HFN, Inc.

ProviderPartner

February 2007

 

 

In this issue:

 

v       Countdown to NPI Compliance Date

 

Provider Hyperlinks

 

Claims Repricing Status

 

Electronic Claims Submission

 

Fax Claims to HFN

 

NPI Information and Submission Form

 

Payor Listing

 

Provider Nominations

 

Provider Group Health Insurance

 

Provider Fee Lookup

 

Provider Orientation Schedule

 

Provider Updates

 

Other HFN Links

 

The HFN ProviderPartner is a bi-monthly publication produced by HFN, Inc.  For questions or comments, please write us at providerpartner@hfninc.com

 

HFN, Inc.

1315 W. 22nd Street

Suite 300

Oak Brook, IL 60523

Phone (630) 954-1232

Fax (630) 954-1308

www.hfninc.com

 
HFN, Inc. ProviderPartner – February 2007

 

Countdown to NPI Compliance Date

 

National Provider Identifier (NPI) is the standard ten-digit unique health identifier for health care providers that has been adopted as a result of HIPAA to replace the various legacy numbers, UPINs, Medicaid numbers and other proprietary numbers that health care entities or health plans have assigned to health care providers.    For Medicare and Medicaid programs, NPI will hopefully be the tool that standardizes the national health care provider identification system which will also be accepted by health plans, clearinghouses, etc.

 

You may apply for an NPI on-line; it is free and will be operational about 120 days after you receive it.  You may call the NPI Enumerator Call Center at (800) 465-3203 if you have questions.  Visit National Provider Identifier Standard from CMS and the US Department of Health & Human Services for more information on NPI with downloads and other related links.

 

Facts you should know…

 

v      By May 23, 2007, all health plans must accept and use NPIs to identify providers in transactions involving claims, eligibility, referrals, and remittance advices.

 

v      HFN is prepared to record your NPI in our system to assist our clients with the HIPAA mandate.  Providers must still include their tax identification number on claims for 1099 purposes.

 

v      Approximately, seventy-five percent of the claims received by HFN are submitted electronically through clearinghouses.  After May 23, 2007, HFN will still reprice clean claims that do not include an NPI number; however, your clearinghouse or the payor may reject a claim without your NPI number, until submitted with your NPI number.

 

v      Contractually, HFN Participating Providers are required to maintain current demographics and any other pertinent information (including but not limited to your NPI number) required by us to operationalize, manage, and adjudicate any services rendered.

 

v      NPI and any other identifying information shared with us will be held in the strictest of confidence and is allowed to be shared as it pertains to billing, adjudication and payment activity for claims.

 

To register your NPI online with HFN, please start by clicking the applicable entity type.  Completing all fields on the form will assist us in identifying you in our system.

 

¡      Entity Type 1 – individual health care providers, including physicians and all sole proprietors

 

¡     Entity Type 2 – health care organizations, including hospitals, physician/practitioner groups or subparts of an organization

 The HFN 2007 Provider Fee Schedules became effective February 1, 2007.  Click here to view your fee schedule on-line.