Medicare Compliance & Reimbursement

NPIs:

Don't Leave Your Home Address In The Database

At last, you can look up other doctors' NPIs.

Any day now you can download a new database from the feds that will help keep claims--and compliance efforts--on track.

What: The new database will help home health agencies and other providers look up referring physicians' National Provider Identifiers (NPIs) for use on Medicare and other claims, said federal officials speaking at a June 20 audioconference held by the Centers for Medicare & Medicaid Services (CMS).

When: This summer the agency will issue the NPI information, which is drawn from National Plan and Provider Enumeration System (NPPES) data. "Very soon we will make available a file [online] to help people understand how the registry will work and where to find it," a CMS official said.

Where: For updates and information, go to www.cms.hhs.gov/NationalProvIdentStand. The first version of the database will be a file you can download from the NPI Web site, according to CMS. The agency will update the file regularly to reflect the revisions providers make to their own NPI files.

In addition, CMS will offer a "query only" version of the database that can be accessed on the Internet. Changes to this database will be made in "real time."

Important reminder: You must update your providers' NPPES data within 30 days of any change.

"Now is the time to update," said a CMS official speaking at the forum, encouraging providers to review their NPI files before publication of the first database. Some providers may want to change home addresses to business addresses, for example. CMS is also encouraging providers to double-check their entries under the category "other provider identifier types," which should include only legacy numbers that link to the provider who applied for the NPI in question.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All