Practice Management Alert
Start Your NPI Application Process Sooner, Not Later
The new National Provider Identifier will make your life easier, but you have to do the legwork first Take the First Step You should take the time now to learn about the NPI application, and plan when you will begin the process for your providers. Ideally, you should complete your applications as soon as possible to ensure you're up and 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, CPC, president of Young Medical Consulting in East Lansing, Mich.
Help is on the way for billers who feel they're drowning in a sea of different provider identifiers.
Beginning May 23, all healthcare providers were able to apply for their National Provider Identifier (NPI). The NPI is a standard, unique healthcare provider identifier that all health plans must accept and that will replace the plethora of current identifiers carriers use, such as the provider identification number (PIN) and the unique provider identifier number (UPIN).
The goal: CMS strives for simpler electronic transmission of health-related standard transactions with the implementation of this new identifier system.
Details: The NPI comes about as part of the National Plan and Provider Enumeration System (NPPES), which is a central electronic enumerating system that CMS developed to improve efficiency and effectiveness within Medicare and Medicaid programs.
"All healthcare providers, whether individuals or organizations, are eligible to receive National Provider Identifiers (NPIs), 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 a 10-digit number that is intelligence-free, meaning that the numbers don't indicate other information about providers, such as medical specialty or the state where they practice. Physicians and NPPs will need to use the NPI when filing claims. In addition, healthcare providers such as nurses, dental hygienists and technicians are eligible to receive and use the NPI because they must identify themselves in some electronic transactions.
Some experts may argue that waiting a few months is better because you'll give CMS time to work out kinks in the application process, Young says. But you should also take into consideration that group and multispecialty practices often have recredentialing nuances that can take extra time to master, she adds.
Good idea: Avoid at all costs waiting until a few months before the deadline to begin your application process, because you're sure to encounter delays due to the rush of other last-minute applicants, Young says. Starting your applications this fall may be the best choice because CMS will have the kinks worked out, you'll avoid this spring's credentialing rush caused by new medical school graduates, and you'll still allow plenty of time to get all your providers' NPIs ready.
Note: For additional NPI information and to complete an application, visit https://nppes.cms.hhs.gov. For a great tutorial on the NPI and application process, check out the NPI Viewlet at www.cms.hhs.gov/medlearn/npi/npiviewlet.asp.
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