Physicians must report changes to National Provider Identifier

September 4, 2009

Physicians need to update the information related to their own NPI numbers. Failure to do so could result in not being paid for some services.

A: Although the university originally applied for the NPI on your behalf, it is your responsibility to update the National Plan and Provider Enumeration System (which assigns NPIs) file within 30 days of any changes. You should call NPPES to request access to your file and update your information. It could be several months before you can resolve all of your claims issues, and you may not be paid for some or all the services you have previously submitted. Contact provider relations for those insurers now and indicate there was a problem with your NPI file that has now been corrected and that you will be refiling those claims. Try to get a commitment that they will readjudicate those claims and pay them.

Medical Economics Consultant Virginia Martin, vice president of operations for Reed Medical Systems in Monroe, Michigan, has more than 30 years of experience as a practice management consultant, and is also a certified coding specialist, certified compliance officer, and a certified medical assistant.