1. Dual Use of NPI & Legacy Identifiers
Presented by Peter Barry
Peter T Barry Company
CoChair WEDI SNIP Transactions Workgroup
CoChair WEDI SNIP NPI Sub-workgroup
Chair INCITS B10.7 Standard Health ID Card
September 8, 2005
WEDI NPI Audiocast, April 15, 2005

2. How does Dual Use Work? Sender puts NPI in Primary Identifier Field
Sender put all legacy identifiers in REF Identifier Fields
At first, receiver ignores NPI, uses legacy identifies.
Later, receiver starts using NPI instead of legacy
When both agree, sender stops sending legacy identifier
Note: you still have to send Tax ID for some provider fields

3. What are legacy identifiers?
A legacy identifier, for purposes of this discussion, is any identifier besides NPI.
So, for this discussion, Federal Tax ID is a legacy identifier, as well as UPIN, a Blue Cross identifier, medical license number, and so forth.

4. Dual Use Strategy

5. What transactions can use Dual NPI & Legacy identifiers?
837 Institutional Claim
837 Professional Claim
837 Dental Claim
835 Remittance Advice
270/271 Eligibility Inquiry & Response
276/277 Claim Status Inquiry & Response (version 2.0 of paper, not yet approved)
278 Services Review & Response

6. What’s the benefit of the Dual Use Strategy?
If implemented one trading partner at a time, NPI could need the same huge bilateral testing and conversion as did transactions.
But dual use offers two solutions:
Schedule independence
Smaller steps
As soon as receiver receives Dual NPI & Legacy identifiers, both sender and receiver can convert their internal systems for NPI at own schedule.

7. Paper on Dual Use Strategy Gives Specifications:
2010AA
BILLING PROVIDER NAME
NM109
Billing Provider Identifier
NPI
REF02
Billing Provider Additional ID
Tax ID
Legacy
2010AB
PAY-TO PROVIDER NAME
Pay-To Provider Identifier
2310A
ATTENDING PHYSICIAN NAME
etc.

8. Problems?
Some payers feel it is technically not feasible to return both NPI and Legacy Identifiers on the 835 Remittance Advice.

9. Recommendation Adopt the Dual Use of NPI & Legacy Identifiers Strategy
Immediately implement the ability to receive NPI even if you ignore it and continue to use legacy identifiers for a time.
Change your internal systems at your own schedule.