Are you up to speed on the National Provider Identifiers?

February 1, 2007

If not, you may not be alone. And the deadline to apply for and start using the 10-digit National Provider Identifier (NPI) is just a few months away.

If not, you may not be alone. And the deadline to apply for and start using the 10-digit National Provider Identifier (NPI) is just a few months away.

If you file a claim electronically with a public or private payer, or bill Medicare electronically or by paper, you must apply for and use the new NPI by May 23 or "run the risk of delayed or rejected claims," reported American Medical News (12/25/06). As the Centers for Medicare & Medicaid Services puts it: "Getting an NPI is free-not having one can be costly."

Yet despite the upcoming deadline, the health-care industry does not seem to be prepared for the switch to the new NPI, which will replace all other identifiers. A survey of members of the Workgroup of Electronic Data Interchange, which includes the American Medical Association as a corporate member, found that more than half would not have NPI capabilities until after April 1. This leaves little room to test billing and claims systems with the new identifiers. As a result, the workgroup is calling on the Centers for Medicare & Medicaid Services to allow the industry to use the old ID numbers for an additional year after the May deadline.

Until these issues are addressed, federal officials still encourage physicians to obtain their NPIs.
You can apply for the NPI online at http://nppes.cms.hhs.gov/ or by calling the NPI enumerator at (800) 465-3203 for a paper application to be completed.