Gateway News! - CMS Legacy Free Day
CMS has requested clearinghouses that submit claims to Medicare to participate in a one day NPI preparation exercise. On May 7, 2008, Gateway EDI will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. On May 8, Gateway EDI will revert back to sending Medicare NPI/legacy pairs as received from the providers.
This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008, deadline. The outcomes of this exercise are described below:
Claims are processed and paid by Medicare. Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23 implementation date.
Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23. Resolution might include changes to the NPPES data to the 855 enrollment record, and in this case, the provider should to contact the payer directly for resolution.
Action required by Customers: Providers should send Medicare claims as normal on May 6, and Gateway EDI will format the data as requested by CMS to meet the requirements of the "Legacy Free" day.
This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008, deadline. The outcomes of this exercise are described below:
Claims are processed and paid by Medicare. Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23 implementation date.
Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23. Resolution might include changes to the NPPES data to the 855 enrollment record, and in this case, the provider should to contact the payer directly for resolution.
Action required by Customers: Providers should send Medicare claims as normal on May 6, and Gateway EDI will format the data as requested by CMS to meet the requirements of the "Legacy Free" day.
posted by Brandy @ 8:40 AM
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