[Alumni-sd] National Provider Identifiers

[Guest guest]

don't know if we are required to have it, but if you do use it you no longer

have to give your tax ID number or SS# to the insurance companies when

providing sub forms. you do need to provide the the SS#/tax ID# to get the

NPI number. i did it on line. the entire process took about 10 min and i

got the number immediately.

 

hope this helps,

 

kath

 

 

On 5/5/07, Ann Fitzgerald <annfitzlac wrote:

>

> I've just heard of this, it looks like we have to register if we are

> to be HIPPA compliant and use insurance. If we don't use insurance,

> are we still obliged to register?

> Thanks,

> Ann

>

> NATIONAL PROVIDER IDENTIFIERS: A REMINDER

>

> David Kailin, Ph.D., M.P.H., L.Ac.

>

> All HIPAA-covered entities, by May 23, 2007, must obtain a National

> Provider Identifier (NPI) number. The NPI will be used as your

> identifier on standard transactions. The requirement applies to

> individual healthcare providers, as well as to health service

> organizations such as hospitals, clinics and pharmacies.

>

> You may apply for an NPI online at https://nppes.cms.hhs.govThe

> application takes about 20 minutes to complete. Or, you may complete

> and mail in a paper form. If you have questions or want to obtain a

> paper form, call the National Plan and Provider Enumerator System

> (NPPES) toll-free at 1 800 465 3203. You will be issued an NPI within

> 15 days of application. My online application was processed, and an

> NPI assigned to me, in about 15 minutes.

>

> Complementary and alternative medicine (CAM) providers will note that

> the application requests a taxonomy code. The first two digits of the

> code indicate the basic category of services into which the provider

> has been placed. Here are several codes that apply to CAM providers:

>

> Acupuncturist 171100000X

> Chiropractor 111N00000X

> Homeopath 175L00000X

> Massage Therapist 225A00000X

> Naturopath 175F00000X

>

> There are subsets of the code for chiropractors to indicate

> sub-specialties.

> Once you have an NPI, you must keep NPPES informed of changes to

> materials submitted on your application, within 30 days of any such

> changes.

>

> Copyright 2007, David C. Kailin

> David C. Kailin, Ph.D., M.P.H., L.Ac is widely regarded as the leading

> authority on CAM-related federal regulations. He is the author of

> Quality In Complementary & Alternative Medicine (2006, CMS Press). Dr.

> Kailin provides consulting services on quality improvement and

> regulatory issues, and for integrative medicine programs. More

> information is available at http://www.convergentmedical.com

> _____________

> Alumni-sd mailing list

> Alumni-sd

> http://mail.pacificcollege.edu/mailman/listinfo/alumni-sd

>

 

 

 

--

Kath Bartlett, LAc, MS, BA UCLA

Oriental Medicine

Experienced, Dedicated, Effective

 

Asheville Center For

70 Woodfin Place, Suite West Wing Two

Asheville, NC 28801 828.258.2777

kbartlett

www.AcupunctureAsheville.com

 

 

 

[Guest guest]

Hi Kath,

 

How did you do this online? Can you send the link?

 

Thank you,

 

 

" " wrote:

don't know if we are required to have it, but if you do use it you no longer

have to give your tax ID number or SS# to the insurance companies when

providing sub forms. you do need to provide the the SS#/tax ID# to get the

NPI number. i did it on line. the entire process took about 10 min and i

got the number immediately.

 

hope this helps,

 

kath

 

On 5/5/07, Ann Fitzgerald <annfitzlac wrote:

>

> I've just heard of this, it looks like we have to register if we are

> to be HIPPA compliant and use insurance. If we don't use insurance,

> are we still obliged to register?

> Thanks,

> Ann

>

> NATIONAL PROVIDER IDENTIFIERS: A REMINDER

>

> David Kailin, Ph.D., M.P.H., L.Ac.

>

> All HIPAA-covered entities, by May 23, 2007, must obtain a National

> Provider Identifier (NPI) number. The NPI will be used as your

> identifier on standard transactions. The requirement applies to

> individual healthcare providers, as well as to health service

> organizations such as hospitals, clinics and pharmacies.

