NPI Deadline Extension? How Does the CMS 1500 and NPI Deadline Extension Affect Your Office

by Michele Redmond - Date: 2007-04-29 - Word Count: 332 Share This!

There is a lot of buzz out there about the CMS, Center for Medicare and Medicaid Services, extending the deadline for NPI's from May 23, 2007 to May 23, 2008 but what does that mean to the average medical provider's office? Does that mean that you don't need to apply for your NPI number for another year?

No it doesn't. Many people misunderstand the purpose of extension. The extension is for entities that are not yet ready to operate on NPI's alone. In most cases this is insurance carriers whose systems are not ready to process claims based on provider's NPI numbers only. They still need legacy numbers on the claims in order to process them.

Also it doesn't mean that they just have an extra year to become compliant. If a complaint is filed they must file a contingency plan that outlines their plans for becoming compliant and shows that they 'in good faith' have been working on becoming compliant.

I have also heard of instances where providers are having trouble obtaining NPI numbers for their group due to the set up of their tax ID#. Until they straighten out the tax ID issue they can't obtain a group NPI.

Some insurance carriers will be compliant by May 23, 2007 and will require providers to be using their NPI numbers on claims. I spoke with New York's Upstate Medicare Division and they advised me last week that they will be requiring NPI numbers on all claims effective May 23, 2007. Claims without NPI numbers will be rejected. Other Carriers can become compliant during the extension and require NPI numbers on claims any date between May 23, 2007 and May 23, 2008.

So bottom line, if you are a medical service provider, you still need to have an NPI number, and if you do not have it by May 23, 2007 you may receive denials for your claims. Don't take the chance, get your NPI number and begin using it as soon as possible.

Copyright 2007 - Michele Redmond

Related Tags: npi number, npi deadline extension, hcfa 1500 form deadline, cms 1500 forms, npi deadline

It is becoming more and more difficult for providers to continue to bill directly from the office. Many are turning to outside specialists, such as Billing Services. Michele Redmond and Alice Scott are co-owners of a medical billing service. They offer an informational website for both physician's offices and the general public looking for information or help with their problems with medical insurance billing. Check out their website for more information on electronic billing and important changes now going on in Medical Insurance Billing, or to sign up for their free monthly newsletter.

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