Family physicians: Take note of news from CMS that will help you get paid in a timely manner for services you provide.
Health care providers can now apply for their National Provider Identifier, which implements a requirement of the Health Insurance Portability and Accountability Act of 1996. The NPI must be used by most HIPAA-covered entities -- health plans, health care clearinghouses and health care providers -- conducting standard electronic health transactions.
Health care providers include individuals, such as physicians, dentists and pharmacists, and organizations, such as hospitals, long-term care facilities, pharmacies and group practices. Any provider transmitting health information electronically in connection with the standard transactions must obtain an NPI, even if the provider uses a billing agency to prepare the transactions.
This single provider identifier replaces the multiple identifiers physicians and other health care providers have been using with various health plans. Physicians will be notified by health plans with which they do business -- including Medicare -- when they should start using their NPI in standard transactions. All HIPPA-covered entities, with the exception of small health plans, must begin using NPIs by May 23, 2007.
The NPI application will soon be available on the CMS Web site.
Check out these other news updates from CMS:
Check Out Updates, Reminders From CMS
By News Staff
- The agency recently implemented a new provider customer service plan that triages provider calls according to complexity. A "provider relations research specialist" handles questions triaged at the third -- or highest -- level. Physicians who contact CMS with complex Medicare questions for which they wish to receive a written answer should ask that their inquiry by handled by a PRRS. Here's why: Physicians who follow written guidance received from a PRRS will be held harmless for outcomes resulting from following that guidance.
- Don't forget that as of March 22, physicians became eligible for payment for smoking and tobacco use cessation counseling. Use CPT code G0375 for an intermediate visit of three to 10 minutes ($12.89); use CPT code G0376 for an intensive visit longer than 10 minutes ($25.39).
