculation, CMS has not [...]