Do you have your NPI?  All contracted vendors, including physicians and hospitals, will be mandated by the Center for Medicare and Medicaid (CMS) to use the NPI for transactional purposes beginning May 23, 2007.

HNE will adopt a dual use strategy beginning December 1, 2006.  On this date, Providers may begin to submit claims using their NPI numbers, but should continue to use their HNE Provider number.  HNE will not use the NPI to adjudicate their claims, but it may be helpful for Providers to begin using the new identifier.  HNE is evaluating whether Providers may discontinue use of their HNE Provider number before May 23, 2007.  The final determination will be made early next year, as our testing progresses. 

If you are using a clearinghouse to submit claims, please contact them regarding their readiness to forward your claims to HNE.

Early next year, HNE will make guidelines available on hne.com to assist Providers in determining whether system testing will be required with HNE.  Although we anticipate that most Providers will be able to begin using the NPI without any testing of their claims submissions, HNE will provide guidance to assist you in making this determination.  We plan to start provider testing April 1, 2007.

The revised HCFA1500 and new UB04 forms were designed to support paper submission using the NPI.  HNE will require the NPI on paper and electronic claims beginning May 23, 2007.  HNE will accept the current forms through May 23, 2007, but thereafter will return submitted claims to the Provider unless the new forms are used and include your NPI.

Additional information regarding your NPI and claim submission to HNE will be made available on www.hne.com as it becomes available.

If your practice has obtained an NPI number, please let us know by e-mail at PEnrollment@hne.com, by fax to (413)233-2665, or by mail to:

Provider Enrollment

Health New England

One Monarch Place

Suite 1500

Springfield, MA 01144-1500