Part B Insider (Multispecialty) Coding Alert

Published on Wed Jul 20, 2005 PDF

Don't wait too long-or you'll be caught in the crush

Sure, all the cool kids are  doing it already. But should you wait to apply for a National Provider Identifier?

Sometimes there are benefits to being an early adopter, but it may pay off to wait until the Centers for Medicare & Medicaid Services irons out any bugs in the NPI application process, say experts. After all, you have over a year to apply.

Medicare started accepting NPI applications in May and will accept NPIs starting in January, as long as they're accompanied by existing Medicare numbers. Alert: From October 2006 to May 2007, Medicare will accept either NPIs or Medicare numbers - but as of May 23, 2007, Medicare will only accept NPIs.

Some experts advise that you wait at least until September or October this year to apply for an NPI because although the CMS Web portal is simple to use, it may still have some glitches. Any Internet-based form is likely to have teething problems, they point out.

If you enter your information into the online form and it isn't working well, you could be dealing with miscues for months, worries consultant Rob Levin with Billing Solutions in Philadelphia, PA. "You could spend time completing the application and sending it in and not have the information entered appropriately." He plans to wait another month before applying on behalf of his clients.

But you shouldn't wait too long. Any kind of enrollment application can take longer than you expect, and you don't want to get caught in the crush. In particular, next June, a new crop of medical school grads will burst onto the scene and they'll all be applying for NPIs, notes consultant Jill Young with Young Medical in East Lansing, MI.

Graduating med students will start to apply for numbers in May, and Medicare often is backed up for four or five months after that, says Young. And then by the time that bottleneck clears up, everyone who waited to apply for an NPI will be applying. "Next year will be May to May" in terms of enrollment delays, Young predicts.

The NPI application process is "pretty straightforward," says consultant Jonathan May with HuTech Resources in Itasca, IL. "You just need to go online with your physician name and some practice information and that's really it."

Tip: Young also recommends having a specific person in your office who deals with credentialing and enrollment issues. That way, one person will be completely up to speed on all the requirements.