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April 2007  
     

NPI Contingency Plan Update - April 23, 2007

For some period after May 23, 2007, Medicare FFS will allow continued use of legacy numbers; it will also accept transactions with only NPIs, and transactions with both NPI and legacy identifiers.

After May 23, 2008, the legacy number will NOT be permitted on any inbound or outbound transaction. Medicare FFS has been assessing health care provider submission of NPIs on claims submitted. As soon as the number of claims submitted with an NPI for primary providers is sufficient to do so, Medicare will begin rejecting claims without an NPI for primary providers following appropriate notice.

In May 2007, Medicare FFS will evaluate the number of submitted claims containing a NPI. If the analysis shows a sufficient number of submitted claims contain a NPI, Medicare will begin to reject claims on July 1, 2007, that do not contain NPIs.

If a sufficient number of claims do not contain NPIs in the May analysis, Medicare FFS will assess compliance in June 2007 and determine whether to begin rejecting claims in August 2007. Medicare FFS will provide advanced notification to providers, Medicare contractors and the shared systems of the date they are to begin rejecting claims when a decision has been made to do so. That date will supersede all dates announced in previous contractor communications.

CMS recognizes that the National Council for Prescription Drug Program (NCPDP) format permits reporting of only one identifier, and will accept either the NPI or legacy number on the NCPDP format until May 23, 2008.

In regard to the remittance advice and the 837 coordination of benefits (COB) transactions, the following will occur until May 23, 2008:

  • If a claim is submitted with an NPI, the NPI will be sent on the associated 835 remittance advice, otherwise the legacy number will be provided;
  • If a claim is submitted with an NPI, the 837 coordination of benefits (COB) transaction will contain both the NPI and the legacy number, otherwise the legacy number will be provided.

By May 23, 2008, the X12 270/271 eligibility inquiry/response supported by CMS via Extranet and Internet must contain the NPI.

Once a decision is made to begin requiring NPIs on claims, primary providers i.e., billing, pay—to and rendering providers must be identified by their NPIs or the claims will be rejected once the decision is made as indicated above. Medicare contractors must then use the NPI crosswalk to locate the NPI and associated legacy identifier submitted on the claim for primary providers.

All other providers are considered secondary providers and include referring, ordering, supervising, facility, care plan oversight, purchase service, attending, operating and "other" providers. Legacy numbers are acceptable for secondary providers until May 23, 2008.

AdvancedMD Wins Best Healthcare Management Solution (Vertical) Award

San Francisco, California (PRWEB) – April 17, 2007 – AdvancedMD, the leading provider of Web-based practice management solutions for medical offices and billing services, was presented the Best Healthcare Management Solution (Vertical) award at the Software & Information Industry Association's (SIIA) 22nd Annual CODiE Awards.

"This award is a great honor for AdvancedMD," said Jim Pack, President & CEO of AdvancedMD. "Our clients praise AdvancedMD for its time-saving workflows that allow them to operate more efficiently—leading to better patient care and more revenue for their offices. To be chosen from such a large pool of domestic and international applicants for this award further demonstrates the superiority of what we offer to the healthcare industry."

The CODiE Awards celebrate outstanding achievement and vision in the software, digital information and education technology industries. Winners were chosen from more than 1,200 nominations submitted by more than 600 companies.

"I applaud all the companies selected as winners or finalists in the 22nd annual CODiE Awards," said Ken Wasch, SIIA President. "The software and information industry continues to move at a dizzying pace, and being recognized by your peers for getting to and staying at the head of the pack in such a dynamic environment is a major accomplishment. It is one of the reasons why the CODiE Awards hold such a special place in our industry."

For a complete list of the 2007 Codie Award winners, please go to: http://siia.net/codies/2007/winners.asp.

About SIIA

The Software & Information Industry Association (SIIA) is the principal trade association for the software and digital content industry. SIIA provides global services in government relations, business development, corporate education and intellectual property protection to more than 800 leading software and information companies. For further information, visit www.siia.net.

About AdvancedMD Software

AdvancedMD Software, Inc., headquartered in Salt Lake City, Utah, is the leader in Web-based medical billing and practice management software. AdvancedMD Software brings to market AdvancedMD, a full-featured billing and scheduling solution and AdvancedEMR, a flexible electronic medical records management system. AdvancedMD solutions include free technical support, top tier security, and fully HIPAA compliant accessibility. AdvancedMD maintains a 98% customer retention rate and serves thousands of providers nationwide. For more information please visit www.advancedmd.com.

     

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