>

> You may apply for an NPI online at https://nppes.cms.hhs.govThe

> application takes about 20 minutes to complete. Or, you may complete

> and mail in a paper form. If you have questions or want to obtain a

> paper form, call the National Plan and Provider Enumerator System

> (NPPES) toll-free at 1 800 465 3203. You will be issued an NPI within

> 15 days of application. My online application was processed, and an

> NPI assigned to me, in about 15 minutes.

>

> Complementary and alternative medicine (CAM) providers will note that

> the application requests a taxonomy code. The first two digits of the

> code indicate the basic category of services into which the provider

> has been placed. Here are several codes that apply to CAM providers:

>

> Acupuncturist 171100000X

> Chiropractor 111N00000X

> Homeopath 175L00000X

> Massage Therapist 225A00000X

> Naturopath 175F00000X

>

> There are subsets of the code for chiropractors to indicate

> sub-specialties.

> Once you have an NPI, you must keep NPPES informed of changes to

> materials submitted on your application, within 30 days of any such

> changes.

>

> Copyright 2007, David C. Kailin

> David C. Kailin, Ph.D., M.P.H., L.Ac is widely regarded as the leading

> authority on CAM-related federal regulations. He is the author of

> Quality In Complementary & Alternative Medicine (2006, CMS Press). Dr.

> Kailin provides consulting services on quality improvement and

> regulatory issues, and for integrative medicine programs. More

> information is available at http://www.convergentmedical.com

> _____________

> Alumni-sd mailing list

> Alumni-sd

> http://mail.pacificcollege.edu/mailman/listinfo/alumni-sd

>

 

--

Kath Bartlett, LAc, MS, BA UCLA

Oriental Medicine

Experienced, Dedicated, Effective

 

Asheville Center For

70 Woodfin Place, Suite West Wing Two

Asheville, NC 28801 828.258.2777

kbartlett

www.AcupunctureAsheville.com

 

[Guest guest]

Beginning May 23, NPI numbers will be required for all electronic

insurance transactions. This does not include information

transmitted by fax or telephone.

 

If you send mail or fax your claim forms, there is no legal

requirement to use an NPI. However, CSOMA expects that carriers

will, over time, increasingly require NPI numbers for non-electronic

transactions as well. But this is ultimately decided on a carrier-by-

carrier basis.

 

NPI numbers can be obtained online at...

 

https://nppes.cms.hhs.gov/

 

You will need to have the following information at hand for this

process:

 

* Provider Name

* SSN (or ITIN if not eligible for SSN)

* Provider Date of Birth

* Country of Birth

* State of Birth (if Country of Birth is U.S.)

* Provider Gender

* Mailing Address

* Practice Location Address and Phone Number

* Taxonomy (Provider Type) [171100000X Acupuncturist]

NOTE: You will need to select " Other Service Provider " on the

initial list of provider types on the online form in order to reach a

list that contains " Acupuncturist. "

* State License Number

* Contact Person Name

* Contact Person Phone Number and Email

 

If you want to obtain a paper application form, contact the NPI

Enumerator at 1-800-465-3203 or TTY 1-800-692-2326.

 

Once you have obtained your NPI, you must notify the NPI Enumerator

of any changes to your information within 30 days of the change.

Except in rare circumstances, your NPI number will not change.

 

 

--

Bill Mosca, LAc

Executive Director

California State Oriental Medical Association (CSOMA)

703 Market Street, Suite 250

San Francisco • CA • 94103-2100

[Toll Free Voice]: (800) 477-4564 • [Fax]: (415) 357-1940

: bill • [Website]: csomaonline.org

On May 6, 2007, at 7:27 AM, wrote:

> Hi Kath,

>

> How did you do this online? Can you send the link?

>

> Thank you,

>

>

> " "

> wrote: don't know if we are

> required to have it, but if you do use it you no longer

> have to give your tax ID number or SS# to the insurance companies

> when

> providing sub forms. you do need to provide the the SS#/tax ID# to

> get the

> NPI number. i did it on line. the entire process took about 10

> min and i

> got the number immediately.

