tci Medicare Compliance & Reimbursement - 2013 Issue 6

Enrollment: Get Your Ordering/Referring NPI In Place Or Lose Pay

May 1 is the deadline you have to watch out for according to CMS. The last thing you want are a heap of claims rejections. If you don’t ensure that your physicians are listed correctly according to their specialties, you could be setting your practice up for denials and pay losses. Background: Back in 2009, the Centers for Medicare & Medicaid Services (CMS) implemented edits for physicians, home health agencies, and durable medical equipment suppliers to detect when claims contained an invalid ordering or referring provider. Under the edits, the ordering physician for home health agency services must...

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