News and Updates >> Client Update
June 28, 2006
Practices MUST obtain NPI numbers
PhyLogic Healthcare is reminding all providers that they must obtain their NPI numbers soon. The NPI (
National Provider Indentifier) will replace the provider identification numbers that providers use
today in the HIPAA standard transactions that they conduct with health plans. Those transactions
include the electronic claim, eligibility inquiry and response, claim status inquiry and response,
payment and remittance advice, prior authorization/referral, and coordination of benefits transactions.
A future benefit of the NPI system is the elimination of the need to track multiple provider numbers for
various health plans.
It is important to note that when the NPI is implemented in May, 2007, providers “old” numbers
will no longer be permitted. Therefore, if a NPI has not been obtained, the provider can be assured
of cash flow problems. It may be foreseeable that some insurance payers may have difficulty in
managing the changeover and that associated problems may arise such as claim denials, failure to
adjudicate claims, and incorrect claim processing. PhyLogic will be monitoring any related developments
and will make every effort to eliminate any such problems which may negatively impact reimbursement. In
order to help mitigate these issues, PhyLogic is encouraging providers to obtain their NPI’s as soon as possible.
Providers have two main options in obtaining their NPI numbers:
- Providers may obtain the numbers themselves by applying on-line or printing and then mailing
the application. This can be done by accessing the following site: https://nppes.cms.hhs.gov/NPPES/Welcome.do; or,
- For a small fee, providers have the option of using an outside company which will complete the entire process for them. One such company PhyLogic has found which can easily provide this service nationally is VantagePoint Healthcare Advisors. They can be contacted at (203) 288-6860 or at www.vantagepointconsult.com.
Once you have obtained your NPI number, please make certain that you provide it to PhyLogic immediately as it is essential for the reimbursement process. Please contact Sara Nied, Manager of Technical Operations, who will update our computer systems with your new number. Sara may be reached at 877-273-3100 ext 126, or at SaraN@phylogic.com.