In preparation for federal implementation of National Provider Identifiers (NPIs) on May 23, 2008, all certified health care providers, who have not already done so, are required to report their NPI to Wisconsin Medicaid immediately. Reporting NPI information now is essential to conducting future business when Wisconsin Medicaid implements NPI, replacing current eight-digit provider numbers.
Health care providers are reminded that Wisconsin Medicaid is only collecting NPI information at this time. Therefore, as previously published, providers are required to continue indicating their eight-digit provider number, even after reporting their NPI, until further notice.
Information on NPI and how to report NPI is detailed in this BadgerCare Plus Update.
National Provider Identifier Implementation
The federal implementation date for National Provider Identifiers (NPIs) is May 23, 2008. In preparation, Wisconsin Medicaid requires all certified health care providers who have not reported their NPI to Wisconsin Medicaid to do so immediately. The NPI information that health care providers report now will be essential to conducting business in the future when Medicaid and BadgerCare Plus implement NPI, replacing current eight-digit Medicaid identification numbers. Failure to report NPI information may result in claim denials or delays in processing future transactions.
Health care providers are reminded that Medicaid is only collecting NPI information at this time. As previously published, providers are required to continue indicating their eight-digit Medicaid identification number on all electronic and paper claims and other transactions (e.g., prior authorization requests) submitted until notification in a future BadgerCare Plus Update.
Additional details on NPI implementation will be specified in future Updates.
National Provider Identifier Implementation Exceptions
The following providers have been identified by Wisconsin Medicaid as providers of non-healthcare services and therefore are exempt from the NPI requirement:
- Personal care only providers.
- Specialized medical vehicle providers.
- Blood banks.
- Community Care Organizations.
However, if one of these providers has an additional, separate certification to provide health care services, an NPI will be required for that certification and must be reported immediately.
Reporting National Provider Identifier
Health care providers who have already reported their NPI information to Wisconsin Medicaid should not submit it again. Providers who have not yet submitted their NPI information are required to do so using one of the following methods:
- Complete the Web-based application, "Report Your NPI Online," on the Wisconsin Medicaid Web site at dhfs.wisconsin.gov/medicaid/ via the NPI link.
- E-mail the information to winpi@dhfs.state.wi.us/. Include the eight-digit Medicaid identification number, corresponding NPI, a contact name, and a telephone number.
- Photocopy and complete the National Provider Identifier Collection form, HCF 13505 (03/08), in the Attachment of this Update and mail it to the address listed on the form.
An NPI confirmation letter for each eight-digit Medicaid identification number is mailed to the address on file. Providers are encouraged to retain their confirmation letter as verification of their NPI submission and for future reference. Providers who have not received a confirmation letter may contact Provider Services at (800) 947-9627 to verify their NPI submission.
Additional Information
For additional information, refer to the July 2007 Update (2007-54), titled “Wisconsin Medicaid Is Now Collecting National Provider Identifiers.”
Attachment — National Provider Identifier Collection
