Home Health & Hospice Week

Providers need a physician NPI directory, but none is available yet.

Home care providers eager to get into compliance with HIPAA National Provider Identifier requirements are facing a major stumbling block--physicians.

Most home health agencies have obtained their own NPIs fine, report industry representatives from around the country. "Colorado agencies are getting their NPIs, no problem," says Ellen Caruso of the Home Care Association of Colorado.

"No one has had trouble getting their own NPIs; they all seem to be on board," adds Casey Blumenthal with the state trade group MHA... An Association of Montana Health Care Providers.

That means most home care providers won't need for themselves the 12-month NPI extension the Centers for Medicare & Medicaid Services is offering (see Eli's HCW, Vol. XVI, No. 12). New providers that aren't quite up to speed on requirements may make use of the extension for their own numbers, allows Todd Stallings with the Indiana Association for Home & Hospice Care.

Still: The extension is good news for those who haven't obtained their numbers yet, notes Joe Hafkenschiel with the California Association for Health Services at Home.

But many providers will need to use the NPI extension because they won't have physician NPIs to include on their claims. Not only do docs seem not to have them, "the physician's office staff often seem not to even know what an NPI is," worries Karen Hinkle with the Kentucky Home Health Association. "We can only hope that physician offices are more prepared than it appears they are."

"There are more problems with the physician numbers" than HHA ones, agrees Neil Johnson with the Minnesota HomeCare Association.

"Many physicians are simply uninformed," believes consultant Pam Warmack with Clinic Connections in Ruston, LA. Docs often "hire individuals in their practice who are not experienced in dealing with federal issues and who are not autonomous enough to seek out information and act upon it," Warmack says. HHAs Dodge Medicaid NPI Bullet Kentucky HHAs went through a "real scare" with their Medicaid program, Hinkle tells Eli. "Until about 2 weeks ago [Kentucky Medicaid] was requiring agencies not only to report their own NPI and applicable taxonomy codes ... but also have the NPI and taxonomy codes for referring physicians."

Thankfully the state is now requiring only the payee's NPI and codes, Hinkle relates.

Even with the extension, providers are "quite concerned that they have to call each physician to get the physician's NPI," Caruso says.

It is "time consuming to get the info from the docs," Blumenthal complains.

These problems underscore "the need for a national directory of providers and their NPIs," stresses Burtonsville, MD-based attorney Elizabeth Hogue.

CMS has yet to issue such a directory and makes no mention of one in its recently released NPI Frequently Asked Questions.