WILSONVILLE, Oregon – The rumor mill as switched into high gear as next year's deadline for obtaining a National Provider Indentifier (NPI) approaches. Not since the early days of HIPAA has a program caused the spread of more misinformation. The following are some fallacies and facts about NPIs.

Myth: I must purchase a NPI implementation kit.

Reality: NPI enumeration is free to all eligible health care providers. However, beware there are those who will attempt to sell you an NPI implementation kit and service.

Myth: Health care providers have only a few months to comply with NPI requirements.

Reality: The national compliance deadline is May 23, 2007; however, Oregon's Office of Medical Assistance Programs is requiring health care providers to report NPI numbers by January 15, 2007.

Myth: All dentists are required to have NPIs.

Reality: Technically, only dentists who use HIPAA standard electronic health care transactions will be required to use NPIs. It is true that Medicare and Medicaid will require NPIs for paper and electronic transactions, and it is possible some health plans may require the NPI on paper claims, but indications are that many will not.

Myth: Claims will not be paid with a NPI.

Reality: While the American Dental Association (ADA) strongly encourages all dentists to sign up for NPIs, it is impossible to say how much paper-based dentists will actually need to use NPIs. Many paper claims will probably be processed and paid normally with NPIs up to the deadline and probably for some time after. For this reason, paper-based dentists may want to apply for NPIs, but they do not need to pay anyone to do this for them, nor do they need pay for training in how to use NPIs.

Myth: Prescriptions will not be honored with NPIs.

Reality: While some states may require provider identifiers on pharmacy transactions, federal law does not require use of the NPI on prescriptions, whether electronic or paper.

For more reliable information about the NPI program, visit ADA's website: www.ada.org

SOURCE: Oregon Dental Association

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