The NPI compliance date is May 23, 2007. It's every provider's responsibility to make sure that an NPI is obtained if the provider is required to do so. If you're not sure, it's time to investigate. Get your NPI now so you have time to prepare before the compliance date. This includes sharing your NPI and appropriately testing it with payers to avoid a disruption in cash flow.

Healthcare providers can still apply for National Provider Identifiers (NPI) in one of three ways.

1. For the most efficient application processing and the fastest receipt of NPIs, healthcare providers should consider using the web-based NPI application process. They can log onto the National Plan and Provider Enumeration System (NPPES) and apply on line at https://nppes.cms.hhs.gov/NPPES/Welcome.do; or
2. Healthcare providers can agree to have an Electronic File Interchange (EFI) organization (EFIO) submit application data on their behalf (i.e., through a bulk enumeration process) if an EFIO requests their permission to do so; or,
3. Healthcare providers may wish to obtain a copy of the paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator located in Fargo, ND, whereby staff at the NPI Enumerator will enter the application data into NPPES. The form will be available only upon request through the NPI Enumerator. Healthcare providers who wish to obtain a copy of this form must contact the NPI Enumerator in any of these ways:

   Phone: 1-800-465-3203 or TTY 1-800-692-2326
   E-mail: customerservice@npienumerator.com

   Mail:
   NPI Enumerator
   P.O. Box 6059
   Fargo, ND 58108-6059

NPI Training Package

CMS has developed a Training package on NPI that will assist providers with self-education, as well as education of staff. This package is also useful to national and local medical societies for group presentations and training. The entire package will consist of five modules: General Information, Electronic File Interchange (EFI), Subparts, Data Dissemination and Medicare Implementation. Each Module consists of a PowerPoint presentation (with speaker's notes) and is designed to stand alone or can be combined with other Modules for a training session tailored to the particular audience. Modules will be posted to the CMS NPI web page as completed.

Modules currently available include:

• Module 1: General Information
• Module 2: Electronic File Interchange (EFI)
• Module 3: Subparts

Source: CMS

Effective January 23, 2004, the final rule regarding the National Provider Identifier (NPI) was published. The Centers for Medicare and Medicaid Services (CMS) started assigning NPI numbers to providers last May. Health Choice Generations will require the NPI to be used as the healthcare provider identifier for all claims submissions starting in May 2007.

Providers currently contracted with Health Choice Generations can now submit their NPI number to the HC Generations Network Services Department. To submit the NPI number, providers can mail or fax a copy of their NPI notification to:

The documentation must include the provider's name and provider's signature. NPI numbers will also be accepted via written notification either by mailing or faxing to the information listed previously.

HC Generations is targeting January 1, 2007 as the optional claims submission date. However, effective May 23, 2007, all claims must be submitted with the NPI when applicable. More information is available at
http://www.cms.hhs.gov/NationalProvIdentStand/.

Click here to register for a NPI number:
https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart

Information on Covered Entities Under HIPAA
CMS has posted a new "Frequently Asked Question" to the CMS website that addresses whether a healthcare provider is a covered entity under HIPAA if they receive health information electronically (e.g. an electronic remittance advice), but do not transmit any health information electronically. The link is listed below or you can go to the CMS.gov website and click on "Questions" in the blue banner.

http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/
std_adp.php?p_faqid=7906&p_created=1158786931&p_sid=fY-kZcii&
p_accessibility=0&p_lva=&p_sp=cF9zcmNoPSZwX3NvcnRfYnk9JnBfZ3
JpZHNvcnQ9MjoyJnBfcm93X2NudD0yNTQxJnBfcHJvZHM9JnBfY2F0cz0mc
F9wdj0mcF9jdj0mcF9zZWFyY2hfdHlwZT1hbnN3ZXJzLnNlYXJjaF9ubCZwX
3BhZ2U9MQ**&p_li=&p_topview=1

Clarification of the Taxonomy Requirement Outlined in CR5243
Effective January 1, 2007, institutional Medicare providers who submit claims for their primary facility and its subparts (such as psychiatric unit, rehabilitation unit, etc.) must report a taxonomy code on all claims submitted to their Fiscal Intermediary. CMS posted a FAQ that clarifies this requirement. The link is listed below or you can go to the CMS.gov website and click on "Questions" in the blue banner.

http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?
p_faqid=7896&p_created=1158064263&p_sid=KiZr-wii&p_accessibility=0&
p_lva=&p_sp=cF9zcmNoPTEmcF9zb3J0X2J5PSZwX2dyaWRzb3J0PSZwX3
Jvd19jbnQ9MSZwX3Byb2RzPTAmcF9jYXRzPSZwX3B2PSZwX2N2PSZwX3
NlYXJjaF90eXBlPWFuc3dlcnMuYV9pZCZwX3BhZ2U9MSZwX3NlYXJjaF90
ZXh0PTc4OTY*&p_li=&p_topview=1

Reminder to Supply Legacy Identifiers on NPI Application
CMS continues to urge providers to include legacy identifiers on their NPI applications. This will help all health plans, including Medicare, to get ready for May 23, 2007. If reporting a Medicaid legacy number, include the associated State name. If providers have already been assigned NPIs, CMS asks them to consider going back into the NPPES and updating their information with their legacy identifiers if they did not include those identifiers when they applied for NPIs. This information is critical for health plans and healthcare clearinghouses in the development of crosswalks to aid in the transition to the NPI.

Source: CMS e-mail 9/25/2006