May 23, is the day that the U.S. Centers for Medicare and Medicaid Services (CMS) has mandated for health care providers defined as “covered entities” under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to begin using their National Provider Identifier (NPI). Although CMS released a contingency implementation plan, that plan requires covered entities to document that they exercised reasonable and diligent efforts to become compliant by the May 23, 2007 deadline date. CMS will begin reviewing complaints of non-compliance beginning May 24th. Also, as soon as the number of claims submitted with an NPI by primary providers is “sufficient” to do so, Medicare will—following appropriate notice—begin rejecting claims without an NPI for primary providers. This could be as early as July. CMS has published a “tip sheet” containing helpful steps for providers based on the contingency guidance released on April 2, 2007. A PDF file of the tip sheet can be viewed at:
http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/ContingencyTipSheet.pdf
If you have not yet applied for your NPI, it is recommended that you do so immediately at:
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