With the May 23 National Provider Identification (NPI) compliance deadline a little more than three weeks away, the Centers for Medicare & Medicaid Services (CMS) is coordinating a one-day NPI preparation exercise for clearinghouses to help physicians and other health care providers evaluate their NPI readiness.

After May 23 physicians must submit claims to all public and commercial payers using just their NPI number. According to Medicare, however, a very low percentage of claims are being submitted with just an NPI number. Most physician claims are being submitted with both an NPI number and a legacy number.

With that in mind, CMS is requesting that on May 7 several clearinghouses remove any legacy numbers included on physicians' submitted claims and forward the claims to CMS with just NPI numbers. The purpose of this one-day exercise is to ascertain what percentage of claims can be successfully processed with just an NPI number in hopes of averting significant claims processing problems after May 23.

On May 8 clearinghouses will revert back to sending claims to Medicare that include both NPI and legacy numbers. Physicians who submit claims with just their NPI number likely will not be affected by this exercise.

Physicians who bill Medicare are urged to: 1) ask their clearinghouse if it is participating in this exercise and, if not, request that it do so; and if their clearinghouse participates, 2) ask whether, should their claims be rejected as a result of this exercise, the clearinghouse will automatically resubmit their claims with both their NPI number and legacy number, or whether action is required by the physician.
Many physicians and other health care entities will need more time to prepare for using just their NPI number on claims. The AMA has requested that CMS extend the May 23 deadline by at least six months to allow physicians to submit claims with both their NPI and legacy numbers, if they still need to do so. CMS, however, has not yet extended the deadline.

CMS will field questions about the NPI process during a conference call at 2 p.m. (EST) on May 14. Advance registration is required.

Visit the CMS website for more information about the NPI standard.

Also, physicians are strongly encouraged to complete a survey aimed at further assessing the industry's readiness for handling claims containing only NPI numbers. This survey is an important opportunity for physicians to report on their ability to conduct electronic transactions and be reimbursed successfully using their NPI number. The survey closes May 13.