According to a June 11 announcement from the Centers for Medicare & Medicaid Services, physicians must reconcile their NPI data with their IRS legal name data in order to get reimbursed.  Every aspect of the data must match, including the exact spelling of names, the use of initials and even blank spaces in the data. The slightest discrepancy could disrupt payment of Medicare claims.

After a yearlong contingency period, the use of NPIs was required by CMS as of May 23. Both before and since that deadline, physicians have had difficulty getting paid due to a host of complications with CMS and clearinghouse systems.  Physicians should ensure that all requirements for Medicare payment are met in order to avoid claims issues.

Source: Healthcare Finance News 6/17/08