Guest guest Posted April 14, 2007 Report Share Posted April 14, 2007 Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2007 Report Share Posted April 14, 2007 Annie, I too have been amazed at how much more confusing the NPI thing is. I currently have a personal one and one for the office. Please post the response you get from the AAFP list serve as I would love to make sure I’m not going to go without pay for the summer. NPI fears Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2007 Report Share Posted April 14, 2007 I have only one NPI, since I am solo-solo. Why would I need a second number ? I have an LLC. Where can I get more information from ? For now, I billed BCBS and did not have any problems.Annie,I too have been amazed at how much more confusing the NPI thing is. I currently have a personal one and one for the office. Please post the response you get from the AAFP list serve as I would love to make sure I’m not going to go without pay for the summer. -----Original Message-----From: [mailto: ] On Behalf Of Annie SkaggsSent: Saturday, April 14, 2007 9:48 AMTo: Subject: NPI fears Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs orPAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalistavailable). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly fil! ed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survi! ve if half or more of that dries up for months. < /o> Any suggestions out there?Annie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2007 Report Share Posted April 14, 2007 From what I've been seeing under CMSs Listserve is that health plans have developed contingency plans for payment problems during the transition. Call your Medicare Ombudsman or representative. Better yet, have your billing service research this issue. They should have contacts at the insurance companies you deal with. Kenney Annie Skaggs wrote: > > Apologies to those also on the AAFP Practicemgt list, as I posted this > there too. > > Maybe I am just paranoid…. > > But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? > > > “My reading of items in AAFP publications on the subject of the NPI > leads me to believe that I should have one NPI number and possibly two > taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no > ancillary staff such as NPs or PAs, so all the care provided under my > supervision is provided by me. My practice has a corporation/is a > corporation (Fayette Family Medicine, PSC) because I am told that > somehow that protects my financial assets (although all it really > seems to do is provide lawyers, accountants and the government with > more opportunities to help themselves to my financial assets). Some of > my insurance payments come made out to Skaggs, and some come > made out to Fayette Family Medicine. Patients generally write their > copay checks out to “FFM” because that’s fastest. I practice in only > one location except for the occasional home visit to infirm elderly > patients who can’t make it to the office. > > I thought I just needed one NPI, and one taxonomy code, but now my > billing service says that I need one NPI for myself and another for > Fayette Family Medicine. She thinks I only need one taxonomy code, but > I read that there is a taxonomy code for groups even if there is only > one provider in the group. Now she also says that I might need a > different NPI for when I make home visits, and yet another for if I > see patients in the hospital (something I rarely do, as I have a good > hospitalist available). > > Yesterday I heard a speaker who works for our state Medicaid plan say > that although CMS originally said one NPI per provider, now they ARE > using multiple numbers and his system can’t figure out how to make it > work, so they are just sticking with the legacy system for the > foreseeable future (he said a year at least) > > What should I do? I have a terrible feeling that this is all going to > add up to nobody paying me for months. > > > Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. > > That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. > > Any suggestions out there? > Annie > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2007 Report Share Posted April 24, 2007 Annie: You need a second NPI for your corporation. We needed that for ours as well. Annie Skaggs wrote: Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Ahhh...imagining that irresistible "new car" smell? Check out new cars at Yahoo! Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 So have you figured out when you use one and when the other? If I request a consult, I give them the individual one…and that’s about the only clear picture I have of this. My biller seems to think that it depends on how they make out the check. If I get paid as Skaggs, then the individual number is what I should use. But if I get a check made out to Fayette Family Medicine, then that insurer will want me to use the corporate one…??? What about the first time I send a claim to a particular plan: do I just guess, or what??? Annie Re: NPI fears Annie: You need a second NPI for your corporation. We needed that for ours as well. Annie Skaggs <askaggsfayettefamilymed> wrote: Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Ahhh...imagining that irresistible " new car " smell? Check out new cars at Yahoo! Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 Did you see the post about the NPI being delayed another year until 2008? The last time we called the Medicare r for N. Calif. a couple of weeks ago, they had a recorded message that came on instead of elevator music telling you not to use the NPI on claims until they sort everything out. Caldwell Tulare, CA > Apologies to those also on the AAFP Practicemgt list, as I posted this there too. > > > Maybe I am just paranoid…. > > > > But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? > > > " My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to " FFM " because that's fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can't make it to the office. > > I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). > > Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can't figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) > > What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. > > > > Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That's right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. > > > > That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there…… what is going to happen? What is going to prevent all of them from saying " Sorry, we're having problems with this new system, bear with us and we'll pay you when we get it fixed. " The doctor earning the " median $165,000 " can probably survive for a while on half that, but I only made $30,000 last year, and I CAN'T survive if half or more of that dries up for months. > > > > Any suggestions out there? > > Annie > > > > > > > > --------------------------------- > Ahhh...imagining that irresistible " new car " smell? > Check outnew cars at Yahoo! Autos. