Providers should not procrastinate using National Provider Identifiers, according to speakers at Thursday's Workgroup for Electronic Data Interchange NPI Forum.
According to Marty Jensen, co-chair of WEDI's business sub-workgroup, most providers think of the NPI transition as a regulatory compliance issue that won't have any impact until the enforcement date next May 23.
"The world will not stand still for the next 10 months," Jensen said. "Medicare will be moving forward and many other payers will be following Medicare's lead."
The Medicare contingency plan, which required all providers to start using NPIs in good faith since May 23 of this year, is intended for working the kinks out, Jensen said.
Jensen said there are already signs of claims processing showing negative impact from the NPI transition that has at times held up all crossover claims for days. CMS is also reporting that some providers are seeing NPI errors, Jensen said.
Jensen has received anecdotal reports from some providers who say they have double-checked their NPI numbers for accuracy and still their claims were denied.
"Those are the kinds of glitches we want to deal with now before next May 23," Jensen said.
Medicare is probably going to be one of the most proactive of the payers, Jensen said, but it is fair to expect greater difficulty with Medicaid plans, each with their own numbers and crosswalk strategies. Also, large regional payers with a large share of the market might not be up to snuff on NPI. All of these are reasons to avoid a midnight switchover, Jensen said.
To transition, providers should send out a few claims each week using NPI to allow time for resolving difficulties and to minimize impact on the bottom line and the need for crisis management, Jensen advised.
Suzanne Stewart, EDI coordinator at Aurora Health Care in Milwaukee, said at the forum that there are a number of ways providers can reduce the risks to accounts receivable while transitioning to NPI. One is to validate ahead of time that all trading partners are ready to send and receive using NPI.
Stewart said Aurora has not quantified the impact of its NPI transition yet, but so far it has extended staff resources, including project managers, office staff and others who have been involved in testing and implementation of the NPI project.
"We have seen some minimal accounts receivable impact due to NPI edits and rejections firing incorrectly with some payers," Stewart said. "We're also seeing an impact to remittance processes as payers had issues with sending out remittances incorrectly due to their cross-walking of NPI numbers, regardless if we sent NPI on our claims yet or not."