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For
Immediate Release:
September 14, 2006
Health
Plans to Impose Early Deadlines for HIPAA Mandated NPIs: Do you
have your New CMS 1500 Forms for October 1, 2006 Deadline? Do
you have your new NPI Provider Identifier (NPI)?
SEP 14, 2006, Mesa, AZ
- The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Final Rule regarding the adoption of national standards and identifiers for electronic claims and other
transactions was adopted January 23, 2004. NPI activities began in 2005 with the first deadline for compliance scheduled May 23, 2007. Small health plans have until May 23, 2008.
"Health care providers should anticipate Health Plans to impose early deadlines for compliance with the HIPAA mandate," says
Paul De Francis, Ph.D., President of Pertexa Healthcare
Technologies, Inc. Upon compliance deadlines, HIPAA covered entities must use NPIs to identify health care providers in standard transactions. These transactions include claims, eligibility inquiries and responses, claim status inquiries and responses, referrals, and remittance advices.
The Revised CMS 1500 Form, which accommodates the new NPIs,
is required for use effective October 1, 2006.
"All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain the NPI to identify themselves in accordance with HIPAA standard transactions," says
De Francis. The National Provider Identifier (NPI) will be the single provider identifier, replacing the different provider identifiers currently used for each health plan with which a Health Care Provider does business. HIPAA covered entities include health plans, health care clearinghouses, and health care providers that conduct electronic transactions for which the Secretary has adopted a standard (i.e., standard transactions).
"The NPIs will improve electronic transactions for the health care industry, since the adoption of national standards for electronic health care transactions will encourage electronic commerce, simplify processing, and reduce the administrative burdens on health care providers," encourages
De Francis. "With the new NPIs, health care providers will be able to submit transactions to any health plan in the United States."
Health care providers include individuals such as physicians, dentists, and pharmacists, and organizations, such as hospitals, nursing homes, pharmacies, and group practices.
Health care providers who transmit health information electronically in connection with any of the standard transactions are required by the Final Rule to obtain NPIs, even if they use business associates, such as billing agencies, to prepare the transactions.
The NPI will replace health care provider identifiers that are in use today in standard transactions. Implementation of the NPI will eliminate the need for health care providers to use different identification numbers to identify themselves when conducting standard transactions with multiple health plans.
De
Francis advises, "This change warrants critical attention by health care providers, considering the direct impact on how they will receive claims reimbursements and accounts receivable payments. Health care providers should take action early to make sure they are prepared to meet health plan deadlines that may precede mandated HIPAA deadlines for compliance."
Pertexa
is well positioned to support compliance with the
new HIPAA mandates. Our highest priority is to anticipate the
changing needs of our clients. We take pride in staying ahead of
ongoing changes, and as a result, Pertexa clients experience
seamless transitions with no adverse affect in their cash flows.
Pertexa Healthcare Technologies, Inc.
Pertexa provides services to physicians, physician groups and billing companies that include health care consulting, medical coding and billing, medical claims expediting, managed care contracting and accounts receivable recovery.
Pertexa increases revenue for physicians and billing offices by improving and accelerating healthcare reimbursements through the use of proven technologies.
Pertexa’s team of excellence includes President, Paul De Francis, Ph.D., Certified Coders, CPCs, CMBs, MBAs, CPAs, and expert Reimbursement Specialists.
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Contact
Information:
Pertexa
Healthcare Technologies, Inc.
2266 S. Dobson Road
Mesa, Arizona 85202
Phone: (520) 204-5957
FAX: (520) 207-2217
Email: info@pertexa.com
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