May 7 Is "Legacy Free" Day - An Opportunity to Check Your NPI Readiness!

CMS, in collaboration with the Healthcare Information and Management Systems Society (HIMSS), has requested clearinghouses that submit claims to Medicare to participate in a one day NPI preparation exercise. Specifically, on Wednesday, May 7, 2008, Clearing House will submit Medicare Part B claims with NPI-only in all provider identifier fields for which a provider uses NPI/legacy pairs. On May 8, Clearing House will revert back to sending Medicare NPI/legacy pairs as received from the providers.

On May 7, 2008, Clearing House will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. Fields already containing NPI-only will be sent to Medicare as usual, and secondary provider identifier fields containing legacy-only will be sent to Medicare as usual. Only NPI/legacy pairs will be altered on May 7, 2008. It is not necessary to remove your legacy provider numbers as Clearing House will be stripping them from all Medicare files submitted during this time period.

This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008, deadline. The outcomes of this exercise are described below:

Claims are processed and paid by Medicare. Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23 implementation date.
Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23. Resolution might include changes to the NPPES data or to the 855 enrollment record, and in this case, the provider should to contact the payer directly for resolution. Please be aware that it could take up to 2 days to get your payer reports back with any rejections.

Action Required by Customer: Providers should send Medicare claims as normal on May 6, and Clearing House will format the data as requested by CMS to meet the requirements of the "Legacy Free" day. If you do not want to participate, please do not send Medicare claims between the times of 2 p.m. CST on May 5 and 2 p.m. CST on May 6.

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