Corporate Compliance

Flaw exposed in new Medicare ID system

Compliance Monitor, September 26, 2007

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The American Medical Association (AMA) and the Medical Group Management Association are warning physicians that their Medicare claims may be denied or delayed because of the change to new physician identification (ID) numbers.

CMS is currently switching to a new system for identifying physicians. Under the new system, each physician who submits claims electronically will be identified by a 10-digit national provider identification (NPI) number. CMS instructed carriers to stop paying claims if the physician's old or legacy number could not be matched up with a new NPI.

Carriers have recommended physicians provide both the legacy number and the NPI.

The two organizations sent CMS a letter on September 11, saying CMS should put the new policy on hold until physicians and carriers can work out the problems.

For more information, visit the AMA's Web site.



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