from: http://www.ihealthbeat.org/articles/2008/6/17/Data-Requirements-for-Medicare-Payments-an-Obstacle-for-Doctors.aspx?topicID=56#
June 17, 2008
Last week, CMS announced that physicians will have to reconcile their national provider identifier data with their Internal Revenue Service data to receive reimbursements, Healthcare IT News reports.
Billing experts say the new requirement will make an already difficult transition to using NPIs even worse. Under the new federal requirement, every part of the data must match, including the exact spelling of names, the use of initials and blank spaces.
Background
CMS began requiring the use of NPIs May 23 after a one-year contingency period.
Experts say that doctors have had trouble receiving payments because of a variety of complications with CMS and clearing house systems.
Cyndee Weston, executive director of the American Medical Billing Association, said many physicians who started using their NPIs prior to the deadline still have not received Medicare reimbursements.
Martin Jensen — chief operating officer and chief analyst at the Healthcare IT Transition Group, a consulting group specializing in helping physicians get paid — said doctors are not getting consistent answers from CMS or its intermediaries about what is blocking their claims.
Reaction to IRS Rule
Weston said the new requirement to match IRS and NPI data “has blindsided the whole industry.” She added, “This is going to affect all the doctors we work for. It’s going to kill their practices.”
“This IRS thing is very immediate, and one we didn’t anticipate,” Jensen said, adding, “It’s definitely going to set off a cascade of mismatches to data.”
According to Jensen, even physicians who have successfully received claims payment using their NPIs might be forced to start over if their IRS data do not match (Manos, Healthcare IT News, 6/17).
