Question

Response

Is there a designated contact for NPI implementation issues?

For all EDI inquiries regarding NPI, contact the EDI Support Team:

• E-mail: EDIsupport@Asuris.com
• Fax: (877) 329-3342
• Idaho and Oregon Submitters
•  (800) 713-1693
• Utah Trading Partners/Submitters
•  (888) 344-5583
• Washington Submitters (800) 374-1477

Do you have a plan to implement NPI?

Yes, Asuris is following Centers for Medicare & Medicaid (CMS) contingency guidance to facilitate compliance in using the NPI for electronic claims submission.

To ensure a smooth transition, we will accept your Asuris provider number only or your NPI with your Asuris provider number until February 29, 2008. On March 1, 2008, you are required to submit an NPI on all electronic claims, with or without your Asuris provider number. On May 23, 2008 Asuris will accept only the NPI as the sole identifier for all HIPAA standard transactions.

Do I still need to include my tax identification number on my claims submissions?

Yes, the NPI does not replace the tax identification number. Your tax identification number is a critical element for the health plan to help us correctly crosswalk your NPI.

How and when will you communicate your plan?

Asuris publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

When will updated Companion Guides be available?

Existing Companion Guides already include current information to support NPI. 

Will you have a transitional period of using both Legacy identifier and the NPI (dual identifier strategy) or do you plan to convert by a certain date?

Yes, Asuris is following Centers for Medicare & Medicaid (CMS) contingency guidance.

• To facilitate compliance with NPI requirements,  we will accept your Asuris provider number only or your NPI with your Asuris provider number until February 29, 2008.
• On March 1, 2008, you are required to submit an NPI on all electronic claims, with or without your Asuris provider number.
• On May 23, 2008 Asuris will accept only the NPI as the sole identifier for all HIPAA standard transactions.

If you will have a transitional period, when will you be able to share that plan?

Asuris publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

If converting without a dual identifier transition period, when do you plan to test?

N/A

Do you have a conversion date? Tentative or firm?

Yes, on March 1, 2008 we will require you to submit all electronic claims with an NPI as the primary identifier. You may continue to submit your Asuris provider number with the NPI through May 22, 2008. Effective May 23, 2008 Asuris will only accept the NPI as the sole identifier for all HIPAA standard transactions.

What is your transition plan for the provider enrollment process?

Asuris does not require providers to re-enroll.

Will NPIs be validated as part of the adjudication process or claims submission process?

Yes, for electronic claims submissions, the NPI will be validated to ensure the formatting of the NPI is correct. For adjudication, the NPI will be validated against the NPI information submitted to Asuris by the provider.  

How can I be sure you have my correct NPI?

The NPI on file will be printed on your payment voucher.

• Please verify now that the NPI on your voucher is correct.
• If you do not see the NPI number or you feel it is incorrect, please contact your provider consultant immediately.

How will the enrollment process change?

N/A

Will taxonomy codes be required to adjudicate claims?

Asuris does not require the use of taxonomy codes at this time.

Do you intend to crosswalk legacy identifiers to NPI within your system?

Yes. Asuris will crosswalk submitted NPI’s to internal legacy identifiers.  We will continue to adjudicate claims under the legacy identifiers. Your tax identification will be an integral part of this crosswalk process.

If Yes, describe how the crosswalk will be used.

We will work with providers to accurately crosswalk our legacy identifiers to NPIs. For assistance, or a list of your current Asuris provider identifiers, contact your provider relations representative. If you plan to enumerate with more  NPI’s than your current number of Asuris legacy identifiers, please contact your provider services representative.

How will you process same provider/multiple locations claims/remittance advices post-implementation?

Asuris will continue to process and distribute payments using processes currently in place.

Do you have subpart requirements?

No. See CMS guidelines related to subparts at: cms.hhs.gov/NationalProvIdentStand/.

Will you require new Trading Partner Agreements?

No

Will you require discussions regarding current contracts?

NPI enumeration will not impact current provider contracts.

Will you require the NPI on paper-based transactions?

While we are not requiring NPI on paper based transactions, it is recommended to include the NPI in all transactions whether submitted electronically or on paper.

Will you require providers to update you in addition to the Enumerator?

Yes, at this time, the Enumerator has not yet disclosed when it will be able to deliver the NPI to payers. Until that process has been defined, we will continue to request that providers notify us of their NPI prior to submission of claims based transactions.

What will be the process?

Asuris offers three ways to submit NPIs:

• Use our online forms on the Asuris Provider Web Site
• Fax or e-mail information
• Contact your provider relations representative

Are you willing to post your organization’s testing and production date/status information to assist with industry coordination?

Asuris publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

Do you qualify as a small health plan?

No

If so, will your organization take the additional year to comply?

N/A – CMS allowed all health plans to have the additional year to establish contingency plans during this year to allow providers more time to comply.

Will your system be updated to accommodate the new UB04, and once approved, the new CMS 1500 forms in accordance with the NPI related changes?

Yes

How many taxonomy codes are supported?  Explain.

Asuris does not require or support the use of taxonomy codes at this time.