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NPI & Medisoft Information Center
NPI Deadline
Paper Claim Deadline
Medisoft Version 11 NPI Compliancy- Service Pack 4 (SP4)
How to add your NPI number to your Medisoft
Release date for Medisoft Version 12
Medisoft Versions 10 and Older
Direct Modules
Using Gateway EDI and Your NPI Compliant Medisoft
How do I remove my Legacy number from my Medisoft?
NPI Rejections and Medisoft
How to apply on line - www.nppes.cms.hhs.gov
> National Provider Identifier (NPI)
> Apply Online for an NPI
Revised
Paper Claim Deadline - June 1, 2007
CMS has recently discovered that there are issues with versions of the revised form, CMS-1500 (08-05), being sold by print vendors, specifically the Government Printing Office (GPO). After reviewing the situation, the GPO has determined that the source files were improperly formatted. This resulted in the sale of both printed forms and printing plates to outside print vendors, which do not comply with the form specifications.
CMS has extended the acceptance period beyond the original April 1, 2007 deadline until the situation is resolved. Medicare contractors will be directed to continue to accept the Form CMS-1500 (12-90) until June 1, 2007 or until further notified by CMS.
During the interim period, CMS contractors will be directed to return, not manually key, any CMS-1500 (08-05) forms they receive, which are not printed to specification. By returning the incorrectly formatted claim forms back to contractors, CMS is able to identify the incorrect forms and allow contractors to begin communications with their form supplier to obtain the correct forms.
How To Tell If Your Claim Form Is Incorrectly Formatted
Use the following guidelines to properly identify which form is correct:
1. The old version of the form contains "Approved OMB-0938-0008 FORM CMS-1500 (12-90) on the bottom of the form (typically on the lower right corner), signifying that this is the 12-90 version. On properly formatted claim forms, there will be approximately a 1/4" gap between the tip of the red arrow above the vertically stacked word "CARRIER" and the top edge of the paper in the upper right-hand corner of the form.
2. The revised version contains "Approved OMB-0938-0999 FORM CMS-1500 (08-05) on the bottom of the form signifying the version is the August 2005 version. In the upper right-hand corner of the form, if the tip of the red arrow is touching or close to touching the top edge of the paper, then the form IS NOT printed to CMS specifications.
For more information, go to www.cms.hhs.gov or use the following link to read the original CMS announcement: http://www.cms.hhs.gov/ElectronicBillingEDITrans/Downloads/1500%20problems.pdf
Medisoft Version 11 Service Pack 4 is now available. Once you have set up your NPI number in your Medisoft, SP4 will enable your V11 to process the NPI number on paper and electronic claims. SP4 is free if you download it from the internet. If you want it from us on a cd and mailed to you, the price is $20.00 to cover our cost for the time, materials and shipping. Click here to download SP4.
How to add your National Provider Identification number to your Medisoft Version 11:
> Provider List
> Edit Provider Record
> "Default Pins" tab
Find the field that says "National Identifier" and place the NPI # in there.
You will also need to do this for any referring providers as well.
If you need Group NPI.
> Provider Class List
> Edit Provider Class Record
> Enter in field called National ID
If you need Facility NPI (CMS box 32).
> Address List
> Edit Facility Address Record
> Enter in field called National ID
Once you have placed your NPI # in your Medisoft, you are ready to print off claims:
> In Claims Management select a report starting with "CMS 1500" (This will be the heading for the report choices.)
Revised
release date for Medisoft Version 12 - April 2, 2007
Medisoft Versions 7 and older-
We are not making any accommodations for Versions 7 or older. The Medisoft Report Designer is available on older versions of Medisoft if you would desire to create your own custom solution to get your NPI number to print on your claim forms.
Medisoft Versions 8, 9 & 10-
Not necessarily. If you have been considering upgrading to a newer version of Medisoft anyway, we recommend you go ahead and upgrade to V12. However, if the only reason you are considering upgrading is because of the NPI number, but you really don't want to upgrade, we have written an NPI report that allows for your claims to be processed electronically with the NPI number at some clearinghouses. It will also allow for printing of the NPI on a paper claim.
How much does the report cost?
$180.00
How can I get the report?
You can order this report on our website or by phone: 866-890-6777. Once we have received your payment, we can email the report or we can mail it to you on a disk.
Medisoft NPI Report
Will this report work with any clearinghouse?
MedTech has successfully mapped this set of reports with Gateway EDI (St. Louis) and MCP (Springfield, MO). We have not done any mapping with other clearinghouses but, we do not have any reason to believe that it wouldn't work with other clearinghouses.
If I buy this report, will MedTech contact my clearinghouse and take care of my mapping testing?
No. For customers who use Gateway EDI or MCP, and are signed up with MedTech as their preferred provider, we offer free support. For everyone else, if you buy this report, it will be your responsibility to contact your clearinghouse and complete any mapping testing needed. **Note: You should contact your clearinghouse prior to any purchase. Some clearinghouses may have created an NPI solution for you already for free.
Have customers already been successfully using your NPI report?
A billing service has successfully completed billing using this report. (*We would like to get more feedback. Contact us at 866-890-6777 to provide NPI report feedback.)
How does this report work?
Once you have successfully installed the report into your Medisoft, then you will select this new report out of the options listed on the reports tab. Once you set up your NPI number in your Medisoft, your number will automatically be entered in the NPI field on the form when you select the new report.
What assurances can MedTech give me that if I buy this, it will work and I will get my monies' worth out of it?
If you buy this report and experience any difficulties with it, call us and we will get it working for you.
Business Hours:
Monday - Friday
8:00-12pm and 1-5pm Central Standard Time
If you are using an older version direct module and want to
continue to process your electronic claims that way, you will have to purchase the Version 11 or 12 direct module to be able to process your NPI number.
Pricing- In addition to the cost of upgrading your Medisoft, here are the upgrade prices for the direct modules:
$549 - FLCT (FL), GPNT (TX and IL), IOWA, TNBB, APN1, and UHIN
$429 - AIM1, ARMB, CAMC, FLMC, FLCT (CT), GAMS, GPNT (DC, DE, MD, VA), NDMB, NHIC, NYEB, NYMA, NYGH, NYUM, OHMB, PABS, and WPS1
$319 - HMSA, WMSC, GPNT (WA)
FREE - Phoenix, Stratus (Stratus is being discontinued by 12/31/2007. You must sign up for the Phoenix module by 12/31/2007 in order to continue to send through MedAvant without
interruption.)
Fax NPI Number
Fax your NPI number to Gateway EDI to Jan Eplin at 314-588-7081. Please include your site number. NOTE: Once you do this, it does not mean that you are ready to transmit claims with your NPI. The purpose of the fax is so they can have it on file.
Include: Site number & NPI number associated with the provider's name or facility name.
Send Test Files
If you have your NPI number and a provision for NPI in your Medisoft then you are ready to send some test files to Gateway EDI to make sure the mapping is in order. Contact Gavin when you are ready to begin the file testing process. We strongly recommend you begin the file testing well in advance of the May 23, 2007 deadline.
Use NPI & Legacy Numbers
Gateway EDI has been ready to receive NPI numbers electronically since October 1, 2006. However, most payers will still require the legacy number in addition to the NPI number on the form so put in both. Gateway EDI suggests using both numbers until May 22, 2007.