The National Provider Identifier (NPI) requirement is part of an administrative simplification mandate of the Health Insurance Portability and Accountability Act (HIPAA). Every provider completing HIPAA-compliant transactions must use an NPI to identify HIPAA covered healthcare providers in standard transactions by the 2007 compliance deadlines to avoid reimbursement issues. The deadlines are staggered, meaning the schedule accommodates a transitional period for each milestone and each type of claim: professional paper HCFA (CMS-1500), institutional paper (UB92/UB04), and electronic (837 professional and institutional). The final deadline for NPI compliance on all claim types is May 23, 2007, however, there are intermim milestones that must be met. For example, you will be required to use the new CMS-1500 (08-05) HCFA claim form prior to May 23rd. For full details, click here.
For detailed information about requirements and exceptions for electronic submission of Medicare claims, refer to Article #MM3440 on the The Centers for Medicare and Medicaid Services (CMS) web site.
08/04/2005: An issue with APC’s Power Chute version 6.x software, which runs on servers, is affecting the performance of some of our customers’ systems—specifically, causing severe performance issues and systems “hanging” or not responding. This is not an issue with Alteer’s software; however, it will affect your ability to run any software on your system—including Alteer Office. To find out more details; how to resolve the issue; and how to prevent it from occurring to your system, click here.
These documents explain the changes that are happening at TRICARE. If you are experiencing R059 rejections (Zip out of jurisdiction) from TRICARE, please be sure to read through the documents. Payer IDs are still assigned by region. Some regions have changed and some have not.
Note: The payer ID for CA Tricare patients has changed.
TRICARE Regional Breakdowns by State
This document explains the new TRICARE regions (with state information) and which contractors and claims processors are responsible for each new region.
TRICARE Regional Transitions by State & FI with Dates
This document is a state by state breakdown of all of the changes that have occurred and are scheduled to occur. It includes the state, former region, new region, former claims processor, former payer ID new claims processor, new payer ID, and the effective date for each change. The information has been sorted three ways for you: 1) by State, 2) by Effective Date, and 3) by Former Payer ID.
A new prescription drug law for California went into effect January 1, 2005. To view a document with important information about this new law, click here.
