Providers: We want doc registry!

Sunday, February 4, 2007

WASHINGTON - While CMS continues pushing providers to get their national provider identification (NPI) numbers, the industry has expressed concern over the lack of a central directory listing physician NPI numbers.

"That is one of the biggest stumbling blocks to prevent fully compliant implementation of NPI across the board without claims delay," said Andrea Stark, a Medicare consultant for MiraVista. "That information should be made public to facilitate coordination."

Beginning May 23, HMEs must include the referring doctor's NPI number on Medicare claims. Ideally, Medicare says, providers should begin using NPI numbers at least 120 days before that, allowing time to implement the numbers in current business practices and work out any bugs.

Mark Gielniak, vice president of Warren, Mich.-based Diabetes Plus, said getting his NPI number was easy. Getting the NPI numbers of his referral sources is another matter.

"We've been trying to collect as many as possible from the physicians we deal with, but we're finding that a lot don't even know what an NPI number is," said Gielniak. "It's not like anyone should be caught off guard.

As of Jan. 18, 1.6 million or 40% of providers had NPI numbers, estimated Kim Brummett, who sits on the National Uniform Claims Committee that oversees NPI numbers. Without a directory, she fears, providers, hospitals, labs--anyone who bills Medicare--will slam physicians with calls all at once, creating system-wide problems.

"You can't possibly get all the NPI numbers for physicians loaded and ready to roll (in one day)--let alone feel comfortable that the DMERCs and the MACS (will be able) to recognize the NPI numbers (for anyone)," said Brummett.

CMS plans to publish a notice in the Federal Register at some point describing its policy for disseminating information from the National Plan and Provider Enumeration System, said a CMS official.