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Medicare now requires NPI |
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Monday, 03 March 2008 |
 CMS (Federal government Centers for Medicare and Medicaid Services) has
asked us to remind all whom bill Medicare for Part B claims of the
following:
Effective March 1, 2008 all CMS-1500 claims MUST have an NPI (national
provider id) or NPI/Legacy pair in the required provider fields.
Failure to include an NPI will result in your claim being rejected.
In the last two years, providers have been advised of the need to
obtain a NPI. Currently, most Medicare providers are submitting
claims which include their new NPI. Medicare computer systems will now
check to confirm the claim includes an NPI. If no NPI, the claim will
be rejected and the provider will receive an error message indicating
the lack of an NPI. If the provider has a NPI, they should make sure
the number of the claim is correct and resubmit the claim. If the
claim is then rejected again, the provider should immediately contact
your Medicare carrier to ensure your provider records are correct.
If you need to contact the Medicare carrier, go to www.cms.hhs.gov/MLNGenInfo and at the bottom of that page, go to the download file and click on "Provider Call Center Toll-Free Numbers Directory."
Then start getting ready for the next step.
If you have been submitting claims with both your NPI and a Medicare
legacy number and those claims have been paid... now is the time to
test your ability to get paid using only your NPI. To do so, try
submitting just two or three claims with just your NPI (and do not use
your Medicare legacy number). If claims with just your NPI are
accepted, you can go ahead and start using just your NPI for more and
more claims. Starting May 23, 2008, Medicare claims must only include
the NPI.
If in need of assistance, call your Medicare carrier provider relations or start with the CMS website at www.cms.hhs.gov/NationalProvidentStand.
But for now, remember as of March 1, 2008 ALL MEDICARE claims must include your NPI.
This information is provided as a member benefit.
Bruce Keeney
Executive Director
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