2/27/08

MARCH 1ST IS A CRITICAL NPI DATE!

Last month, CMS issued the January NPI message to all providers.  (You can view the January NPI message online at http://www.cms.hhs.gov/NationalProvIdentStand/02_WhatsNew.asp on the CMS website.)  This week begins a weekly messaging campaign for Medicare Fee-For-Service providers in order to raise the level of urgency as the March 1 implementation date approaches. 

Prior to March 1, 2008:

Claims with both an NPI and a Medicare legacy number are rejected if the pair is not found on the Medicare NPI Crosswalk.  

Claims submitted with just a Medicare legacy number are being paid (unless of course, they have other errors that cause them to be rejected).

As of March 1, 2008:

Claims with both an NPI and a Medicare legacy number will continue to be rejected if the pair is not found on the Medicare NPI Crosswalk.

Claims without an NPI in the primary provider field will be rejected! 

Claims with only a Medicare legacy number in the primary provider field will be rejected! 

This means that you will not be able to get paid for any Medicare services you provide until you begin using your NPI.  Also, if needed, you must correct any data which may be preventing an NPI/legacy match on the NPI crosswalk. The correction might require that you file a CMS-855 Medicare Provider Enrollment form with your Medicare carrier, A/B MAC, or DME MAC, a process which can take a number of months to accomplish.