Connecting the Dots ... Federal Tax ID to NPI Type 2 and Pharmacy NCPDP

1. Connecting the Dots ... Federal Tax ID to NPI Type 2 and Pharmacy NCPDP Presented byHQ MEDCOM UBO Programs & Compliance Analyst, Patient Administration Division, Health Policy and Services, Army Medical Department 28 August 2012 0800-0900 EDT 30 August 2012 1400-1500 EDT From your computeror Web-enabledmobile devicelog into: http://altarum.adobeconnect.com/ubo.  Enter as a guest, then enter your name plusyour Service affiliation (e.g., Army, Navy, Air Force) for your Service to receive credit. Instructions for CEU credit are at the end of this presentation. [Note: The TMA UBO Program Office is not responsible for and does not reimburse any airtime, data, roaming or other charges for mobile, wireless and any other internet connections and use.] Listen to the Webinar by audio stream through your computer or Web-enabledmobile device.To do so, it must have a sound card and speakers. Make sure the volume is up (click “start”, “control panel”, “sounds and audio devices” and move the volume to “high”) and that the “mute” check box is not marked on your volume/horn icon. If you do not have a sound card or speakers or have any technical problems before or during the Webinar, please contact us at webmeeting@altarum.orgso we may assist and set you up with audio. You may submit a question or request technical assistance at anytime by typing it into the “Question” field on the left and clicking “Send.”

2. Objectives Learn why the Organizational National Provider Identifier, (NPI Type 2) and NCPDP Provider ID are linked to the facility Tax ID Number (TIN), Legal Business Name (LBN) and Mailing Address. Learn how to update the information on file with the IRS. Learn how to update Facility NPI Type 2 data in the National Plan and Provider Enumeration System (NPPES). Learn how to request Pharmacy NPI Type 2 and NCPDP Provider ID updates.

3. Why Facility NPI Type 2 Is Linked to TIN • Centers for Medicare & Medicaid Services (CMS) requires a TIN to obtain an NPI Type 2 for your Medical Facility. • CMS requires the LBN of the NPI Type 2 match the LBN of the TIN. • This also applies when outlying clinics and pharmacies enumerated with the Parent Facility TIN. • CMS/NPPES does TIN/LBN verification checks with the IRS to verify the enumerated entity exists.

4. Why Pharmacy NPI Type 2 and NCPDP Are Linked to TIN • NCPDP Provider ID requirements changed when NPI requirement was implemented. • Pharmacies are required to have an NPI Type 2. • As with facility NPI Type 2, CMS requires the LBN of the Pharmacy NPI Type 2 match the LBN of the TIN. • The TMA Pharmacy Operations Center (TMA POC) enumerated all DoD Pharmacies. • NCPDP requires the LBN of the NCPDP Provider ID match the LBN of the TIN. • An IRS TIN Verification Letter is required to be appended to each NCPDP Provider ID in the NCPDP database. • NCPDP uses the IRS TIN Verification Letter to validate TIN and LBN.

5. Tax ID Number • The LBN and mailing address used for the Facility and Pharmacy NPI Type 2, NCPDP Provider ID, and on the medical claim form must match what the IRS has in their database for the TIN. • IRS updates can be made: • By letter when changing LBN (sample letter included). • By letter or IRS Form 8822-B when just changing mailing address. • The IRS Form 8822-B provides the address to send the form to based on the facility location. • IRS Form 8822-B can be found on the IRS Website: http://www.irs.gov. • IRS TIN Verification letter can be obtained: • By calling 1-800-829-0115 or 1-877-829-5500. • By written request. Use appropriate address from the 8822-B.

6. Sample Letter to IRS LETTERHEAD MTF NAME [DATE] ATTN [OFFICE SYMBOL] STREET ADDRES CITY STATE ZIP DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE CENTER CINCINNATI OH 45999-0023 OR OGDEN UT 84201-0023 Re: EIN/TIN [##-#######] Internal Revenue Service, Request the [legal business name and/or address] for US [Service] Military Treatment Facility [Name], EIN/TIN [##-#######] be changed: From: [OLD NAME] [OLD ADDRESS] [OLD CITY STATE ZIP] To: [NEW NAME] [NEW ADDRESS] [NEW CITY STATE ZIP] [NEW NAME] is a (501(c)(1) Exempt Organization - Instrumentality of the United States. Request a letter of verification be sent to this facility upon completion of these requested updates. If you have any issues, questions or concerns, please contact me at [Point of contact information]. Sincerely,   SIGNATURE BLOCK OF POC

7. IRS Form 8822-B

8. Example of an IRS Verification Letter

9. Updating NPI Type 2 – Facility • The easiest and fastest way to update your Facility NPI Type 2 is on-line at https://NPPES.CMS.HHS.GOV • If you don’t have a user name and password, you can create one. • You will need: • The NPI Type 2, • Organization Name as listed in NPPES, • EIN(TIN) used to obtain NPI Type 2. • If you don’t know if on-line access has been created, please contact your Service UBO Representative. • NPPES Screen Shots included on slides 16-20.

