Question

Response

Is there a designated contact for NPI implementation issues?

For all EDI inquiries regarding NPI, contact the EDI Support Team:

• E-mail: EDIsupport@regence.com
• Fax: (877) 329-3342
• Idaho and Oregon Submitters
•  (800) 713-1693
• Utah Trading Partners/Submitters
•  (888) 344-5583
• Washington Submitters (877) 329-3342

Do you have a plan to implement NPI?

Yes, Regence is following Centers for Medicare & Medicaid (CMS) contingency guidance to facilitate compliance in using the NPI for electronic claims submission.

As of March 1, 2008, you are required to submit an NPI on all electronic claims, with or without your Regence provider number. We will notify you at a later date when the Regence identifier will no longer be accepted.

Do I still need to include my tax identification number on my claims submissions?

Yes, the NPI does not replace the tax identification number. Your tax identification number is a critical element for the health plan to help us correctly process your payments.

How and when will you communicate your plan?

Regence publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

When will updated Companion Guides be available?

Existing Companion Guides already include current information to support NPI. 

Yes, Regence is following Centers for Medicare & Medicaid (CMS) contingency guidance.

• You are now required to submit an NPI on all electronic claims, with or without your Regence provider number. We will continue in this dual-use mode until further notice.
• We will notify you at a later date when the Regence identifier will no longer be accepted.

If you will have a transitional period, when will you be able to share that plan?

Regence publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

If converting without a dual identifier transition period, when do you plan to test?

N/A

Do you have a conversion date? Tentative or firm?

Yes, as of March 1, 2008 you are required to submit all electronic claims with an NPI as the primary identifier. You may continue to submit your Regence provider number with the NPI until further notice.  We will notify you at a later date when the Regence identifier will no longer be accepted.

What is your transition plan for the provider enrollment process?

Regence does not require providers to re-enroll.

Will NPIs be validated as part of the adjudication process or claims submission process?

Yes, for electronic claims submissions, the NPI will be validated to ensure the formatting of the NPI is correct. For adjudication, the NPI will be validated against the NPI information submitted to Regence by the provider.  

How can I be sure you have my correct NPI?

The NPI on file will be printed on your payment voucher.

• Please verify now that the NPI on your voucher is correct.
• If you do not see the NPI number or you feel it is incorrect, please contact your provider relations representative immediately.

How will the enrollment process change?

N/A

Will taxonomy codes be required to adjudicate claims?

Regence does not require the use of taxonomy codes at this time.

How will you process same provider/multiple locations claims/remittance advices post-implementation?

Regence will continue to process and distribute payments using processes currently in place.

Do you have subpart requirements?

No. See CMS guidelines related to subparts at: cms.hhs.gov/NationalProvIdentStand/.

Will you require new Trading Partner Agreements?

No

Will you require discussions regarding current contracts?

NPI enumeration will not impact current provider contracts.

Will you require the NPI on paper-based transactions?

While we are not requiring NPI on paper based transactions, it is recommended to include the NPI in all transactions whether submitted electronically or on paper.

Will you require providers to update you in addition to the Enumerator?

Yes, at this time, the Enumerator has not yet disclosed when it will be able to deliver the NPI to payers. Until that process has been defined, we will continue to request that providers notify us of their NPI prior to submission of claims based transactions.

What will be the process?

Regence offers three ways to submit NPIs:

• Use our online forms on the Regence Provider Web Site
• Fax or e-mail information
• Contact your provider relations representative

Are you willing to post your organization’s testing and production date/status information to assist with industry coordination?

Regence publishes and distributes NPI status updates in quarterly provider newsletters. NPI status and detailed information is available on the Provider Web Site. Other methods such as direct mailings and voucher stuffers may also be used for sharing information or requesting action from providers related to NPI.

Do you qualify as a small health plan?

No

If so, will your organization take the additional year to comply?

N/A – CMS allowed all health plans to have the additional year to establish contingency plans during this year to allow providers more time to comply.

Will your system be updated to accommodate the new UB04, and once approved, the new CMS 1500 forms in accordance with the NPI related changes?

Yes. This has already been accomplished.

How many taxonomy codes are supported?  Explain.

Regence does not require or support the use of taxonomy codes at this time.