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National Provider Identifier (NPI)
Deadline:
May 23, 2007
It's time to get your NPI:
PDF
NPI Application:
PDF
Busting the myths
In the June 16 edition of the ADA E-Gram, the American Dental Association stated: Just as we experienced with HIPAA, misinformation about the National Provider Identifier is spreading. It then busted a few of the biggest myths:
- Myth: Dentists need to purchase commercial NPI
implementation guides. Reality: Enumeration is free to all eligible health care providers. NOTE: AzDA has been receiving phone calls from members who've gotten NPI Implementation Guide sales solicitations. We spoke with the ADA Legal Department on July 6, who told us: These offers are not necessarily a "scam". However, since the ADA nor AzDA have seen the product, we are unable to determine its validity. To purchase (or not) one of these guides is strictly a business decision dentists must make. However, they must remember that purchasing a guide is not necessary because they can do this themselves.
- Myth: 2006 compliance deadline. Reality: The deadline is May
23, 2007.
- Myth: Dentists are required to have NPIs. Reality: Technically, only dentists who use HIPAA standard electronic health care transactions will be required to use NPIs. It's possible some health plans may require the NPI on paper claims, but current indications are that many won't, at least for now.
- Myth: Claims won't be paid without an NPI. Reality: Possibly, if a claim is submitted electronically without an NPI on or after the May 23, 2007 deadline. It's impossible to say with certainty how much a paper-based dentist will need to use NPIs. Many paper claims doubtless will be processed and paid normally without NPIs up to the deadline and probably for some time after. For this reason, paper-based dentists may want to consider applying for NPIs. But they don't have to pay anyone to do that for them and in most cases won't need to pay anyone to teach them how to use their NPIs.
- Myth: Prescriptions won't be honored without NPIs. Reality: While it's true that some states may require provider identifiers on pharmacy transactions, federal law doesn't require use of the NPI on prescriptions, whether electronic or paper.
Additional Information:
http://www.ada.org/prof/resources/topics/npi.asp
1-800-621-8099 ext. 4608
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