Welcome
CMS, in collaboration with the Healthcare Information and Management Systems
Society (HIMSS), has requested clearinghouses that submit claims to Medicare
to participate in a one day NPI preparation exercise. Specifically, on
Wednesday, May 7, 2008, Gateway EDI will submit Medicare Part B claims with
NPI-only in all provider identifier fields for which a provider uses
NPI/legacy pairs. On May 8, Gateway EDI will revert back to sending Medicare
NPI/legacy pairs as received from the providers.
On May 7, 2008, Gateway EDI will strip the legacy identifiers when they are
submitted as part of an NPI/legacy pair. Fields already containing NPI-only
will be sent to Medicare as usual, and secondary provider identifier fields
containing legacy-only will be sent to Medicare as usual. Only NPI/legacy
pairs will be altered on May 7, 2008. It is not necessary to remove your
legacy provider numbers as Gateway EDI will be stripping them from all
Medicare files submitted during this time period.
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.
Please be aware that it could take up to 2 days to get your payer reports
back with any rejections.
Action required by your Customer: 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. If your customers do not
want to participate, they should not send Medicare claims between the times
of 2 p.m. CST on May 5 and 2 p.m. CST on May 6.
This information has been shared with our mutual clients via banner pages,
client website as well as listed in the client newsletter.
Please let me know if you have any questions or concerns.
Information provided by- 
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