NPI, Accreditation Conferences Discussed at Open Door; Round Two Timetable–Not

BALTIMORE–Not using your National Provider Identification
number? Then you will likely start seeing rejection of claims as
early as this week, CMS officials said Wednesday during a CMS Open
Door conference call.

HME providers were to start using the NPI number on their claims
beginning Jan. 1, reminded Stewart Streimer, acting deputy director
for the Center for Medicare Management. Providers can still use
their legacy number along with the NPI in the primary fields only,
but beginning May 23, only the NPI number will be acceptable in the
primary fields, he said.

“If you are submitting claims without the NPI in the primary
field, you are probably not seeing rejections yet. The bulk of
those rejections will start coming early [this] week,” Streimer
warned. He urged providers to make sure their provider enrollment
is current “so the NPI can work successfully.”

He also suggested that providers who have successfully used the
NPI number along with the legacy number start sending small batches
of claims with the NPI number only to see if they will flow through
the system without any problem.

While there was no new information for HME providers on this
first call of the new year, Joel Kaiser, deputy director of DMEPOS
policy for CMS, did address the dearth of information available
when the second round of competitive bidding was announced last
week.

With the first round, he said, the announcement included
critical details such as HCPCS codes, ZIP codes and a timeline for
bidding and implementation.

“At this point in time in Round Two, we aren’t quite there yet,”
he said. “But the important thing is that we need to get suppliers
started getting accredited and getting their businesses ready.” He
said the information about the products included in the bid and ZIP
codes included in the bidding areas, as well as implementation
details, will be released “in just a couple of months.”

As for the Round Two timetable, Kaiser said, “We will have a
detailed timeline when we are ready to have a detailed
timeline.”

CMS officials also clarified some accreditation deadlines for
HME providers: Those applying for a provider number through the
National Supplier Clearinghouse between now and Feb. 29 must be
accredited by Jan. 1, 2009. Providers who apply for a provider
number after March 1 must already be accredited. CMS has already
announced that all providers who wish to continue billing Medicare
must be accredited by Sept. 30, 2009.

Anticipating more questions about accreditation, CMS said it
would hold quarterly conferences on the issue, with the first one
scheduled for Jan. 22. Providers must register for the conference
at
http://www2.eventsvc.com/palmettogba/012208.

While much of the call was a reiteration of information that has
been in CMS communications and in the press for months, it was
still news to some providers, a point made clear in the
question-and-answer segment of the Open Door session.

“What are the requirements to participate in competitive
bidding?” a caller asked.

The question apparently took CMS officials aback, because the
response was a bit delayed. Finally it came: “You need to register
for a user ID. Other than that, I think you are
eligible.”