Medicare Compliance & Reimbursement

Get all your ducks in a row when you apply for an NPI.

If you've been waiting to get a national provider identifier (NPI), then wait no longer. You must have one by May 2007, and it may take some time to figure out how to make the NPI work with your systems.

You can get an NPI by going to https://nppes.cms.hhs.gov or calling 1-800-465-3203 to request a paper application. "I postponed applying for our NPI numbers," says Betsy Hill with Pacific Women's Center in Eugene, OR. But "once I bit the bullet, it was actually quite easy."

You should call the NPI hotline (listed above) to make sure you're using the correct taxonomy code for your provider, says Nancy Klein, a coder with Matrix Pain Management in Saginaw, MI.

Tip: Hill recommends you print out a blank application before you apply online, just so you can be sure you have all the required information ready for each of your providers.
You may also need to apply for an NPI for your physician group or one for each tax ID number your group bills under.

The only hard part is that when a new doctor joins your group, you can't enroll her in Medicare until she has an NPI, even though it's not required for billing yet, notes Kyle Thomas with Medical Park Family Care in Anchorage, AK.

Important: If you have multiple locations but only one tax ID, then you need only one NPI for your group. Coder Amanda Maldonaldo called the NPI information line, and at first a representative told her that she needed a different NPI for each location. But she called the Centers for Medicare & Medicaid Services and found out she needed only one.

Once you have your NPIs, your job isn't done because you still have to make sure you're able to use them, Hill adds. "The greatest concern is that May 2007 will come, we will be unprepared and our cash flow will pay the price she says."