MIR-2006-11AB, November 2006

NPI: Get It. Share It. Use It.
October 23 rd means only seven months remain until the National Provider Identifier (NPI) compliance date. Over 1,300,000 NPIs have been issued so far --- do you have your NPI yet?

Act Now!
Don’t procrastinate; getting your NPI is only the first step in preparing for the compliance date. You should allow time to share your NPI with payers and other trading partners, update your referral lists, as well as modify and test computer systems.

Resources for Commonly Asked Questions
The Centers for Medicare & Medicaid Services (CMS) has compiled a list of resources that will help to answer many questions on NPI. Visit http://www.cms.hhs.gov/NationalProvIdentStand/07_Questions.asp#TopOfPage to view this resource. Additionally, CMS continues to build its database of Frequently Asked Questions (FAQs) on NPI. Recently, an FAQ on Electronic File Transfer (EFT) of payments from health plans to health care providers was added. You can view all existing NPI FAQs at http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_sid=Qjr3YRYh&p_lva=&p_li=&p_page=1&p_
cv=&p_pv=&p_prods=0&p_cats=&p_hidden_prods=&prod_lvl1=0&p_search_text=NPI&p_
new_search=1&p_search_type=answers.search_nl on the CMS Web site.

Participate in the Latest WEDI Industry Survey
The Workgroup for Electronic Data Interchange (WEDI) is currently conducting a survey to measure the next stage of NPI readiness across the healthcare industry. To access the survey, go to: http://www.surveymonkey.com/s.asp?u=415952639752 on the Web. Also note, this survey will only be open for a short time. The last day to participate is October 31, 2006.

*Special Information for Medicare Providers*

Billing Medicare
Medicare is testing the new software that has been developed to use the National Provider Identifier (NPI) in the existing Medicare fee-for-service claims processing systems. Providers have until May 23, 2007 before they are required to submit claims with only an NPI.

Until testing is complete within the Medicare processing systems, Medicare urges providers to continue submitting Medicare fee-for-service claims in one of two ways:

• Use your legacy number , such as your Provider Identification Number (PIN), NSC number, OSCAR number, or UPIN; or
• Use both your NPI and your legacy number.

Until testing of the new software that uses the NPI in the Medicare systems is complete and until further notice from Medicare, the following may occur if you submit Medicare claims with only an NPI:

• Claims may be processed and paid, or
• Claims for which Medicare systems are unable to properly match the incoming NPI with a legacy number (e.g., PIN, OSCAR number) may be rejected to the provider, and then you will need to resubmit the claim with the appropriate legacy number.

Required Use of NPI on Medicare Paper Claim Forms
Medicare will require the NPI on its paper claim forms. A variety of MLN Matters articles are available on this topic at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/MMArticles_npi.pdf on the CMS NPI Web page.

How to Share Your NPI with Medicare
Medicare providers may share their NPIs with Medicare in three different ways:

• For new Medicare providers, an NPI must be included on CMS-855 enrollment application.
• Existing Medicare providers must provide their NPIs when making any changes to their Medicare enrollment information.
• Medicare providers should use their NPI, along with appropriate legacy identifiers, on their Medicare claims.

Still not sure what an NPI is and how you can get it, share it, and use it? As always, more information and education on the NPI can be found at the CMS NPI page at www.cms.hhs.gov/NationalProvIdentStand on the CMS Web site. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203.

Getting an NPI is free
- not having one can be costly.

 CMS Learn Resource 200610-13