1 NPI – HDX Services Readiness Strategy Kathy Ducharme Sheryl McClelland.

Slides:

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Presentation transcript:

1 NPI – HDX Services Readiness Strategy Kathy Ducharme Sheryl McClelland

2 HDX Services – NPI Implementation Strategy NPI Overview HDX Eligibility Service HDX Electronic Claims Service HDX Electronic Remittance Service

3 NPI Overview Final Rule mandated 5/23/2007 Standard unique identifier for Health Care Providers –Type 1: Individual –Type 2: Organizational Providers must apply for their NPIs NPPES assigns NPIs: 10 digit number – last digit is a self check digit (ISO Luhn)

4 HDX Eligibility Service Goals Implementation Strategy Timeline

5 HDX Eligibility Service - Goals Utilize the Dual Use Strategy proposed by WEDI Insulate Providers from varying Payer timelines Ability to react to Payer changes quickly Provide a solution that requires only one set of changes for the Providers

6 HDX Eligibility Service – Implementation Strategy Providers send both Legacy identifiers and NPI on eligibility requests –Option 1: NPI as primary, Legacy as secondary –Option 2: Legacy as primary, NPI as secondary HDX preference is Option 1 HDX will maintain a transparent table of all payers indicating their NPI processing requirements HDX will map the identifiers according to the payers’ requirements Transaction will be successful as long as the Provider’s eligibility request contains the data needed for the Payer.

7 HDX Eligibility Service - Timeline October 1, Communication to all our Provider Integration Partners December 1, Internal Testing with Provider Integration Partners January HDX Eligibility Service changes implemented in Production January Providers begin sending NPI

8 HDX Electronic Claims Service Goals Implementation Strategy Timeline

9 HDX Electronic Claims Service - Goals Utilize the Dual Use Strategy proposed by WEDI Enable Providers to Migrate Individually Provide a solution that requires only one set of changes for the Providers Enable Providers to easily submit their NPI’s

10 HDX Electronic Claims Service – Implementation Strategy ECS Customer Option –Supports NPI at both the facility and doctor level –Recommend confirmation of third-party, payer, and remittance software readiness ECS Payer Option –INVISION/UNITY customers MUST submit NPI’s to Siemens –NPI is used to route transactions and reports –Recommend confirmation of payer and remittance software readiness

11 HDX Electronic Claims Service - Timeline NPI ready NOW October 31, 2006 – Customer Memo Z061031C ECS Payer Option: –INVISION/Unity Providers must submit NPI –Contact us now via: –NPI ready - once NPI submission process is complete January 2007 – can submit NPI via web page

12 HDX Electronic Remittance Service Goals Implementation Strategy Timeline

13 HDX Electronic Remittance Service - Goals Utilize the Dual Use Strategy proposed by WEDI Enable Providers to Migrate Individually Provide a solution that requires only one set of changes for the Providers Enable Providers to easily submit their Payee level NPI’s Early Adopter Testing

14 HDX Electronic Remittance Service – Implementation Strategy Supports WEDI advocated Dual-Use transition strategy Customers MUST submit Payer level NPI’s to Siemens Siemens must load NPI into Enrollment Database –Update OML for Invision/Unity customers NPI will be used to route transactions and reports to appropriate destination Submit your NPPES NPI Enumeration documents

15 HDX Electronic Remittance Service - Timeline October 31, 2006 – Customer Memo Z061031C November 2006: –Contact Siemens to initiate NPI submission process –Contact us now via: December 2006 – Claims & Remit 3.8 Customer Memo December 2006 – begin Early Adopter testing January submit NPI via web page (if not already submitted) Jan/Feb 2007 – Changes implemented in Production

16 For Your HDX NPI Information – –Read about HDX NPI strategy or WEDI press releases –Read additional information on related links sidebar –Upcoming Customer Memos WEDI Call to Arms listed on website Contact us:

17

18 The Power of HDX Question and Answer Session

19 The Power of HDX “ This presentation is designed to give conclusive examples of how we deliver the best practice integration. ”

20 The Power of HDX