Medicare has mandated a change from the current provider identification system to a new National Provider Identifier (NPI). The change will occur on May 23, 2007. This change is not an option, but is mandated for Medicare and, ultimately, all private payers that accept electronic claims.
Officially, Medicare should allow an office to include both the NPI and the current Physician Identification Number (PIN) until the change date. All payers are required to process claims with your older PIN until May 23. Many private-sector payers are not capable of accepting the NPI at this time, but some, such as Medicare, are capable of accepting the NPI with the older PIN.
You may be wondering why you should bother using the NPI at all if a PIN works. In our experience, dry runs can be useful in preventing many disasters. We would strongly recommend that you obtain and begin using your NPI in conjunction with your current PIN as soon as possible. The NPI will be your financial lifeline after May 23, as Medicare will no longer process claims without the NPI after that date.
The transition period will not be easy. Ultimately, however, the NPI should make medical service providers less dependent on some vendors and better able to share critical patient data. The standardization to the provider-specific NPI mandated across all providers is designed to eliminate some of the custom numbers currently required by some private payers. With the elimination of custom numbers and some of the older PIN numbers in existence, the system will take one more step toward improving electronic communication.
To obtain your NPI, visit https://nppes.cms.hhs.gov/ for an easy-to-use application process.
Conversion factor cut averted
As most physicians know by now, Congress has stepped in to block the conversion factor reduction for Medicare services. The Deficit Reduction Act of 2006 was signed by President Bush, and Medicare was able to make the fee schedule changes prior to Jan. 1, 2007, avoiding at least in part some of the problems created last year.
The Tax Relief and Health Care Act (TRHCA) of 2006 achieved several things, including:
The final impact of all the changes-including relative value unit changes and the freezing of the conversion factor-will translate into a 0% change in overall Medicare payments to urologists for 2007.