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CCNV 2ND ANNUAL CLIENT CONFERNCE

CCNV 2ND ANNUAL CLIENT CONFERNCE. NATIONAL PROVIDER IDENTIFIER AND YOUR ACCOUNTS RECEIVABLE Diane Harris 10/16/06. DISCUSSION. Getting started National Provider Identifier (NPI) Tips Preparing your billing staff for NPI.

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CCNV 2ND ANNUAL CLIENT CONFERNCE

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  1. CCNV 2ND ANNUAL CLIENT CONFERNCE NATIONAL PROVIDER IDENTIFIER AND YOUR ACCOUNTS RECEIVABLE Diane Harris 10/16/06

  2. DISCUSSION • Getting started • National Provider Identifier (NPI) Tips • Preparing your billing staff for NPI

  3. UNDERSTAND HOW THE INTRODUCTION OF A NATIONAL IDENTIFICATION NUMBER FOR ALL PROVIDERS OF MEDICAL SERVICES WILL IMPACT YOUR FACILITY • COMMUNICATE WITH HEALTH PLANS OUTSIDE OF THE CCNV NETWORK TO DETERMINE THEIR NPI IMPLEMENTATION GUIDELINES

  4. THE NPI IS REQUIRED FOR ALL PROVIDERS OF MEDICAL SERVICES • LOCUM TENENS AND CONTRACT PROVIDERS WHO PROVIDE MEDICAL SERVICES AT YOUR FACILITY WILL BE REQUIRED TO PRESENT THEIR INDIVIDUAL NPI’S

  5. YOUR BILLING STAFF WILL NEED TO KNOW WHAT TO DO IF ANOTHER PROVIDER’S NPI IS NEEDED AND IS UNKNOWN (e.g., referred services) • SUGGESTION: COMPILE YOUR REFERRING PHYSICIAN NPI’S SOONER THAN LATER

  6. NPI’S WILL BE USED FOR ALL BILLING TRANSACTIONS • ALL MEDICARE PRODUCTS • ALL MEDICAID PRODUCTS • ALL COMMERCIAL PRODUCTS • CLAIMS WILL BE REJECTED • EFFECTIVE 5/23/07 WITHOUT NPI’S • REJECTION CODE WILL BE: 16 INDICATING THE CLAIM LACKS INFORMATION THAT IS NEEDED FOR ADJUDICATION

  7. IF YOU ARE CURRENTLY RECEIVING MULTIPLE REMITTANCES FROM CARRIERS DUE TO MULTIPLE PROVIDER ID’S THIS WILL CEASE WITH THE NPI • CMS RECOMMENDS RECEIVING YOUR FUNDS ELECTRONICALLY VIA ELECTRONIC FUND TRANSFER OR EFT. THIS IS THE CURRENT TREND WITH MOST MAJOR CARRIERS

  8. COMPANION TECHNOLOGIES IS IN THE PROCESS OF UPDATING YOUR SOFTWARE PROGRAMMING FOR THE NEW 1500 FORM (8/05) AND THE NEW UB FORM (04) TO INCLUDE ELECTRONIC SUBMISSION • ECLINICAL WILL ALSO BE PREPARED FOR THE NEW HIPPA FORMAT PRIOR TO 5/23/07 • THE 1500 FORM (8/05) IS READY AND ON SALE • THE MEDICAID FORM IS READY AND IN USE • THE UB FORM (04) IS NOT YET READY FOR RELEASE

  9. CONTINUE TO USE BOTH YOUR LEGACY NUMBERS AND NPI NUMBERS ON CLAIMS UNTIL 5/23/07. THIS WILL ALLOW THE CROSS WALK OF DATA TO OCCUR FOR YOUR FACILITY • CREATE A PROCESS TO SHARE YOUR NPI’S WITH BUSINESS PARTNERS FOR BILLING PURPOSES(HOSPITALS, E-PRESCRIBING, SKILLED NURSING FACILITIES)

  10. 1500 FORM

  11. UB 04

  12. PREPARATION IS THE KEY TO SUCCESS WITH THE NPI AND YOUR AR! • THIS IS A NEW PROCESS FOR INSURANCE CARRIERS, PROVIDERS AND SOFTWARE VENDORS, ARE YOU READY?

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