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Doctors to get national billing ID numbers

Universal identifiers could cut paperwork, but some experts worry about the government's ability to manage the database.

By Joel B. Finkelstein, amednews staff. Feb. 23, 2004.

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Washington -- The move to a one-number-fits-all billing system has begun, but it will be a long time before doctors get to use that national standard in actual transactions.

A new government rule lays out the map toward replacing each physician's myriad billing numbers with one universal identifier that he or she would use to bill all insurers, both public and private. Overall, the final regulation is a positive step toward reducing physicians' paperwork burdens so they can concentrate more on patient care, said AMA Trustee Joseph M. Heyman, MD.

For some, though, enthusiasm for National Provider Identifiers, or NPIs, is tempered by the long road to implementation.

Under the new rule, the Centers for Medicare & Medicaid Services will not begin distributing the 10-digit numbers until May 23, 2005, and use of the NPIs will not officially be required until May 23, 2007.

"A lot of us were shocked to see that ... in the first 16 months, [CMS is] not going to give out any NPIs," said Robert Tennant, the Medical Group Management Assn.'s health informatics expert. "That's the big disappointment." Many physicians' offices currently have several dozen, if not more, billing numbers for all the different insurance plans they accept, he added.

The 16-month window between the rule's release and when the government will start doling out numbers is designed to give CMS the time it needs to create a new database to handle every physician, hospital, health plan and other entity covered under the Health Insurance Portability and Accountability Act. That task will be especially difficult because the database will contain more than just the basic billing data currently used for Medicare transactions.