May 2007 Newsletter
HARP is Ready…
For the NPI-Revised CMS-1500 and UB-04
As May 23, 2007 is fast approaching, “Contingency Plans” are in the air. May 23, 2007 is when the National Provider Identifier (NPI) will be required on electronic transactions for HIPAA covered entities. However, the Centers for Medicare & Medicaid Services (CMS) have announced a one-year, non-enforcement contingency plan.
The contingency plan permits health plans to accept legacy identifiers until May 23, 2008. During the transition, they may accept legacy numbers with NPI or NPI alone. Each health plan, however, may set its own timetable.
Medicare published guidance on how they will edit NPIs after May 23, 2007. They will begin to require NPIs for primary providers as early as July 2007 if a sufficient number of claims they receive have NPIs. Legacy numbers will continue to be acceptable for secondary providers, such as referring providers, until May 23, 2008. See MLN Matters MM5595 for complete details.
HARP and Quadax EDI are successfully sending NPIs on electronic transactions for those payers who are ready to accept them. HARP users and Quadax Service Consultants continue to work together gathering NPIs and legacy qualifiers and populating them into HARP.
Another step in this transition is to include NPIs on hardcopy claims. With HARP software release 2.29F, the new CMS-1500 form (08/05) was successfully implemented. These claims now include an NPI if entered into HARP. A HARP software release, which included the new UB-04 form, was implemented on April 30.
What should HARP clients be doing to prepare?
- Providers should obtain their own NPIs and the NPI for any provider that refers patients to them.
- Billing Services should gather NPIs from providers they bill for and the NPIs for referring/ordering providers as well.
- Share your NPIs with the payers with whom you are currently registered.
- Work with your Quadax Service Consultant to populate NPIs in HARP and the Quick EDI system.
- Work with your Quadax Service Consultant to populate legacy qualifiers.
- Work with your Quadax Service Consultant to populate taxonomy codes (institutional providers only).
- Obtain new CMS-1500 forms and/or UB-04 forms.