News
CSM Changes to Patient Signature Rules
NEMSIS related FIPS Codes
North Carolina Changes to PreMIS Import Data Submission Process Effective 1/1/08
NPI Trainng Module Now Available
The NPI Registry and the downloadable file are now available. To view the Registry, visit https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do on the web. The downloadable file is available at http://nppesdata.cms.hhs.gov/cms_NPI_files.html on the web.
Additionally, the final module in the NPI Training Package is now available. Module 4, Data Dissemination, is now available at NPI_Module4_Data_Dissemination.pdf on the CMS website. This module describes the policy by which CMS will make certain NPPES data available, as well as the data CMS is disclosing.
New NPI Rejections Effective October 29, 2006
Effective October 29, 2007, Highmark Medicare Services Part B will begin editing the NPI/Legacy ID combinations for validity against the NPI crosswalk file for Medicare Part B claims submitted on paper or electronically. Where a match cannot be located on the crosswalk, claims will be rejected or returned to the provider.
When the claim is rejected or returned, a provider should first verify that the correct NPI was submitted. If the correct NPI was submitted, you will need to verify that your legacy identifier (PIN or NSC) number corresponds with the information on file with the National Plan and Provider Enumeration System (NPPES). NPPES data may be checked, or updated as appropriate, online at https://nppes.cms.hhs.gov. Once corrected, send a small volume of claims using your NPI. If the claims are not rejected, you are strongly encouraged to increase your NPI claim volume.
If your NPPES information is correct and you have included and matched ALL Medicare legacy identifiers with a corresponding NPI in NPPES, but you are experiencing provider identifier problems with your claims that contain an NPI, you may need to submit a Medicare enrollment application (i.e., the CMS-855). Please contact your contractor if you need more information.
NOTE: Until October 29, 2007, when rejections will occur for claims where an NPI/Legacy ID match cannot be located on the crosswalk, Informational Edits are reported on the MCS Edit Report for claims submitted electronically. These edits are currently informational only, and the claim is still forwarded to the Medicare processing system for processing and payment consideration, provided no other rejection errors occur.
Therefore, providers who receive informational edits should review and correct the issue now to avoid rejections starting October 29, 2007.
2007 Ambulance Fee Schedule
Gateway EDI Eligibility Press Release
2007 Medicare Part B Deductible
The Medicare Part B deductible for 2007 is $131.00. For more information on the 2007 Medicare premiums and deductibles, view the Centers for Medicare and Medicaid Services Medicare Learn Network MLM Matters at:
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5345.pdf
Healthcare Planning Model
NPI. Get it. Share it with Aetna. Then use it with Aetna. Follow these NPI steps by April 15 to allow us time to process your information. Delaying may disrupt the processing of your electronic transactions.
Get it now.
- Apply online at https://nppes.cms.hhs.gov. Or, call 1-800-465-3203.
- You need an NPI if you use HIPAA standard electronic transactions such as electronic claims, referrals, precertification requests and eligibility inquiries.
Share it with Aetna.
Then use it in electronic transactions with Aetna.
- We can accept and use your NPI if it is included in a real-time transaction, but only if it has been previously entered into our database. Otherwise, the transaction will reject.
- Beginning May 23, 2007, you must include your NPI in all HIPAA standard electronic transactions.
Providers enrolled in ERA/EFT will receive a communication regarding the payee level NPI to be used in their Electronic Remittance Advice (ERA).
|
