National Provider Identifier requirement swells claim denials

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Health Imaging News, June 10, 2008

A provision of the 1996 Health Insurance Portability and Accountability Act requiring healthcare providers to submit a National Provider Identifier for Medicare and Medicaid reimbursement went into effect May 23. Early reports indicate that the impact of the NPI deployment has resulted in nearly one-quarter of submitted claims being rejected since that date. Hospitals, physicians, clinics, and labs that fail to submit an NPI for Medicare claims for services after May 23 will have their claims returned as unprocessable, according to CMS.

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