 Printable Copy of Plan
Sisters of St. Francis Health Services
NPI Transition Plan Final
January 29, 2008
ATTACHMENT A
Template for Documenting an NPI Contingency Plan
Organization Name: Sisters of St. Francis Health Services
Contact (Name/Phone/Email):
Deb White Paul Plomin
System Patient Access Director Vice President of Finance
Coordinated Business Office (CBO) Sisters of St. Francis Corporate Offices
Deborah.white@ssfhs.org paul.plomin@ssfhs.org
219-554-4322 574-256-3935
Website: http://www.ssfhs.org
Plan Last Updated: 1/29/08
NPI Contingency Plan Adoption Statement:
The Sisters of St. Francis Health Services (SSFHS) is officially adopting an NPI Contingency Plan, in accordance with CMS NPI Contingency Guidance and applicable regulations. This plan covers all hospital entities including:
St. Francis Health Services
St. Margaret Mercy
St. James Hospital and Health Services
St. Anthony Memorial Hospital
St. Anthony Medical Center
St. Clare Medical Center
St. Elizabeth Regional Hospital
Physicians Regional Hospital
This plan covers all standard SSFHS applications and systems. Non-standard applications and systems will be responsible for documenting their own transition plan
Key Contingency Plan Dates:
SSFHS will accept/submit, as applicable, the following identifiers in HIPAA electronic transactions, in the manner and for the purposes specified herein:
- SSFHS began sending Legacy and NPI numbers for all transactions as of 08/01/07 for all sites all Affinity billed applications. Some transactions were sent as NPI + Legacy prior to this date, see details below in table.
- SSFHS Coordinated Business Office will communicate with Clearing house PerSe to coordinate and track the cut-over of NPI only by payor. The clearinghouse is tracking all payors and has committed to sending SSFHS NPI only data as each payor is deemed ready to receive information.
Lists of transactions timetable applies to (if one table does not apply to all transactions that your organization performs, please provide additional table(s) as appropriate): Mark with “X”
X 837P X 837I 837D X 835 X 270/271 X 276/277 __ 278 __ 834
|
Identifier |
Primary Providers
(Billing/Pay To; Rendering)
|
Secondary Providers (Referring, Ordering, Operating, Other)
|
|
Legacy ID Only |
SSFHS is not currently sending legacy only ID for any transactions |
SSFHS is not currently sending legacy only ID for any transactions |
|
NPI+Legacy
|
· NPI+Legacy started to be submitted / accepted as of 01/01/07 (releasing through Epremis / Relay. NPI+Legacy through Affinity on 05/23/07 with the exception of St. Elizabeth Regional Health who began on 08/18/07)
NPI+Legacy will continue to be
submitted/accepted through May 23, 2008 |
· NPI+Legacy started to be submitted/ accepted as of 01/01/07 (releasing through Epremis / relay with the exception of ST. ELIZABETH REGIONAL HEALTH. 05/23/07 – Affinity with the exception of St. Elizabeth Regional Health who began on 08/18/07)
NPI+Legacy will continue to be submitted/accepted through May 23, 2008
|
|
NPI Only
|
· NPI only started to be submitted/ accepted after clearing house tests each payer. Clearing House will facilitate the NPI only sharing process.
· NPI Only will be REQUIRED to be sent/received starting May 23, 2008
· After May 23, 2008 Legacy IDs will NOT be sent
|
· NPI Only started to be submitted/ accepted May 23, 2008
NPI Only will be sent/received starting May 23, 2008
· After May 23, 2008 Legacy IDs will NOT be sent
|
Key Questions and Answers:
|
What requirements does the health plan have for sharing NPIs prior to production use? |
All credentialed providers NPI numbers have been obtained and shared. All non-staff provider NPI’s will be obtained through NPPES. Use of NPI alone in transactions cannot start until NPPES dissemination is available to us |
|
When both legacy and NPI are present in the same transaction, which ID is used for processing? |
We are sending both NPI and Legacy to the clearinghouse and the clearinghouse is sending the appropriate ID number as each payor is ready to receive NPI only. With the exception of Medicare who will be sent straight to Medicare. |
|
How does the health plan recommend providers test transactions with NPI? |
CBO will follow all instructions given by the clearinghouse. The clearinghouse is facilitating the testing of NPI’s with payers who have determined that they are ready to receive NPI only. |
|
What are the timelines and transition requirements for paper claims? |
n For UB92/UB04
o UB92 will stop being accepted May 23, 2007 (Exception of Medicare Illinois who continues to use UB92’s)
o UB04 started to be accepted May 23, 2007 and will be the only form accepted starting May 23, 2007. NPI and Legacy accepted since May 23, 2007 at the CBO with the exception of Illinois Department of Public Aid (IDPA) who continue to use the UB92
n For CMS 1500 Form
o Version 08/05 started to be accepted July 1st, 2007 at the CBO.
