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Providers make rapid progress on using NPI in claims
When CMS kicked off the National Provider Identifier program a couple of weeks ago, a significant minority of Medicare and Medicaid claims were being rejected--with as many as one-quarter of claims filed bouncing, according to one vendor. Just a week later, however, CMS has reported that providers' filings had gotten much better, fast. According to the agency, most intermediaries were reporting that over 90 percent of claims were NPI-compliant, with some reporting 100 percent compliance. The problems that remained largely involved providers using legacy numbers for their secondary provider identifier field, which should also include the provider's NPI, CMS noted.
To learn more about CMS's report:
- read this HFMA News item
Related Articles:
Claims rejections go through the roof with NPI requirement
Providers want another NPI implementation delay
Smaller providers not ready for NPI
National provider identifier deadline extended
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Comments
By Martin Jensen | Posted 1:01pm | June 4, 2008
There are reasons to be skeptical of the CMS announcement. First, they say that the claims are "compliant" but that is not the same as saying they are getting properly crosswalked and paid. Many providers only learn their claims have failed when they get an ADR letter by mail, sometimes weeks later. Also, some of the "improvement" is certainly due to the fact that providers and clearinghouses are holding back claims that they know will deny, or will get crosswalked incorrectly. Finally, if you go by CMS's 2006 volumes, the 10% not getting through constitutes a little over 385,000 claims being rejected every day.
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