Although the new CMS 1500 paper claim form became available for use on October 1, 2006, providers have until June 2007, before they are required to submit insurance claims with the NPI number and use the revised CMS 1500 form. Many health plans, including Medicare, Medicaid, private health insurance issuers, and all health care clearinghouses must accept and use NPIs in standard transactions by May 23, 2007. Small health plans have until May 23, 2008, to accept and use NPIs in standard transactions. After those compliance dates, health care providers may use only their NPIs to identify themselves in standard transactions, where the NPI is called for.
The new CMS 1500 form that incorporates the NPI number is available in OfficeMate 7.2 and above. This version can be downloaded using the related Knowledge Base article linked below.
Note: The NSF electronic claims file format, which is being phased out, will not be updated to be compatible with the NPI number. Only ANSI files will be supported. Refer to the related article below for information on switching from the NSF to the ANSI file format.
We suggest checking with your insurance carrier for updates to this revised form and process. VisionWeb clients should call the VisionWeb/Emdeon Help Desk at 866.745.4951 prior to submitting the new print image. GatewayEDI clients switching from the NSF format to ANSI format should call 800.969.3666 prior to submitting claims using the new format and NPI number. Be sure and check with your insurance carrier to see if they accept the new CMS 1500 form before you install OfficeMate 7.2 or above, which will contain the new CMS 1500 form and NPI number changes.
Related Information