>

> hope this helps,

>

> kath

>

> On 5/5/07, Ann Fitzgerald <annfitzlac wrote:

>>

>> I've just heard of this, it looks like we have to register if we are

>> to be HIPPA compliant and use insurance. If we don't use insurance,

>> are we still obliged to register?

>> Thanks,

>> Ann

>>

>> NATIONAL PROVIDER IDENTIFIERS: A REMINDER

>>

>> David Kailin, Ph.D., M.P.H., L.Ac.

>>

>> All HIPAA-covered entities, by May 23, 2007, must obtain a National

>> Provider Identifier (NPI) number. The NPI will be used as your

>> identifier on standard transactions. The requirement applies to

>> individual healthcare providers, as well as to health service

>> organizations such as hospitals, clinics and pharmacies.

>>

>> You may apply for an NPI online at https://nppes.cms.hhs.govThe

>> application takes about 20 minutes to complete. Or, you may complete

>> and mail in a paper form. If you have questions or want to obtain a

>> paper form, call the National Plan and Provider Enumerator System

>> (NPPES) toll-free at 1 800 465 3203. You will be issued an NPI within

>> 15 days of application. My online application was processed, and an

>> NPI assigned to me, in about 15 minutes.

>>

>> Complementary and alternative medicine (CAM) providers will note that

>> the application requests a taxonomy code. The first two digits of the

>> code indicate the basic category of services into which the provider

>> has been placed. Here are several codes that apply to CAM providers:

>>

>> Acupuncturist 171100000X

>> Chiropractor 111N00000X

>> Homeopath 175L00000X

>> Massage Therapist 225A00000X

>> Naturopath 175F00000X

>>

>> There are subsets of the code for chiropractors to indicate

>> sub-specialties.

>> Once you have an NPI, you must keep NPPES informed of changes to

>> materials submitted on your application, within 30 days of any such

>> changes.

>>

>> Copyright 2007, David C. Kailin

>> David C. Kailin, Ph.D., M.P.H., L.Ac is widely regarded as the

>> leading

>> authority on CAM-related federal regulations. He is the author of

>> Quality In Complementary & Alternative Medicine (2006, CMS Press).

>> Dr.

>> Kailin provides consulting services on quality improvement and

>> regulatory issues, and for integrative medicine programs. More

>> information is available at http://www.convergentmedical.com

>> _____________

>> Alumni-sd mailing list

>> Alumni-sd

>> http://mail.pacificcollege.edu/mailman/listinfo/alumni-sd

>>

>

> --

> Kath Bartlett, LAc, MS, BA UCLA

> Oriental Medicine

> Experienced, Dedicated, Effective

>

> Asheville Center For

> 70 Woodfin Place, Suite West Wing Two

> Asheville, NC 28801 828.258.2777

> kbartlett

> www.AcupunctureAsheville.com

>

>

[Guest guest]

At 04:37 PM 5/6/2007, Bill Mosca <mosca wrote:

 

>Beginning May 23, NPI numbers will be required for all electronic

>insurance transactions.

 

Hi Bill,

 

Does that requirement extend beyond Medicare electronic transactions?

 

My reading of the legislation and regulations (at the time of an

earlier discussion here) indicated the key element (of HIPPA law) was

CMS, i.e. Medicare transactions, and that ripple-effect into

insurance in general would probably be gradual. Has any organization

of general carriers set policy or dealines here?

 

 

 

 

--

 

 

Version: 7.5.467 / Virus Database: 269.6.5/792 - Release 5/6/2007 9:01 PM

[Guest guest]

Thank you, Bill.

 

 

 

Bill Mosca <mosca wrote: Beginning May 23, NPI numbers will be

required for all electronic

insurance transactions. This does not include information

transmitted by fax or telephone.

 

If you send mail or fax your claim forms, there is no legal

requirement to use an NPI. However, CSOMA expects that carriers

will, over time, increasingly require NPI numbers for non-electronic

transactions as well. But this is ultimately decided on a carrier-by-

carrier basis.

