NPI – Are You Ready? - Patient Payments | …

1 NPI Are You Ready? The presentation was created to assist Navicure clients in navigating the information received regarding OverviewGetting an NPI is free - Not Having One Can Be National provider Identifier (NPI) is a Health Insurance Portability and Accountability ActThe National provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification NPI is a unique identification number for covered health care health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

2 This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical May 23, 2008, the NPI must be used in lieu of legacy provider identifiers in the HIPAA standards ChecklistSTEP 1 Acquireyour NPIs IMMEDIATELYYou can apply online at OR by phone: Providers can obtain a paper application by calling NPPES at 1-800-465-3203, MondayFriday 8:30 a m5:00 p mMonday -Friday, 8:30 -5:00 through the Electronic File Interchange (EFI): Providers can apply for multiple NPIs, through the EFI by visiting the site for information on this process.

3 PNPI ChecklistSTEP 2 - Registeryour NPIs IMMEDIATELYWith NPPES online athttps://nppes cms hhs gov/NPPES/Welcome doWith NPPES online at ** Navicure is not authorized to complete this step on your your payers to confirm your NPI is registered with ALL your payers to confirm your NPI is registered with each.** Navicure is not authorized to complete this step on your Navicure via email* at update your @pycompany profile.*NPI and any profile updates cannot be taken over the will require that clients use their NPI prior to the deadline to ensure that everything is working properly before May DatesBeginning Monday, April 21, Navicure began a rollout to require NPIs in Navicure s system ahead of the May 23rddeadline.

4 We are doing this to ensure that all the yyginformation that Navicure and payers will be require on May 23rdis acquired and registered with the parties by then. We do this not to put an added burden on our clients. Instead, it is to ensure uninterrupted cash flow come May Monday, May 12, Navicure will begin submitting claims to payers with NPIs EXCLUSIVELYno legacy numbers, except in instances where we know payers are not yet prepared to accept NPIs exclusively We will do this to ensure that NPIs are correctly registered with payers whenNPIs exclusively.

5 We will do this to ensure that NPIs are correctly registered with payers when claims are submitted. Again, our intent is to ensure that cash flow is not interrupted on May 23 and thereafter. We will share a schedule for this rollout in the coming two weeks. Our intent is to have tested exclusive NPI submission with clients in every state by Friday, May DatesNavicure will require NPIs AHEAD of May 23rddeadlineNavicure will process claims to Medicare with NPIs exclusively and with both legacy and NPIs for commercial OH 4/24/2008 GA, FL, VT, HI 4/28/2008 PA, TX, SD, WY 4/29/2008 NC, SC, WV, ID 4/30/2008 IL, AZ, IA, OR 5/1/2008 NY, CA, ND, MT 5/2/2008 MS, VA, ME, MN 5/5/2008 TN, KS, MO, OK, UT 5/6/2008 MA, NJ, CT, AK, NH5/6/2008 MA, NJ, CT, AK, NH 5/7/2008 RI, MI, AL, MD, WI 5/8/2008 NE, KY, IN.

6 DE, NM 5/9/2008 CO, LA, AR, WA, NV 5/12/2008 DC PR VI5/12/2008 DC, PR, VIHelpful ://nppes cms hhs gov/NPPES/Welcome will Host NPI National Roundtable Q&A Sessionon May 19, 2008 CMS will host a national NPI Roundtable Q&A session to address questions from the Medicare provider community qpyprior to May 23rd. This Roundtable will be on May 19th from 2-3:30PM will not be collected during the registration process for this will be no presentations during this call; we will open the lines to take questions following a brief introduction. For registration details, visit the CMS the Navicure Knowledge Base for payer contact information or Google is a useful tool as QuestionsWill there be a temp or surrogate NPI?

7 No temp/surrogate NPI will be issuedNo temp/surrogate NPI will be issuedCan I correct NPI on Navicure?YesAny viewable data on Navicure can be updatedYes Any viewable data on Navicure can be 33 of the Navicure 1500 form will update 24 JWhat about Ordering/Referring/Attending?What about Ordering/Referring/Attending? the Navicure Knowledge Base for payer contact information orUse the Navicure Knowledge Base for payer contact information or Google is a useful tool as QuestionsWhat is the difference between legacy, PTAN and NPI?Legacypreviously issued payer credentialed provider numberLegacy previously issued payer credentialed provider numberPTAN - provider Transaction Access Number previously issued payer credentialed provider numberNPI - 10-position, intelligence-free numeric identifier (10-digit number)p,g(g)NPI Codes?

8 The provider Taxonomy is a unique alphanumeric code ten characters in length The provider Taxonomy CodeThe provider Taxonomy is a unique alphanumeric code, ten characters in length. The provider Taxonomy Code List allows a single provider (individual, group, or institution) to identify their specialty category. For payers who require the use of taxonomy codes it is recommended that Navicure clients confirm their provider profile reflects the information used in NPI ://www wpc-edi com/codes/ QuestionsWarning and Informational MessagesWARNING!

9 YOUR CLAIM WAS SUBMITTED WITHOUT A NPIM343 UNABLE TO IDENTIFY PROV INFORMATIONALU ntil May 23 you might find informational or warning messages from Navicure or the payer. These will turn into rejection and cause payment issues if not corrected. To resolve please confirm NPI registration is on file with all payer and Code requirement some payers are using the zip+4 to assist in their internal crosswalk of rejection for invalid billing zip code:BILLING ZIP CODE-INVALID. MUST CONSIST OF 9 ZIP CODE INVALID. MUST CONSIST OF 9 rejection for invalid facility zip code:FACILITY ZIP CODE - INVALID.

10 MUST CONSIST OF 9 NUMERICS. Can I still send my Legacy ID s to Navicure?Can I still send my Legacy ID s to Navicure?Yes, If clients continue to send legacy ids, Navicure will strip off the legacy id before sending out to the insurance company if they are accepting NPI only. Some payers will continue to accept QuestionsWEDI Bulletin----NPIs for Secondary ProvidersIf the entity that is required to be identified in the secondary provider field ( , the yqyp(,ordering/referring/attending/opera ting/supervising/purchased service/other/service facility provider or prescriber) does notfurnish an NPI, the billing provider must attempt to obtain that NPI in order to enter it on the claim.)