Practice Management Alert

You-ll soon have access to real-time, up-to-date information

As of Aug. 1, you-ll be able to look up national provider identifier (NPI) information using a query-only database from CMS: the NPI Registry.

History: CMS had planned to give you access to the National Plan and Provider Enumeration System (NPPES) database at the end of June but then delayed the release to give providers more time to look up their information in the NPPES database and delete anything they wouldn't want the public to be able to view.

The database will include real-time NPPES information, according to Empire Medicare's Web site. That means you-ll have quick access to -Freedom of Information Act (FOIA) -disclosable data for newly enumerated providers, as well as updates and changes to enumerated providers- FOIA-disclosable data- as soon as it's available in the NPPES system.

How it works: You-ll be able to search the database by query using information such as a provider's name or NPI number. You-ll get a list of all NPPES records that meet the criteria you enter in the query. Once you select the record or records you wish to view, the NPI Registry displays the available information for that record.

Getting NPIs for referring physicians has been very time-consuming, says Rebecca Marthaller, CMRS, owner of Lower Columbia Medical Billing in Longview, Wash. -I know of many billing offices that are looking forward to this database.-

-I think this a step forward that we need,- says Shannon Smith, CRTT, CPC, CMSCS, director of coding and reimbursement for DoctorsManagement in Knoxville, Tenn. -One of the biggest provider complaints regarding NPI has been that they have not been published thus far -- meaning when you received a referral/consult in which the NPI number is needed for the claim form, you would have to obtain this information from the practice even if it meant an additional phone call. Before the UPIN, we were able to look up that information.-

Important: Not all of your providers- information in the database will be publicly available, according to CMS- Jim Bossenmeyer during a recent Open-Door forum. Social Security numbers, dates of birth, countries of birth, and other sensitive data won't be in the public database.

Up next: CMS plans to also provide you with a downloadable file with the same FOIA-disclosable NPPES data for providers registered with NPIs.

Read more: You-ll soon be able to find more information on the NPI Registry on the CMS NPI Web page at www.cms.hhs.gov/NationalProvIdentStand/06a_DataDissemination.asp.