Physicians Plus Approach to NPI

1
Physicians Plus Approach to NPI

• Cindy Case
• Ann Bartlett

2
Use of the NPI

• NPI Number is not a private number.
• The NPI will be in our 2008 provider directory.
• ALL par providers will be required to obtain an
  NPI yes, regardless of submission type.
• We expect a 4 6 month transition period in
  which we will accept either number.

3
NPI Approach

• Early 2005 - Updated website with NPI FAQs,
  links, articles and provider expectations.
• Spring 2005 Plan development and beginning
  phase of outreach to providers (Newsletter
  articles).
• Spring 2006 - Formal Communication to Providers,
  Vendors and Business Partners.

4
NPI Approach Cont.

• Summer 2006 Follow up to Providers and
  continued outreach visits.
• Summer 2006 Began collection NPI numbers
• Summer 2006 - Outreach to pharmacy providers via
  Business Partner.

5
Where are we today

• Thus far we have collected approx. 1500 of 2500
  par providers.
• Providers are encouraged to go to our website to
  complete the NPI form at www.pplusic.com
• Larger provider groups are encouraged to submit
  electronically.
• The NPI will be collected via the PACT form and
  Credentialing application.

6
Testing

• Testing will occur in November and December 2006.
• We are expecting that well have the vast
  majority of NPIs loaded prior to testing.
• We will run existing 837 files to test (this may
  include UWMF, WebMD, etc.)

7
Dual Processing

• Run dual processing from January till compliance
  date.
• A reminder message will be sent on the EOP to
  providers missing their NPI.
• Missing NPI reports will be run beginning in
  early March 2007 for par providers.
• PNM will contact providers to collect the missing
  NPIs.

8
(No Transcript)
9
After Compliance Date

• Electronic files (par and non par) missing an NPI
  will error back to the provider.
• Par providers submitting paper claims with no NPI
  will be returned.
• Non Par paper claims will be processed
  accordingly.

10
Visit our website at www.pplusic.com

• Contact Information
• cindy.case_at_pplusic.com
• ann.bartlett_at_pplusic.com