Medicare Compliance & Reimbursement

The new NPI will make life easier, but providers aren't spared the legwork.

Hospitals that feel like they are drowning in a sea of different provider identifiers when billing for your therapist's services can breathe easier, because help is coming.

Beginning May 23 all health care providers were able to apply for their National Provider Identifier.
 
The NPI is a standard unique health care provider identifier that all health plans must accept and that will replace the plethora of current identifiers carriers use, such as the provider identification numbers and the unique provider identifier number.

The goal: The Centers for Medicare and Medicaid Services is striving for simpler electronic transmission of health-related standard transactions with the implementation of this new identifier system.

Details: The NPI is a part of a central electronic enumerating system that CMS developed to improve efficiency within Medicare and Medicaid programs.

"All health care providers, whether individuals or organizations, are eligible to receive National Provider Identifiers, which are designed to be lifelong identifying numbers," according to the NPI Viewlet, an educational resource CMS created to help with NPI implementation. "All health plans must accept and use NPIs on or before May 23, 2007," except for small health plans, which have an additional year to comply.

The NPI is an "intelligence-free" 10-digit number, meaning the numbers don't indicate other information about a provider, such as medical specialty or the state where they practice.

Providers should take the time now to learn about the NPI application and plan when they will begin the process for their therapists. Ideally, a provider would complete applications as soon as possible to ensure it is ready to go well before the deadline.

"If the instructions are as easy as we're hearing, and if the process is as easy as we're hearing, why not do it now?" asks Jill Young with Young Medical Consulting in East Lansing, MI.

Some experts may argue that waiting a few months is better because it gives CMS time to work out kinks in the application process, Young says. But providers should also take into consideration that group and multi-specialty practices often have re-credentialing nuances that can take extra time to master, she adds.

Good idea: At all costs avoid waiting until a few months before the deadline to begin the application process because the typical rush of last-minute applicants creates a logjam near the deadline, Young says.