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NPI – HDX Services Readiness Strategy

NPI – HDX Services Readiness Strategy. Kathy Ducharme Sheryl McClelland. HDX Services – NPI Implementation Strategy. NPI Overview HDX Eligibility Service HDX Electronic Claims Service HDX Electronic Remittance Service. NPI Overview. Final Rule mandated 5/23/2007

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NPI – HDX Services Readiness Strategy

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  1. NPI – HDX Services Readiness Strategy Kathy Ducharme Sheryl McClelland

  2. HDX Services – NPI Implementation Strategy • NPI Overview • HDX Eligibility Service • HDX Electronic Claims Service • HDX Electronic Remittance Service

  3. NPI Overview • Final Rule mandated 5/23/2007 • Standard unique identifier for Health Care Providers • Type 1: Individual • Type 2: Organizational • Providers must apply for their NPIs • NPPES assigns NPIs: www.nppes.cms.hhs.gov/NPPES/Welcome.do • 10 digit number – last digit is a self check digit (ISO Luhn)

  4. HDX Eligibility Service • Goals • Implementation Strategy • Timeline

  5. HDX Eligibility Service - Goals • Utilize the Dual Use Strategy proposed by WEDI • Insulate Providers from varying Payer timelines • Ability to react to Payer changes quickly • Provide a solution that requires only one set of changes for the Providers

  6. HDX Eligibility Service – Implementation Strategy • Providers send both Legacy identifiers and NPI on eligibility requests • Option 1: NPI as primary, Legacy as secondary • Option 2: Legacy as primary, NPI as secondary • HDX preference is Option 1 • HDX will maintain a transparent table of all payers indicating their NPI processing requirements • HDX will map the identifiers according to the payers’ requirements • Transaction will be successful as long as the Provider’s eligibility request contains the data needed for the Payer.

  7. HDX Eligibility Service - Timeline • October 1, 2006 - Communication to all our Provider Integration Partners • December 1, 2006 - Internal Testing with Provider Integration Partners • January 2007 - HDX Eligibility Service changes implemented in Production • January 2007 - Providers begin sending NPI

  8. HDX Electronic Claims Service • Goals • Implementation Strategy • Timeline

  9. HDX Electronic Claims Service - Goals • Utilize the Dual Use Strategy proposed by WEDI • Enable Providers to Migrate Individually • Provide a solution that requires only one set of changes for the Providers • Enable Providers to easily submit their NPI’s

  10. HDX Electronic Claims Service – Implementation Strategy • ECS Customer Option • Supports NPI at both the facility and doctor level • Recommend confirmation of third-party, payer, and remittance software readiness • ECS Payer Option • INVISION/UNITY customers MUST submit NPI’s to Siemens ERSCONTACT.MED@SIEMENS.COM • NPI is used to route transactions and reports • Recommend confirmation of payer and remittance software readiness

  11. HDX Electronic Claims Service - Timeline • NPI ready NOW • October 31, 2006 – Customer Memo Z061031C • ECS Payer Option: • INVISION/Unity Providers must submit NPI • Contact us now via: ERSCONTACT.MED@SIEMENS.COM • NPI ready - once NPI submission process is complete • January 2007 – can submit NPI via web page

  12. HDX Electronic Remittance Service • Goals • Implementation Strategy • Timeline

  13. HDX Electronic Remittance Service - Goals • Utilize the Dual Use Strategy proposed by WEDI • Enable Providers to Migrate Individually • Provide a solution that requires only one set of changes for the Providers • Enable Providers to easily submit their Payee level NPI’s • Early Adopter Testing

  14. HDX Electronic Remittance Service –Implementation Strategy • Supports WEDI advocated Dual-Use transition strategy • Customers MUST submit Payer level NPI’s to Siemens • Siemens must load NPI into Enrollment Database • Update OML for Invision/Unity customers • NPI will be used to route transactions and reports to appropriate destination • Submit your NPPES NPI Enumeration documents

  15. HDX Electronic Remittance Service - Timeline • October 31, 2006 – Customer Memo Z061031C • November 2006: • Contact Siemens to initiate NPI submission process • Contact us now via: ERSCONTACT.MED@SIEMENS.COM • December 2006 – Claims & Remit 3.8 Customer Memo • December 2006 – begin Early Adopter testing • January 2007 - submit NPI via web page (if not already submitted) • Jan/Feb 2007 – Changes implemented in Production

  16. For Your HDX NPI Information • www.hdx.com – • Read about HDX NPI strategy or WEDI press releases • Read additional information on related links sidebar • Upcoming Customer Memos • WEDI Call to Arms listed on website • Contact us: HDXSERVICESNPI.MED@SIEMENS.COM

  17. Question and Answer Session The Power of HDX

  18. This presentation is designed to give conclusive examples of how we deliver the best practice integration. ” “ The Power of HDX

  19. The Power of HDX

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