The NPI Debate Heats Up

Posted on August 31, 2008 by Dr. David Edward Marcinko MBA

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Questionable Benefits for Providers

[By Darrell Pruitt; DDS]pruitt

I really hate lies!

Even though I have been a member of the American Dental Association [ADA] for 26 years, and intend to remain a member for the rest of my life, I cannot stand by silently any longer while my professional organization uses lies and/or deception to trick trusting members into volunteering for NPI numbers. 

Now, to see what I mean, please read what the ADA tells dentists about the benefits of the NPI number http://www.ada.org/prof/resources/topics/npi.asp

  • 1. Once implemented across the entire health care industry, the NPI will be accepted by all dental plans as a valid provider identifier on electronic dental claims and other standard electronic transactions.
  • 2. Dentists will not have to maintain multiple, arbitrary identifiers required by dental plans, nor will they have to remember which number to use with which dental plan.
  • 3. NPIs introduce an important element of standardization to electronic transactions that should improve transaction acceptance rates.   

Questionable Benefits Review

See what I mean? Now let’s review:  

  • 1. Number one clearly benefits only insurers and number three is unwashed tyranny.  The smell of sweet buzzwords counter-balancing the odor of the verb “should” immediately revealed to me traditional PR hucksterism … and I’ve seen better. The NPI number, which is conveniently necessary for electronic transactions, will only make it cheaper for insurers to deny claims.  I think anyone can see that denials will increase for natural, bottom line reasons.
  • 2. That leaves benefit number two – reduction of ID numbers – as dentists’ last hope of a return on investment in the voluntary NPI.  And, ROI could take a while.  In the first place, how much do multiple identification numbers actually slow dentistry production in a computerized dental office?  Why don’t we get silly?
  • 3. Of all things, for the ADA to list simplification as a benefit of the NPI is embarrassing, but here is what will make a few ADA leaders avoid each other in the halls of Headquarters next week. Even though the promise of simplification is lame, it is technically the only benefit the NPI number lends dentists and their patients.

Enter the AAFP

Here now, is some fresh bad-news for certain ADA leaders and members who trusted their advice. 

In an article that was posted yesterday on the American Academy of Family Physicians (AAFP) website, it looks like CMS reneged on simplification.

http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20080829keep-ptans.html

PTANS 

“Notice to physicians: Hold on to your Medicare Provider Transaction Access Numbers [PTANs], also known as legacy numbers which were to have been retired after the mandatory use of National Provider Identifier [NPI] numbers on May 23.” CMS has found another use for those old PTANs.”

Imagine that.  Instead of eliminating all of those identifiers as promised, the NPI is just one more number to add to the hard drive.

Assessment

Regardless, patients don’t suffer harm from all this, right?  Wrong. 

I’ll describe harm from HIPAA, the biggest blunder in the history of dentistry, and medicine, next time. 

Conclusion

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Health Insurers Secrets

Posted on August 31, 2008 by Dr. David Edward Marcinko MBA

Seven Things you don’t Know about Health Insurance

By Staff Reporters

“Myth Busters”

Wrapped up in all the noise these days are myths on health insurance that were perhaps once true – or maybe never were.

So, here’s a look at seven things you probably didn’t know about your health insurer.

Link: http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/7SecretsOfHealthInsurers.aspx

Conclusion

Your thoughts are appreciated; especially from insurance agents, industry insiders and medical providers; please opine and comment.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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