 

NPI numbers can be obtained online at...

 

https://nppes.cms.hhs.gov/

 

You will need to have the following information at hand for this

process:

 

* Provider Name

* SSN (or ITIN if not eligible for SSN)

* Provider Date of Birth

* Country of Birth

* State of Birth (if Country of Birth is U.S.)

* Provider Gender

* Mailing Address

* Practice Location Address and Phone Number

* Taxonomy (Provider Type) [171100000X Acupuncturist]

NOTE: You will need to select " Other Service Provider " on the

initial list of provider types on the online form in order to reach a

list that contains " Acupuncturist. "

* State License Number

* Contact Person Name

* Contact Person Phone Number and Email

 

If you want to obtain a paper application form, contact the NPI

Enumerator at 1-800-465-3203 or TTY 1-800-692-2326.

 

Once you have obtained your NPI, you must notify the NPI Enumerator

of any changes to your information within 30 days of the change.

Except in rare circumstances, your NPI number will not change.

 

 

--

Bill Mosca, LAc

Executive Director

California State Oriental Medical Association (CSOMA)

703 Market Street, Suite 250

San Francisco • CA • 94103-2100

[Toll Free Voice]: (800) 477-4564 • [Fax]: (415) 357-1940

: bill • [Website]: csomaonline.org

On May 6, 2007, at 7:27 AM, wrote:

> Hi Kath,

>

> How did you do this online? Can you send the link?

>

> Thank you,

>

>

> " "

> wrote: don't know if we are

> required to have it, but if you do use it you no longer

> have to give your tax ID number or SS# to the insurance companies

> when

> providing sub forms. you do need to provide the the SS#/tax ID# to

> get the

> NPI number. i did it on line. the entire process took about 10

> min and i

> got the number immediately.

>

> hope this helps,

>

> kath

>

> On 5/5/07, Ann Fitzgerald wrote:

>>

>> I've just heard of this, it looks like we have to register if we are

>> to be HIPPA compliant and use insurance. If we don't use insurance,

>> are we still obliged to register?

>> Thanks,

>> Ann

>>

>> NATIONAL PROVIDER IDENTIFIERS: A REMINDER

>>

>> David Kailin, Ph.D., M.P.H., L.Ac.

>>

>> All HIPAA-covered entities, by May 23, 2007, must obtain a National

>> Provider Identifier (NPI) number. The NPI will be used as your

>> identifier on standard transactions. The requirement applies to

>> individual healthcare providers, as well as to health service

>> organizations such as hospitals, clinics and pharmacies.

>>

>> You may apply for an NPI online at https://nppes.cms.hhs.govThe

>> application takes about 20 minutes to complete. Or, you may complete

>> and mail in a paper form. If you have questions or want to obtain a

>> paper form, call the National Plan and Provider Enumerator System

>> (NPPES) toll-free at 1 800 465 3203. You will be issued an NPI within

>> 15 days of application. My online application was processed, and an

>> NPI assigned to me, in about 15 minutes.

>>

>> Complementary and alternative medicine (CAM) providers will note that

>> the application requests a taxonomy code. The first two digits of the

>> code indicate the basic category of services into which the provider

>> has been placed. Here are several codes that apply to CAM providers:

>>

>> Acupuncturist 171100000X

>> Chiropractor 111N00000X

>> Homeopath 175L00000X

>> Massage Therapist 225A00000X

>> Naturopath 175F00000X

>>

>> There are subsets of the code for chiropractors to indicate

>> sub-specialties.

>> Once you have an NPI, you must keep NPPES informed of changes to

>> materials submitted on your application, within 30 days of any such

>> changes.

>>

>> Copyright 2007, David C. Kailin

>> David C. Kailin, Ph.D., M.P.H., L.Ac is widely regarded as the

>> leading

>> authority on CAM-related federal regulations. He is the author of

>> Quality In Complementary & Alternative Medicine (2006, CMS Press).

>> Dr.

