Reporting Your National Provider Identifier (NPI) On Medicare Claims
As we work toward a smooth transition to the National Provider Identifier, we have found that many providers have obtained NPIs but are not utilizing them when submitting their claims. If you have received your NPI, we strongly encourage you to begin including both your legacy number (OSCAR number) and the NPI when submitting claims to Medicare. In addition, it is extremely important to utilize the NPI that matches with the legacy number that was reported with NPPES, and that this combination is correct in NPPES. Submitting your claims in this manner will help in validating the NPI process during Stage 2 to determine any potential problems or issues that may occur, allow everyone time to make corrections or install fixes prior to May 23, 2007 (Stage 3), and reduce your risk of potential interrupted claim payments.
If you have not obtained your NPI by now you should do so immediately, as the deadline to obtain an NPI is quickly approaching and it will take time to do the remaining work to use it. This includes working on your internal billing systems, coordinating with billing services, vendors, and clearinghouses, and testing with payers. If you delay applying for your NPI, you risk your cash flow and that of your health care partners. The Centers for Medicare & Medicaid Services (CMS) encourages all providers to obtain NPIs in a manner similar to how you receive OSCAR numbers (Medicare Identification numbers) in a one-to-one relationship. When applying for an NPI, be sure to provide complete and accurate data to NPPES as failure to do so will lead to significant delays in claim processing if the information submitted with NPPES does not match with Medicare records. You will also want to consider other payers as well when submitting your application to NPPES.
You can apply for an NPI online at: https://nppes.cms.hhs.gov/ or can call the NPI enumerator to request a paper application at (800) 465-3203.
Information and education on the NPI can be found on the CMS Website at the CMS NPI page:
http://www.cms.hhs.gov/NationalProvIdentStand
Page Last Updated: Tuesday, 15-Jul-2008 10:34:58 CDT
