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Medicare NPI Contingency Update

Friday, April 27, 2007

On April 23, 2007 Medicare announced their NPI Contingency Plan. Previously, it was announced by CMS that Health Plans would be authorized to accept claims without the NPI on a contingency basis. Each plan, was to develop a plan for how this would be carried out. Here are a few things to note:

Medicare will continue to accept "legacy only" claims for some unspecified period of time. How long this "legacy only" time period lasts will be dependent upon how many providers begin submitting claims using either "NPI Only" or "NPI AND legacy".
Providers who need to submit an identifier for another provider as part of the Medicare claims submission (i.e. the referring physician's identifier) CAN use the legacy number of that provider through May, 2008.

Information courtesy of the Healthcare Billing & Management Association

The AdvancedMD Advantage: AdvancedMD software is NPI compliant and ready to accept the new system at any time. Use both your existing (legacy) number and the NPI number when submitting electronic claims and test transactions with those entities. Visit our NPI page for additional NPI contingency details and links to the NPI number application page.

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