CMS initiates NPI-IRS data match for reimbursements

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CMS creates data-match to help providers receive reimbursements. Source: Maryland Dept of Health  

The Centers for Medicare & Medicaid Services (CMS) has initiated a data match to ensure that national provider identifier (NPI) numbers, the legal business name (LBN) and employer identification number (EIN), are consistent with IRS data to receive reimbursements.

Use of NPIs began May 23 after a one-year contingency, according to CMS. Experts have reported that doctors have had trouble receiving payments because of a variety of complications with CMS and clearing house systems.

CMS plans to send letters to physicians who are incorporated if their corporation's legal business name is not accurately reflected in the NPPES.
According to billing experts, new requirements will make an already difficult transition to using NPIs even worse. Under the new federal requirement, every part of the data must match, including the exact spelling of names, the use of initials and blank spaces.

While physicians have been told they will be given 15 days to respond, the American Medical Association (AMA) said it has received assurances from CMS that they will not deactivate any numbers immediately following this timeframe.

Physician offices can generally obtain the EIN/LBN from IRS paperwork, such as a CP-575, a quarterly tax payment coupon or other IRS correspondence that contain this data. Also, there may be instances where the physician does not readily maintain required IRS documentation. In this case, the physician applicant can request a verification letter (IRS 147C) from the IRS that identifies its EIN and LBN.