Issue #26
May 20, 2008
Editor: Laura J. Pugh
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Issue #26 May 20, 2008 Editor: Laura J. Pugh |
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The final, final implementation deadline is this week, so I want to make sure that everyone is aware of how to transmit NPI-Only. Medicare claims must contain NPI-Only for all Provider fields on ALL electronic and paper claims sent beginning May 23, 2008. CONTACT YOUR PAYORS: Please keep in mind that every Payor may not be prepared to accept NPI-Only! If you are not sure if the Payor can accept NPI-Only, PLEASE CALL THE PAYOR OR CHECK THEIR WEBSITE. The NPI is required to be sent electronically for the billing provider, the rendering provider, the referring provider and the ordering provider, just to name a few! I know it can get a little confusing, so let me break it on down for you: Billing Provider: 837P Claims - Medicare EMC Invoice Type: Enter the NPI in Company Setup Utilities (8), Company Setup (1). Uncheck the “Send Electronically” check box directly to the right of the MCR Provider# (Part B). CPR+ automatically sends the Company NPI for the Billing Provider assigned to the claim (box 33) and for the Rendering Provider. For the Ordering Physician (box 17a), remove the entry for question #13 on the 1500 Options tab in the Insurance Company record – Databases (7), Insurance Companies (4). Yes, you will have to remove the value from each insurance company record. Yes, Customer Support could remove all of them for you at once, but not all payors are going to be ready for NPI-Only! 837P Claims – WebMD Medical / Claimsnet Invoice Type: If the payor required a secondary provider number for the Billing and Rendering Providers, these values are stored in the Electronic Setup (F8) of the insurance company record - Databases (7), Insurance Companies (4), select Insurance Company. Remove the provider number entered in the Billing Provider Secondary ID field and also remove the Billing Provider ID Qualifier. Removing the provider number in the Provider Secondary ID field and the Secondary ID Qualifier will ensure that the provider number will no longer be sent for the Rendering Provider. In other words, remove any provider numbers and qualifiers that are populated. For the Ordering Physician (box 17a), remove the entry for question #13 on the 1500 Options tab in the insurance company record – Databases (7), Insurance Companies (4). Yes, you will have to remove the value from each insurance company record. Yes, Customer Support could remove all of them for you at once, but not all payors are going to be ready for NPI-Only! Supervising, Rendering and Referring Providers – Electronic Info tab: To send NPI-Only for any of the above mentioned providers that have been selected on the Electronic Info tab, simply remove the Provider ID Qualifier. If the payor requires the taxonomy code in place of the legacy Provider ID, then select the Send Taxonomy check box to the far right. NCPDP 5.1 / Pharmacy Claims Changes will need to be made in the Electronic Setup (F8) of the insurance company record to send NPI-Only for both the Provider and the Prescriber. There are two ways to handle this for the Provider of Services:
Some payors may also require the NPI for the (E9) Insurance Provider ID. (The default for this is also in the Electronic Setup (F8) of the insurance company record.) If so, then select 05 for the National Provider Identifier (NPI) for the (EY) Insurance Provider ID Qualifier and enter the NPI in the Provider Number field on the General / Billing Info tab. For the Prescriber:
NPI Implementation is definitely going to be a challenge; not only for providers, but for clearinghouses and payors as well. The key to successfully transitioning from provider ID’s to NPI- Only is knowing each payor’s requirements. Use the payor’s website as a resource - most have companion documents outlining their requirements.
This article is the first in a series that we will be providing so that you will have a better understanding of each class that will be offered at this year’s CPR+ User Conference. The P.O. & Inventory Management class should be attended by the person(s) responsible for managing inventory as well as members of your warehouse staff. The objective of this class is to learn how to manage your inventory within CPR+ efficiently and effectively. Attendees will also learn how to create purchase orders within the system and how to send them electronically. If you want to learn how to receive inventory from the purchase order without the need to search for each and every item on the invoice, come to this class! The class will begin with setting up and editing a supplier. The trainer will review each screen, and show you how to easily add the information about a supplier, including how to tag a supplier as a Cardinal (Drug) Supplier. If so, the cost and reorder number can be automatically added by CPR+.
