OLYMPIA -- Washington State's Medicaid program is reminding hospitals, nursing homes, doctors, dentists and other health-care providers that they must report their new National Provider Identifiers (NPI) to the Department of Social and Health Services (DSHS) by August 17.

Adding an NPI to a billing or claim form does not fulfill the reporting requirement because the old payment system has no capability to capture it.

Reporting NPIs to DSHS on Medicaid claims is not only a federal requirement, but an important step to ensuring uninterrupted payments when the state's new provider payment system is put into operation next year. DSHS needs to map providers' NPI to each of their current Medicaid billing numbers for the new system, which is named ProviderOne. If providers don't report their NPI by August 17, their current provider IDs will be consolidated to a single number for ProviderOne resulting in a single pay-to address, a single check, and a single remittance advice. In addition, providers who don't report their NPI could experience denied claims or delayed payments.

Providers must use one of these three options to report their NPI:

• Visit the ProviderOne Web site at http://maa.dshs.wa.gov/ProviderOne/providers.htm.
• E-mail questions to ProviderOne@dshs.wa.gov
• Phone DSHS at 1-800-562-3022 (select option 2, then option 4).

Providers were supposed to obtain their NPI from the federal government earlier this spring. General information on the NPI and how to get one is available through web site of the federal Centers for Medicare and Medicaid Services (CMS): www.cms.hhs.gov.

DETAILED INSTRUCTIONS FOR PROVIDERS:

• To report the NPI to the state, providers need to have their NPIs at hand, along with their Tax Identification Number or Social Security Number, and one of their current seven-digit Medicaid provider identification numbers.
• Providers have their choice of ways to report the NPI. They can enter their NPI(s) directly through our Internet Web site or upload large files.
• Instructions for using the NPI Reporting Tool for direct entry or file upload can be downloaded from: http://maa.dshs.wa.gov/ProviderOne/providers.htm.  
• Providers without access to the Internet can contact DSHS Provider Enrollment Staff at 1-800-562-3022 (select option 2, then option 5).

Providers should include both their state provider ID and their NPI on their Medicaid billings until ProviderOne is put into service.

What if providers miss this deadline?Most providers have more than one Medicaid billing number as well as tax identification codes. If providers don't report an NPI for each number, they won't be able to get payments based on these different billing categories once ProviderOne goes into service. That means they would receive lump sum payments that will be more difficult to match to their business records.

The new identifiers - a unique ten-digit number for each provider - are part of the federal Health Insurance Portability and Accountability Act (HIPAA). They are issued by the federal government.

FOR ADDITIONAL BACKGROUND, CONTACT:

Tammy Firkins, ProviderOne Communications, HRSA, DSHS, 360-725-1008

Jim Stevenson, Communications Director, HRSA, DSHS, 360-902-7604 (Pager: 360-971-4067).