>> Kailin provides consulting services on quality improvement and

>> regulatory issues, and for integrative medicine programs. More

>> information is available at http://www.convergentmedical.com

>> _____________

>> Alumni-sd mailing list

>> Alumni-sd

>> http://mail.pacificcollege.edu/mailman/listinfo/alumni-sd

>>

>

> --

> Kath Bartlett, LAc, MS, BA UCLA

> Oriental Medicine

> Experienced, Dedicated, Effective

>

> Asheville Center For

> 70 Woodfin Place, Suite West Wing Two

> Asheville, NC 28801 828.258.2777

> kbartlett

> www.AcupunctureAsheville.com

>

>

[Guest guest]

On May 6, 2007, at 7:18 PM, wrote:

> At 04:37 PM 5/6/2007, Bill Mosca <mosca wrote:

>

>> Beginning May 23, NPI numbers will be required for all electronic

>> insurance transactions.

>

> Does that requirement extend beyond Medicare electronic transactions?

 

 

Chris,

 

Yes, the requirements for mandatory NPI use extend to all electronic

transactions, not just Medicare. If you are transmitting insurance

claim information electronically, you are a " covered entity " and must

comply beginning on May 23.

 

Medicare is requiring that ALL transaction (not just electronic)

comply. Of course, acupuncture is not a covered service within

Medicare so this has no immediate impact on us.

 

All of this falls under the HIPAA Privacy Rule which governs the use

and disclosure of Protected Health Information for all providers,

health plans, hospitals, and other health care operations.

 

I'm not aware of any general carriers that have announced mandatory

compliance deadlines for non-electronic communications. (But we have

not done a survey, so I can't be certain that this hasn't been

mandated by some carriers.)

 

Worst case, you'll get a rejected claim from a carrier that requires

an NPI, and you'll have to resubmit the claim. This is why CSOMA has

recommended that members who do substantial insurance billing start

using their NPI (and the new CMS-1500 form) starting now.

 

Regards,

Bill

 

--

Bill Mosca, LAc

Executive Director

California State Oriental Medical Association (CSOMA)

703 Market Street, Suite 250

San Francisco • CA • 94103-2100

[Toll Free Voice]: (800) 477-4564 • [Fax]: (415) 357-1940

: bill • [Website]: csomaonline.org

[Guest guest]

Regards,

Angela Pfaffenberger, Ph.D.

 

angela.pf

Phone: 503 364 3022

-

" Bill Mosca " <mosca

<Chinese Medicine >

Monday, May 07, 2007 10:51 AM

Re: Re: [Alumni-sd] National Provider Identifiers

 

 

On May 6, 2007, at 7:18 PM, wrote:

> At 04:37 PM 5/6/2007, Bill Mosca <mosca wrote:

>

>> Beginning May 23, NPI numbers will be required for all electronic

>> insurance transactions.

>

> Does that requirement extend beyond Medicare electronic transactions?

 

 

Chris,

 

Yes, the requirements for mandatory NPI use extend to all electronic

transactions, not just Medicare. If you are transmitting insurance

claim information electronically, you are a " covered entity " and must

comply beginning on May 23.

 

Medicare is requiring that ALL transaction (not just electronic)

comply. Of course, acupuncture is not a covered service within

Medicare so this has no immediate impact on us.

 

All of this falls under the HIPAA Privacy Rule which governs the use

and disclosure of Protected Health Information for all providers,

health plans, hospitals, and other health care operations.

 

I'm not aware of any general carriers that have announced mandatory

compliance deadlines for non-electronic communications. (But we have

not done a survey, so I can't be certain that this hasn't been

mandated by some carriers.)

 

Worst case, you'll get a rejected claim from a carrier that requires

an NPI, and you'll have to resubmit the claim. This is why CSOMA has

recommended that members who do substantial insurance billing start

using their NPI (and the new CMS-1500 form) starting now.

 

Regards,

Bill

 

--

Bill Mosca, LAc

Executive Director

California State Oriental Medical Association (CSOMA)

703 Market Street, Suite 250

San Francisco • CA • 94103-2100

[Toll Free Voice]: (800) 477-4564 • [Fax]: (415) 357-1940

: bill • [Website]: csomaonline.org

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