Medicare Compliance & Reimbursement

If you’ve lagged behind on using NPIs for checking patients’ Medicare status, the honeymoon is nearly over.

Now: In the Common Working File, providers currently “are allowed to use either legacy Provider Numbers (CMS Certification Number [CCN] or Unique Physician Identification Number [UPIN]) or NPI on CWF Provider Queries” to check patients’ eligibility, CMS says in a recent MLN Matters article.

Then: As of Jan. 2, 2018, CWF will accept only an NPI as a valid Provider Number for such queries, CMS says in the article at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10098.pdf.