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Published byBenjamin Hubbard Modified over 9 years ago
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CCNV 2ND ANNUAL CLIENT CONFERNCE NATIONAL PROVIDER IDENTIFIER AND YOUR ACCOUNTS RECEIVABLE Diane Harris 10/16/06
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DISCUSSION w Getting started w National Provider Identifier (NPI) Tips w Preparing your billing staff for NPI
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w UNDERSTAND HOW THE INTRODUCTION OF A NATIONAL IDENTIFICATION NUMBER FOR ALL PROVIDERS OF MEDICAL SERVICES WILL IMPACT YOUR FACILITY w COMMUNICATE WITH HEALTH PLANS OUTSIDE OF THE CCNV NETWORK TO DETERMINE THEIR NPI IMPLEMENTATION GUIDELINES
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w THE NPI IS REQUIRED FOR ALL PROVIDERS OF MEDICAL SERVICES w LOCUM TENENS AND CONTRACT PROVIDERS WHO PROVIDE MEDICAL SERVICES AT YOUR FACILITY WILL BE REQUIRED TO PRESENT THEIR INDIVIDUAL NPI’S
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w YOUR BILLING STAFF WILL NEED TO KNOW WHAT TO DO IF ANOTHER PROVIDER’S NPI IS NEEDED AND IS UNKNOWN (e.g., referred services) w SUGGESTION: COMPILE YOUR REFERRING PHYSICIAN NPI’S SOONER THAN LATER
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w NPI’S WILL BE USED FOR ALL BILLING TRANSACTIONS ALL MEDICARE PRODUCTS ALL MEDICAID PRODUCTS ALL COMMERCIAL PRODUCTS w CLAIMS WILL BE REJECTED EFFECTIVE 5/23/07 WITHOUT NPI’S REJECTION CODE WILL BE: 16 INDICATING THE CLAIM LACKS INFORMATION THAT IS NEEDED FOR ADJUDICATION
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w IF YOU ARE CURRENTLY RECEIVING MULTIPLE REMITTANCES FROM CARRIERS DUE TO MULTIPLE PROVIDER ID’S THIS WILL CEASE WITH THE NPI w CMS RECOMMENDS RECEIVING YOUR FUNDS ELECTRONICALLY VIA ELECTRONIC FUND TRANSFER OR EFT. THIS IS THE CURRENT TREND WITH MOST MAJOR CARRIERS
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w COMPANION TECHNOLOGIES IS IN THE PROCESS OF UPDATING YOUR SOFTWARE PROGRAMMING FOR THE NEW 1500 FORM (8/05) AND THE NEW UB FORM (04) TO INCLUDE ELECTRONIC SUBMISSION w ECLINICAL WILL ALSO BE PREPARED FOR THE NEW HIPPA FORMAT PRIOR TO 5/23/07 THE 1500 FORM (8/05) IS READY AND ON SALE THE MEDICAID FORM IS READY AND IN USE THE UB FORM (04) IS NOT YET READY FOR RELEASE
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w CONTINUE TO USE BOTH YOUR LEGACY NUMBERS AND NPI NUMBERS ON CLAIMS UNTIL 5/23/07. THIS WILL ALLOW THE CROSS WALK OF DATA TO OCCUR FOR YOUR FACILITY w CREATE A PROCESS TO SHARE YOUR NPI’S WITH BUSINESS PARTNERS FOR BILLING PURPOSES( HOSPITALS, E- PRESCRIBING, SKILLED NURSING FACILITIES)
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1500FORM1500FORM
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U B 04
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w PREPARATION IS THE KEY TO SUCCESS WITH THE NPI AND YOUR AR! w THIS IS A NEW PROCESS FOR INSURANCE CARRIERS, PROVIDERS AND SOFTWARE VENDORS, ARE YOU READY?
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