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The Impending NPI Deadline
By Staff Reporters
Most of us know that until now, hospitals and other healthcare organizations had until May 23, 2008 to implement the National Provider Identifier (NPI) scheme for Medicare claims; but we were apparantly wrong!
CMS said today that hospitals must get their NPI in place for submitting Medicare fee-for-service claims by January 1, 2008. If not, CMS will begin rejecting such claims. (CMS is will still accept non-NPI claims from professional services providers like doctors, labs and clinics).
CMS officials say they’re moving up the deadline because most providers are already on board with the NPI.
Really! Are they sure? Not from my view of the universe!
To be sure, providers who aren’t using the NPI are already technically in trouble already, as the original deadline is long past. However, as part of the transition to full NPI rollout, CMS has been letting them slide if (in essence) they promised to work on it by filing a contingency plan.
Anyone caught off guard with this announcement?
– A Healthcare CTO
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Filed under: Information Technology | Tagged: Health I.T. |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
I sure was.
Thanks for the info.
I will look right into the matter.
Incidentally, I have been using this health IT dictionary, which is an excellent related resource on the general topic.
Best of luck to all!
-A HIT Manager
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FYI, I have been covering the NPI issue on my blog, the HIT Transtion weblog at http://blog.hittransition.com. You can read up on NPI issues by clicking on the National Provider Identifier category link in the right-hand margin.
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Does anyone know what percentage of providers already have NPI numbers?
Thanks.
-Darrell
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NPI Readiness
Darrell, the CMS reported that as of January 2007, over 1.6M providers have obtained an NPI.
And, a recent survey of the health care industry, conducted by the Workgroup for Electronic Data Interchange (WEDI), indicates that providers should have already obtained an NPI and be focusing on implementation and testing with health plans and clearinghouses. If you have not obtained your NPI by now you should do so immediately so that you can begin the implementation and testing process.
Thanks
NOTE: For related health IT terms: http://www.HealthDictionarySeries.com
-The Moderators
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NPI Questions
More NPI information and education can be found at the CMS website NPI page: http://www.cms.hhs.gov/NationalProvIdentStand
Providers may also apply for an NPI online at http://www.nppes.cms.hhs.gov or may call the NPI enumerator to request a paper application at 1-800-465-3203.
Dr. David E. Marcinko
Hope Hetico; RN, MHA, CMP
[Chief and Managing Editors]
http://www.HealthCareFinancials.com
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Dear Barbara:
You told me that 1.6M providers had obtained NPI numbers a year ago. Can you tell me what the sample size was back then? I was also hoping for more recent information.
Hope, I looked over the website you mentioned and there is nothing offered that comes close to answering my questions.
I would also like to know how the numbers are broken down by Type 1 and Type 2 as well as by state and specialty. I was hoping that I would not have to file a request under the FOIA to obtain this information.
Whether or not I personally have an NPI number or not should have nothing to do with my request for important information that some seem to want to keep hidden.
Darrell Pruitt DDS
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Definition of HL7?
Can anyone tell me what exactly HL7 is, and why?
Thanks
-A
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What is HL7?
ANSWER: According to the webstite: http://www.HL7.org
“Health Level Seven (HL7) is one of several American National Standards Institute (ANSI) – accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven’s domain is clinical and administrative data.”
“Headquartered in Ann Arbor, MI, Health Level Seven is like most of the other SDOs in that it is a not-for-profit volunteer organization. Its members– providers, vendors, payers, consultants, government groups and others who have an interest in the development and advancement of clinical and administrative standards for healthcare—develop the standards. Like all ANSI-accredited SDOs, Health Level Seven adheres to a strict and well-defined set of operating procedures that ensures consensus, openness and balance of interest.”
A frequent misconception about Health Level Seven (and presumably about the other SDOs) is that it develops software. In reality, Health Level Seven develops specifications, the most widely used being a messaging standard that enables disparate healthcare applications to exchange keys sets of clinical and administrative data.
Members of Health Level Seven are known collectively as the Working Group, which is organized into technical committees and special interest groups. The technical committees are directly responsible for the content of the Standards. Special interest groups serve as a test bed for exploring new areas that may need coverage in HL7’s published standards.
A list of the technical committees and special interest groups as well as their missions, scopes and current leadership is available on their web site.
Best.
Hope Hetico; RN, MHA
Atlanta, Georgia
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Hello All,
The material on electronic medical records and HIT in your print-guide is excellent. Dr. Mata and Dr. Metfessel are unbelievable writers, experts and thought leaders on hospital and enterprise-wide information technology systems.
But, is there an information source on EHRs for us solo or small medical group practitioners? Any info at all is appreciated.
Thanks.
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A Doc,
Try these website resources, without guarantees or “quid-pro-quo”:
http://www.EMRupdate.com
http://www.GreenwayMedical.com
http://www.e-MDs.com
http://www.EMRexperts.com
http://www.NextGen.com
http://www.AllScripts.com
Thanks for the compliments on “Healthcare Organizations [Financial Management Strategies].”
Other sources are encouraged.
All the best.
-Moderators
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RE: NPI Database
From: A friend
A free and very easy-to-use NPI number database lookup is available here: http://npinumberlookup.org
Best.
-Anonymous
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More NPI Links
CMS Resources:
http://www.cms.hhs.gov/NationalProvIdentStand/06_implementation.asp
WEDI National Provider Identifier Resource Center:
http://www.wedi.org/npioi/public/articles/index.cfm?fuseaction=link
National Plan and Provider Enumeration System (NPPES)
https://nppes.cms.hhs.gov/NPPES/Welcome.do
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Another national medical provider identifier deadline is approaching.
As of March 1, 2008, doctors who bill Medicare electronically must include NPIs on all claims in addition to the older IDs they have been using. The older “legacy” identifiers alone will not suffice. And, after May 23, 2008, physicians will be required to use only NPIs on electronic claims submitted to Medicare and all other health care payers. Therefore, any information discrepancies must be cleared before then.
Although electronic deadlines don’t apply to physicians who file only paper claims, those who send their claims to a clearinghouse intermediary must comply.
Thanks
Ann
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Can anyone tell me what the sample size was back then? I was also hoping for more info.
Thanks.
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NPI Update
According to HFMA News, when the Centers for Medicare and Medicaid Services [CMS] launched the National Provider Identifier [NPI] program a few weeks ago, a significant minority of Medicare and Medicaid claims were rejected; in fact as many as one-quarter may have been rejected. Now, just a week later, CMS reports that medical provider’s have gotten much better.
According to the agency, most intermediaries were reporting that over 90 percent of claims were NPI-compliant, with some reporting 100 percent compliance. The problems that remained largely involved providers using legacy numbers for their secondary provider identifier field, which should also include the provider’s NPI.
You comments are appreciated.
-Staff Writers
Executive-Post
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