Do you use McKesson for drop shipping? If you want to learn how to tag a delivery ticket to generate a file to McKesson so that they will “drop ship” the order directly to the patient, show up for this class! You have the ability with CPR+ to create, modify and print purchase orders which can help in restocking supplies carried by your company. An advantage of doing purchase orders within the program is that the on-hand inventory count can be updated automatically when you receive a P.O.
If you already have our CPR+ Scan module, you know how much time and paper you can save with it, but are you using it to create P.O.’s? If you want to learn how, attend this class! The trainer will step through the process of creating a P.O. using CPR+ Scan. As items are scanned in, CPR+ Scan determines the default supplier and adds the items to a “virtual P.O.” When you sync CPR+ Scan with CPR+, these “virtual P.O.’s” are transferred and stored within the application as pending. If you don’t have CPR+ Scan, (you should!) this class is still for you. The trainer will discuss viewing or editing an unfinished P.O. He or she will explain that any P.O. that was not sent after it was created is moved to the unfinished P.O. section of CPR+. You’ll learn where to access the unfinished P.O.’s so that you can update or complete them. You can even create a new P.O. from this screen. No need to jump to a different area to get your job done!
If you want to learn how to replenish your stock levels from the P.O. screen in CPR+, register for this class! If you want to find the screen that gives you a visual history of your purchase orders, come to this class! How about learning those time-saving shortcut keys? By now, you know what to do… Attend this class!
This session will only be offered once during the conference, so be sure to attend! |
Requirement Deadline NPI-Only Implementation is May 23, 2008 User Conference Class Highlight: Announcement:
How do I get an NDC Number to Transmit Electronically for DME MAC Claims? Medicare: NDC numbers are only sent for Oral Anti-Cancer medications. Question #2 on the 1500 Options tab of the insurance company record must be populated with an N for NDC#. CPR+ stores all the approved NDC numbers in a table called NDCLOOKUP. If the NDC on the line item is in this table, CPR+ will populate the 2410 LIN with the NDC number and the 2410 REF with the prescription number. What if I Need to Send the Description of the Drug also? The Description Field in CPR+ does not transmit electronically. If the payor requires the description / name of the drug, it must be entered in the Narrative Field Line Item level. To enter a narrative, you can either right click on the line item and select Narrative or press Alt+N. The "Enter Narrative for EMC file" box will display. There is an 80 character limitation set on this field. This is an ASC X12 4010A limitation, not a CPR+ limitation. What about Medical Claims? WebMD Medical: There are two insurance company options that need to be set for the NDC number to transmit electronically. On the 1500 Options tab, question #2 must be populated with an N for NDC #. In the Electronic Setup (F8) for that payor, the question Submit NDC / RX Information must be set to Y. CPR+ will populate the 2410 LIN with the NDC number and the 2410 REF with the prescription number. If your destination payor requires that the NDC Units and NDC Units Qualifier be sent also, there is another insurance company setting for that directly below the Submit NDC / RX Information. For more details on WebMD electronic setup options, contact Kim Carlsen today.
CPR+ Palm User Guide Now Available by Phil Raynes Definitive Homecare Solutions is pleased to announce the release of the CPR+ Palm User Guide. This 40-page document will take you through the process of getting started and how to use this time-saving module in CPR+. Included in this guide are step-by-step instructions on setting up CPR+ and many screenshots from both the Palm OS and Windows Mobile OS versions of CPR+ Palm. The guide is available for any CPR+ customer by clicking here. In addition, you can access this and many other documents by opening your F1 Online Help and clicking the CPR+ Manuals, Guides and Step-by-Steps link from the Contents tab.
Back Up Service Update User Conference
Class Highlight:
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