Why You Should Get Your NPI Now

Internal Medicine World ReportJuly 2006
Volume 0
Issue 0

Medical Officer, Office of the Administrator, Director, Physicians Regulatory Issues Team, Centers for Medicare & Medicaid Services, Department of Health and Human Services

As many of you probably know, the Centers for Medicare & Medicaid Services (CMS) has a new enrollment form for providers who are enrolling in the Medicare program or who need to update their enrollment data, for instance, because of a change in address. The form is clearer and easier to use than the form it replaced, but 2 new features may be a surprise for some physicians and their practice staff.

? The first new feature is that the form cannot be completed until the provider has obtained the new National Provider Identifier (NPI). As discussed last month, the NPI is not mandatory for claims processing until May 23, 2007, so some of you may feel that this is a move on the part of CMS to push physicians along. But in fact, it will be a timesaver for all of you. By obtaining your NPI now and getting it properly entered into the Medicare provider enrollment database, you will avoid having to fill additional Medicare forms later had you been permitted to defer obtaining your NPI. I spent only 5 minutes online to apply for my NPI. So just do it, and save time later.

The website you need to use to get the essential information about your NPI is www.cms.hhs.gov/NationalProvIdentStand. Once you are ready to apply, go to https://www.nppes.cms.hhs.gov.

? The second new feature is that the new form requires providers to sign up for electronic funds transfer (EFT). Some of you liked to receive a paper check for one reason or another and were concerned that this option would gradually cease to exist.

Let me assure you that the EFT requirement did not originate here at CMS. Federal law?specifically 31 U.S.C. ? 3332(f) (1)?requires that "all Federal payments made after February 1, 1999, shall be made by electronic funds transfer." CMS delayed the implementation as long as was possible, but since this is a statutory requirement, compliance is not optional for the agency. Medicare providers currently receiving paper checks can transition to a paperless process by filling out the Authorization Agreement for Electronic Funds Transfer (CMS-588).

Finally, the Physicians Regulatory Issues Team is interested in hearing from providers who are having trouble with enrollment and with applying for an NPI. We have worked around some EFT concerns with some large groups in New York recently. By all accounts, the NPIs have been working very efficiently. You can reach us with questions and concerns at prit@cms.hhs.gov.

For more information about the Medicare enrollment process, including mailing addresses and telephone numbers for the carrier or fiscal intermediary serving your area, go to www.cms.hhs.gov/MedicareProviderSupEnroll on the CMS website.

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