n Usage of NPI on paper forms will follow the same requirements as electronic transactions (in terms of accepting NPI only, NPI+Legacy, or Legacy only)
n NPIs should NOT be sent on the paper claim forms being phased out |
Health Care Provider:
|
Health Care Provider:
St. Anthony Medical Center - Crown Point
St. Anthony Memorial Health - Michigan City
St. Margaret Mercy
St. James Hospital & Health Centers
St. Elizabeth Regional Health
St. Francis Hospital & Health Centers
St. Claire
Physicians Regional Hospital
|
|
Transactions timetable applies to (indicated by X):
_X_ 837P _X_ 837I __ 837D _X_ 835 _X_ 270/271 _X_ 276/277 __ 278 __ 834
|
|
Identifier |
Primary Providers
(Billing/Pay To; Rendering)
|
Secondary Providers (Referring, Ordering, Operating, Other)
|
|
Legacy ID Only |
· SSFHS is not currently sending legacy only ID for any transactions |
· SSFHS is not currently sending legacy only ID for any transactions |
|
NPI+Legacy
|
· NPI+Legacy started to be submitted / accepted as of 01/01/07 (releasing through Epremis / Relay. NPI+Legacy through Affinity on 05/23/07 with the exception of St. Elizabeth Regional Health who began on 08/18/07)
· NPI+Legacy will continue to be
submitted/accepted through May 23, 2008 |
· NPI+Legacy started to be submitted/ accepted as of 01/01/07 (releasing through Epremis / relay with the exception of St. Elizabeth Regional Health. 05/23/07 – Affinity with the exception of St. Elizabeth Regional Health who began on 08/18/07)
· NPI+Legacy will continue to be submitted/accepted through May 23, 2008
|
|
NPI Only
|
· NPI only started to be submitted/ accepted after clearing house tests each payer. Clearing House will facilitate the NPI only sharing process.
· NPI Only will be REQUIRED to be sent/received starting May 23, 2008
· After May 23, 2008 Legacy IDs will NOT be sent |
· NPI Only started to be submitted/ accepted May 23, 2008
NPI Only will be sent/received starting May 23, 2008
· After May 23, 2008 Legacy IDs will NOT be sent
|
Clearinghouse:
|
Health Care Clearinghouse: [Health Care Clearinghouse Name] |
|
Transactions timetable applies to (indicated by X):
X_ 837P _X_ 837I _X_ 837D _X_ 835 _X_ 270/271 _X_ 276/277 _X_ 278 _X_ 834
|
|
Identifier |
Primary Providers
(Billing/Pay To; Rendering)
|
Secondary Providers (Referring, Ordering, Operating, Other)
|
|
Legacy ID Only |
· Legacy IDs ONLY will continue to be submitted/accepted through [January 31, 2008]
|
· Legacy IDs ONLY will continue to be submitted/accepted through [May 23, 2008]
|
|
NPI+Legacy
|
· NPI+Legacy started to be submitted/ accepted [October 1, 2006]
(Note: Dual ID usage will be adapted to each plan’s ability to accept both IDs]
· NPI+Legacy will continue to be submitted /accepted through [May 23, 2008] |
· NPI+Legacy started to be submitted/ accepted [October 1, 2006]
(Note: Dual ID usage will be adapted to each plan’s ability to accept both IDs]
· NPI+Legacy will continue to be submitted /accepted through [May 23, 2008]
|
|
NPI Only
|
· NPI Only started to be submitted/ accepted [May 23, 2007]
(Note: NPI-only usage will be adapted from this date on to each plan’s ability to accept it as only identifier]
· NPI Only will be REQUIRED to be sent/ received from trading partners starting [May 23, 2008]
· After [May 23, 2008] Legacy IDs will NOT be permitted to be sent
|
· NPI Only started to be submitted/ accepted [May 23, 2007]
(Note: NPI-only usage will be adapted from this date on to each plan’s ability to accept is as only identifier]
· NPI Only will be REQUIRED to be sent/ received from trading partners starting [May 23, 2008]
· After [May 23, 2008] Legacy IDs will NOT be permitted to be sent
|
|