Health Information Management

Tip of the week: Contact payers when designing your contingency plan

HIM-HIPAA Insider, July 9, 2007

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When CMS announced that it would not enforce the May 23 deadline for NPI implementation, many covered entities were relieved. But now is not the time to sit back and relax; covered entities should act now to ensure compliance and accurate reimbursement.

The CMS guidance does not extend the deadline for NPI implementation--it just states that the agency won't enforce the rule until May 2008 for covered entities that are working on a contingency plan and can demonstrate that they're making good-faith efforts to comply with the rule.

When designing your contingency plan, remember to determine all of the information that your payers will need to process your claims. Some will require taxonomy codes, and others will want the place of service or ZIP codes, or other data, in order to process claims properly. Not all plans will require the same data, but you want to design a form that carries everything and a system that submits all of the data to all of your payers. This way there's a standardized form for your billing clerks to fill out.

Editor's note: This tip was adapted from an article in the July 2007 issue of Briefings on HIPAA. For more information, click here.



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