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 Annie: You are ahead of me on this one but our EMR has a place for each. I susbect billing requirement dictate when one or both are used, but i do not know the RULES. Annie Skaggs wrote: So have you figured out when you use one and when the other? If I request a consult, I give them the individual one…and that’s about the only clear picture I have of this. My biller seems to think that it depends on how they make out the check. If I get paid as Skaggs, then the individual number is what I should use. But if I get a check made out to Fayette Family Medicine, then that insurer will want me to use the corporate one…??? What about the first time I send a claim to a particular plan: do I just guess, or what??? Annie -----Original Message-----From: [mailto: ] On Behalf Of EglySent: Tuesday, April 24, 2007 12:21 AMTo: Subject: Re: NPI fears Annie: You need a second NPI for your corporation. We needed that for ours as well. Annie Skaggs <askaggsfayettefamilymed> wrote: Apologies to those also on the AAFP Practicemgt list, as I posted this there too.Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Ahhh...imagining that irresistible "new car" smell?Check out new cars at Yahoo! Autos. Ahhh...imagining that irresistible "new car" smell? Check out new cars at Yahoo! Autos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2007 Report Share Posted April 28, 2007 According to my medical consultant, my EMR vendor (Alteer), and reading the NPI info for myself, it seems that if you need an additional # (other than the one for yourself, under your name) for your facility, it is only if the insurance company(ies) wants you to have one, and they (the ins co) will let you know if you need one. Why does something that’s supposed to make it easier to identify providers have to be so confusing? Oh, the government is behind it, I forgot… A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of Annie Skaggs Sent: Tuesday, April 24, 2007 7:57 PM To: Subject: RE: NPI fears So have you figured out when you use one and when the other? If I request a consult, I give them the individual one…and that’s about the only clear picture I have of this. My biller seems to think that it depends on how they make out the check. If I get paid as Skaggs, then the individual number is what I should use. But if I get a check made out to Fayette Family Medicine, then that insurer will want me to use the corporate one…??? What about the first time I send a claim to a particular plan: do I just guess, or what??? Annie -----Original Message----- From: [mailto: ] On Behalf Of Egly Sent: Tuesday, April 24, 2007 12:21 AM To: Subject: Re: NPI fears Annie: You need a second NPI for your corporation. We needed that for ours as well. Annie Skaggs <askaggsfayettefamilymed> wrote: Apologies to those also on the AAFP Practicemgt list, as I posted this there too. Maybe I am just paranoid…. But I am getting a terrible feeling about this whole NPI thing. I sent the following question in to FPM, but what do you guys think? “My reading of items in AAFP publications on the subject of the NPI leads me to believe that I should have one NPI number and possibly two taxonomy codes. I am a solo family doctor ( Skaggs, MD) with no ancillary staff such as NPs or PAs, so all the care provided under my supervision is provided by me. My practice has a corporation/is a corporation (Fayette Family Medicine, PSC) because I am told that somehow that protects my financial assets (although all it really seems to do is provide lawyers, accountants and the government with more opportunities to help themselves to my financial assets). Some of my insurance payments come made out to Skaggs, and some come made out to Fayette Family Medicine. Patients generally write their copay checks out to “FFM” because that’s fastest. I practice in only one location except for the occasional home visit to infirm elderly patients who can’t make it to the office. I thought I just needed one NPI, and one taxonomy code, but now my billing service says that I need one NPI for myself and another for Fayette Family Medicine. She thinks I only need one taxonomy code, but I read that there is a taxonomy code for groups even if there is only one provider in the group. Now she also says that I might need a different NPI for when I make home visits, and yet another for if I see patients in the hospital (something I rarely do, as I have a good hospitalist available). Yesterday I heard a speaker who works for our state Medicaid plan say that although CMS originally said one NPI per provider, now they ARE using multiple numbers and his system can’t figure out how to make it work, so they are just sticking with the legacy system for the foreseeable future (he said a year at least) What should I do? I have a terrible feeling that this is all going to add up to nobody paying me for months. Last year when I changed billers I accidentally gave the new biller a Medicare number that was from when I had worked for a previous employer. We discovered the problem within 3 weeks and fixed it, so we were submitting the correct number, but it still took Medicare six whole months to start paying me again AT ALL. That’s right, five months and one week of correctly filed claims did not get paid as a result of three weeks of incorrectly filed ones. I finally had to have my Congressional Representative intervene to get them to start paying me again. And of the three weeks of incorrectly filed claims (from March of 2006, about half of those have STILL not been paid. That experience has left me a little gun-shy. If all the payers are like my state Medicaid administrator and built their systems on one number per provider, so they have only one field in their programs for that number, but there are multiple numbers out there……what is going to happen? What is going to prevent all of them from saying “Sorry, we’re having problems with this new system, bear with us and we’ll pay you when we get it fixed.” The doctor earning the “median $165,000” can probably survive for a while on half that, but I only made $30,000 last year, and I CAN’T survive if half or more of that dries up for months. Any suggestions out there?Annie Ahhh...imagining that irresistible " new car " smell? Check out new cars at Yahoo! Autos. Quote Link to comment Share on other sites More sharing options...
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