NPI Must Match IRS Data

May 23 marked the date that the Centers for Medicare & Medicaid Services began requiring use of new National Provider Identifiers or NPIs, under the Health Insurance Portability and Accountability Act, or HIPAA. One reason for the 10-digit unique identifiers, according to CMS, is to simplify and make more efficient standard benefits transactions.

Those transactions may have become more complicated. In a June 11 announcement, CMS stated that physicians will have to reconcile their NPI data with their IRS legal name data to ensure payment. Some billing experts say that the requirement could cause big problems for physicians if an error as minor as spelling, use of initials in the name or blank spaces in the data fields cause the NPI and IRS systems to fail to match.

CMS has reportedly told some physicians to start over with a new NPI enrollment, a process which could take months. The CMS has a Web site dedicated to the NPI.