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NPI compatible Medisoft software!

NPI is coming! Read below to get the information you need to
know so your Medicare payments don't get delayed.

We, at JB Medical, always strive to keep our customers informed of the latest trends and government regulations. That is why we’ve researched the details of NPI for you and put them on our website. If we’re willing to go the extra mile for people who aren’t our customers, imagine how we’ll treat you when you are a customer. We specialize in finding more efficient billing solutions for our clients. If you find yourself researching NPI and would like to discuss your goals that you have for your practice, please feel free to give us a call at 877-787-8686.

Do you have your NPI?
Nation Provider Identifiers will be required on claims sent on or after May 23, 2007. Every health care provider needs and NPI. Learn more about the NPI and how to apply for your NPI by visiting The National Plan and Provider Enumeration System web site.

Who does this affect ?
All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain an NPI for use to identify themselves in HIPAA standard transaction which includes Medicare physicians, providers, suppliers and billing staff who submit claims for services to Medicare contractors and carriers. Once enumerated, a provider's NPI will not change. The NPI remains with the provider regardless of job or location changes.

What if you don't get an NPI ?
Medicare will only accept claims with NPI's. No NPI number on your claims means no payment for your services.

I don't bill Medicare so will this still affect me ?
Yes, this is a Government mandate. All insurance carriers will require an NPI for processing claims. The deadline date on the NPI mandate for insurance companies has not been set. But be prepared and get your NPI # and compatible software now since all insurance carriers will require it as well.

What does this mean for Medisoft users?
If you don't have Medisoft software version 11 or higher, your software will not be compliant with the new NPI rules and regulations. HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Don't delay your claims and payments for services. Upgrade your Medisoft now so you will be ready by May. For questions on the NPI mandate and how to apply if you don't have an NPI, visit the CMS web site listed above.

What is the NPI?
The National Provider Identifier (NPI) is a standard, unique number that is assigned to healthcare providers - both individuals such as physicians and organizations such as medical group practices and hospitals - to identify them. You will recive your NPI free of charge.

What is the purpose of the NPI?
The NPI is designed to simplify and improve electronic transactions, encourage their increased use and reduce the administrative burdens of healthcare.

In what transactions will the NPI be used?
The NPI will be used in claims, claims status reports, payment and remittance EOBs, coordination of benefits, enrollment and disenrollment in a health plan, eligibility for a health plan, premium payments, referral certification and authorization, electronic prescribing--and more. Note that the NPI will be used by private carriers as well as by Medicare and Medicaid.

What is the time schedule on the NPI? Jan 3, 2006 - Oct 1, 2006:
Medicare systems will accept claims with an NPI and use NPI for some responses, but an existing legacy Medicare number must also be on the claim. Claims with only NPIs will be rejected. Oct 2, 2006 - May 22, 2007: CMS systems will accept an existing legacy Medicare billing number AND/OR an NPI on claims, but MSSNY, your County Medical Society, and CMS recommend using both. If a problem arises, a physician might not get paid if only the NPI was used. May 23, 2007 – Forward: CMS systems will only accept NPI numbers. (But small health plans have until 5/23/2008.) Also, please realize that payers, other than Medicare, could require the NPI before these timelines.

Who must obtain an NPI?
Any physicians who treat patients and need claims to be paid by health plans for services they render, need to obtain an NPI. And, note that Medicare now requires that any physician who is new to the Medicare Program or any physician who is changing their existing Medicare enrollment information obtain an NPI before the enrollment process or changes can be accomplished.

How do I obtain and NPI?

• You can use the web-based National Plan and Enumeration System (NPPES) to apply over the web: http://nppes.cms.hhs.gov. Be sure to include all legacy identifiers (previously used PINs, UPINs, and other ID numbers) that you have used with any payers, private as well as Medicare and Medicaid. If you report a Medicaid number, be sure to include the state name.
• Or, you can fill out a paper NPI Application/Update form and mail it to the NPI Enumerator (Fox Systems), PO Box 6059, Fargo, ND 58108-6059. To obtain an application form, call 800-465-3203 or 800-692-2326 (TTY), or e-mail customerservice@npienumerator.com

How long does it take to get an NPI?
CMS estimates that by mail, an application should take approximately 10 days. Some MSSNY members report that electronic NPI applications have taken only minutes.

What if I plan to continue filing paper claims?
MSSNY advises physicians who intend to continue filing paper claims to apply for their NPI through the US surface mail. If you apply for the NPI electronically, you might possibly be considered a HIPAA-covered entity. CMS says applying for an NPI on-line will not cause a physician to be a HIPAA covered entity. However, if you are concerned, apply through the mail. HIPAA covered entities would have to comply with HIPAA Privacy and Security regulations, and would have to conduct all future transactions electronically.

I've heard that if I am enrolling for the first time, or am changing my billing information, I will be required to accept electronic funds transfer (EFT).
It’s true. But MSSNY is currently seeking clarification from the AMA and CMS on whether this EFT requirement will automatically make the physician a HIPAA-covered entity.

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Upgrade to Medisoft v11 so you will be ready and there will be no delay
in receiving your Medicare or Insurance payments.