The clock is ticking for physicians to sign up for a National Provider Identifier, the new 10-digit number that will be used by Medicare, Medicaid, and many private health plans to process claims.
The deadline for registering for an NPI number is May 23.
Physicians who are not using an NPI after that date could experience cash flow disruptions, according to the Centers for Medicare and Medicaid Services.
The transition to a single identifier that can be used across health plans is required under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Most health plans and all health care clearinghouses must begin using NPIs to process physicians' claims in standard transactions by May 23.
Small health plans have another year to become compliant.
“The NPI is the new standard identifying number for all health care billing transactions, not just for billing Medicare or Medicaid.
“National standards like the NPI will make electronic data exchanges a viable and preferable alternative to paper processing for health care providers and health plans alike,” said Aaron Hase, a CMS spokesman.
As of Jan. 29, more than 1.6 million NPIs had been assigned, according to CMS.
Physicians and other health care providers can apply for an NPI online or by using a paper application. In addition, organizations like hospitals or professional associations can submit applications for several physicians in an electronic file.
Officials at CMS are urging physicians who haven't yet signed up to do so soon. A physician who submits a properly completed electronic application could have his or her NPI in 10 days.
However, it can take 120 days to do the remaining work to use it, Mr. Hase said. The preparation includes working on internal billing systems; coordinating with billing services, vendors, and clearinghouses; and testing the new identifier with payers, he said.
So far, the process of obtaining an NPI has been relatively easy, said Brian Whitman, senior analyst for regulatory and insurer affairs at the American College of Physicians. The application process itself takes only about 10 minutes, he said.
But one thing to be aware of is that you may already have an NPI. Because some large employers may have already registered their providers, physicians may be surprised to learn that they already have a number, Mr. Whitman said.
As the May deadline approaches and more and more physicians get registered, the next question is how widely CMS plans to disseminate the NPIs.
CMS officials have said they are considering creating some type of directory of NPIs that could be available to physicians and office staff.
Physicians can apply for an NPI online at https://nppes.cms.hhs.gov