How will NPI dovetail with NSC? TBA

Friday, September 30, 2005

BALTIMORE - Applications for the 10-digit National Provider Identification numbers have been rolling in since May, but providers still have questions about how the new enrollment process will work.
Top of mind is how NPI will dovetail, if at all, with the National Suppliers Clearinghouse. Despite the questions, few words were spoken of NPI and the NSC during a late-August Open Door Forum on provider enrollment applications.
That's because a lot of the details are "still being fleshed out," said attorney Asela Cuervo. At this stage in the game, one thing is for sure: NPI isn't a substitute for the NSC.
"Providers will need to have both," Cuervo said. "NPI is going to be a number, basically, and it's not going to have any intelligence embedded into it. It will be separate from enrollment, where you look at whether the supplier is qualified to be in the Medicare program."
CMS created NPI, a requirement of the Health Insurance Portability and Accountability Act of 1996, to help improve electronic transactions for health care. NPI numbers, "global" numbers used across the board for all payers, accompanied by an existing Medicare number will be accepted beginning Jan. 3, 2006.
Wade Hendrickson, chairman of the National Supplier Clearinghouse Advisory Committee, said it's too soon to tell whether NPI and the NSC will streamline the enrollment process by sharing information, but providers "are optimistic."
The NSC is adopting a software system that would help facilitate information sharing, he sad.
One issue discussed during the Open Door Forum was submitting applications online, which Hendrickson said would be "faster, cleaner and easier to track." CMS and the company that will dole out NPI numbers, Fox Systems, is still tweaking the system, especially as it relates to providers with multiple locations and multiple tax IDs.
All HIPAA-covered health plans must implement the NPI by May 23, 2007. Small health plans have until May 23, 2008.
Those deadlines seem far away, but providers worry about how smoothly the process will work, with some entities working with NPI numbers and others still making the transition.
"But that sort of has been the HIPAA-implementation model," Cuervo said. "Issues will be worked out on a case-by-case basis."
The bottom line on NPI: "There are a lot of folks who think it's overkill," Cuervo said.