10. NPIs Type 2 Matching TIN

11. Updating Pharmacy NPI Type 2 and NCPDP Provider ID • The TMA Pharmacy Operations Center (TMA POC) is solely responsible for the enumeration and management of DoD Pharmacy Identifiers NPI Type 2 and NCPDP Provider IDs. • When changes are made to LBN and/or mailing address the TMA POC needs to be notified and provided the new IRS TIN Verification Letter. • Provide the new letter, NPI Type 2 and NCPDP Provider ID that requires updating to your Service UBO Representative who will in-turn provide to the TMA POC.

12. Pharmacy NPI Type 2 and NCPDP Matching TIN

13. Summary The Legal Business Name (LBN) and Tax ID Number (TIN) used in NPPES for Facility and Pharmacy NPI Type 2 must match the IRS LBN and TIN. The LBN and TIN used in NCPDP for Pharmacy NCPDP Provider ID must match the IRS LBN and TIN. Ensure IRS information is up-to-date and make changes as needed. Ensure NPI Type 2 and NCPDP Provider ID information is updated to match IRS information.

14. Questions and Review

15. Additional Information – TIN and NPPES • Tax ID Number (TIN) and Employer ID Number (EIN) are interchangeable. • The National Plan and Provider Enumeration System (NPPES) was developed by the Centers for Medicare and Medicaid Services (CMS) to assign the National Provider Identifier (NPI) to eligible health care providers. • CMS uses NPPES to enumerate and maintain information on all providers who have been enumerated. • NPI is a 10-digit number used to identify: • Type 1: Individuals who render health care or provide atypical services, or furnish health care supplies to patients; e.g., physicians, dentists, nurses, chiropractors, pharmacists, physical therapists, nurse practitioners, physician assistances, etc. • Type 2: Organizations that render health care services, or furnish health care supplies to patients; e.g., hospitals, home health agencies, ambulance companies, health maintenance organizations, durable medical equipment suppliers, pharmacies, dental clinics, etc.

16. Additional Information-NCPDP • NCPDP - National Council for Prescription Drug Programs is both a an Organization and a National Pharmacy Provider Identifier. • NCPDP is a not-for-profit, ANSI-accredited*, Standards Development Organization. NCPDP creates and promotes data interchange standards for the pharmacy services sector of the healthcare industry. NCPDP also provides information and resources that educate the industry. The standards are continually revised and updated to meet the ever-changing healthcare environment. These changes to the standards are reflected by the version of each standard. • The NCPDP Provider Identification Number (NCPDP Provider ID) formerly known as the NABP number, was developed over twenty-five years ago to provide pharmacies with a unique, national identifier that would assist pharmacies in their interactions with pharmacy payers and claims processors. The NCPDP Provider ID is a seven-digit numbering system that is assigned to every licensed pharmacy and qualified Non-Pharmacy Dispensing Sites (NPDS) in the United States.

17. National Plan & Provider Enumeration System (NPPES)

18. National Plan & Provider Enumeration System (NPPES)

19. NPPES – Creating Login for Existing NPI

20. NPPES - Registry

21. NPPES – Organizational NPI Type 2 Look-up

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24. Other Organizations Accepting AAPC CEUs Participants certified with the American Health Information Management Association (AHIMA) may self-report AAPC CEUs for credit at https://secure.ahima.org/certification/ce/cereporting/. The American College of Healthcare Executives (ACHE) grants one (1.0) Category II ACHE educational credit hour per one (1.0) hour executive/management-level training course or seminar sponsored by other organizations toward advancement or recertification. Participants may self-report CEUs on their personal page at http://www.ache.org/APPS/recertification.cfm. The American Association of Healthcare Administrative Managers (AAHAM) grants one (1.0) CEU unit “for each hour in attendance at an educational program or class related to the health care field” for AAHAM-credentialed participants who self-report using AAHAM’s on-line CEU tool. Participants may self-report CEUs during their recertification process at http://www.aaham.org/Certification/ReCertification/tabid/76/Default.aspx.