SYSTEMS I N D I A N A H E A L T H C O V E R A G E P R O G R A M S NPI Reporting Tool User Guide L I B R A R Y R E F E R E N C E N U M B E R : S Y A P 1 0 0 1 2 R E V I S I O N D A T E : A U G U S T 2 0 0 6 V E R S I O N 1. 0
Library Reference Number: SYAP10012 Document Management System Reference: NPI Reporting Tool User Guide (18278) Address any comments concerning the contents of this manual to: EDS Publications Unit 950 North Meridian Street, Suite 1150 Indianapolis, IN 46204 Fax: (317) 488-5169 EDS and the EDS logo are registered marks of Electronic Data Systems Corporation. EDS is an equal opportunity employer, m/f/v/d. Copyright 2005 Electronic Data Systems Corporation. All rights reserved Library Reference Number: SYAP10012 I-1
NPI Reporting Tool User Guide Document Version Number Revision Date Revision Page Number(s) Reason for Revisions Revision History Revisions Completed By Version 1.0 August 2006 All New manual Web Team/ Publications Unit Library Reference Number: SYAP10012 i
NPI Reporting Tool User Guide Table of Contents Section 1: Introduction... 1-1 Overview... 1-1 Section 2: Logging On To the Tool... 2-1 Overview... 2-1 Accessing the NPI Reporting Tool... 2-1 Links to the NPI Reporting Logon Window... 2-4 The NPI Reporting Logon Window... 2-5 Login Button... 2-6 Re-logon to the NPI Site Window... 2-6 Re-Logon Button... 2-7 Logon As Different User Button... 2-8 Section 3: NPI Reporting... 3-1 Overview... 3-1 NPI Reporting Navigation and Functionality... 3-1 Field Descriptions... 3-1 View Reporting History Button... 3-2 Logoff Button... 3-2 Query Information Section... 3-2 Contact Information Section... 3-2 Provider/NPI Information Section... 3-3 Section 4: NPI Reporting Rendering Providers... 4-1 Overview... 4-1 NPI Reporting Rendering Providers Navigation and Functionality... 4-1 Field Descriptions... 4-1 Return to Group Provider Button... 4-1 Provider/NPI Information Section... 4-3 Section 5: NPI Reporting History... 5-1 Overview... 5-1 NPI Reporting History Navigation and Functionality... 5-1 Field Descriptions... 5-1 Close Button... 5-2 Expand Latest Reportings Button... 5-3 View Rendering Provider History Button... 5-3 Section 6: NPI Reporting History Rendering Providers... 6-1 Overview... 6-1 NPI Reporting History Rendering Providers Navigation and Functionality... 6-1 Field Descriptions... 6-1 Return to Group History Button... 6-2 Expand Latest Reportings Button... 6-2 Index...I-1 Library Reference Number: SYAP10012 iii
NPI Reporting Tool User Guide Section 1: Introduction Overview The purpose of this document is to assist providers with accessing and using the NPI Reporting Tool available on the Indiana Health Coverage Programs (IHCP) Web site at http://www.indianamedicaid.com. More information about the National Provider Identifier (NPI) is contained in the NPI Fact Sheet available on the National Provider Identifier (NPI) page of the IHCP Web site at http://www.indianamedicaid.com/ihcp/providerservices/pdf/tr370_npi_facts.pdf. Library Reference Number: SYAP10012 1-1
Section 2: Logging On To the Tool Overview After receiving a National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES), the provider must report it to Indiana Health Coverage Programs (IHCP). The IHCP then matches each reported NPI to the provider s current IHCP number and service location. Providers who received an NPI notification letter containing a password to access the NPI Reporting Tool may begin reporting their NPI to the IHCP. This section details the accessing and logging on to the NPI Reporting tool. Accessing the NPI Reporting Tool The NPI Reporting Tool can be accessed from the IHCP Web site at http://www.indianamedicaid.com. Links are available from the following pages and menus: 1. On the IHCP Web site home page, click on the Report your NPI to the IHCP link located in the NPI section (Figure 2.1). 2. From anywhere in the IHCP Web site, click on Provider Services in the menu bar, move to National Provider Identifier (NPI). A secondary menu displays. Select Report Your NPI from the menu (Figure 2.1). 3. On the National Provider Identifier (NPI) page of the IHCP Web site, located at http://www.indianamedicaid.com/ihcp/providerservices/npi.asp, click on the Report Your NPI link in the NPI News section of the page (Figure 2.2). The NPI Reporting Logon window displays (Figures 2.1 and 2.2). When accessing the NPI Reporting Tool have the following information available: The reporting provider s tax identification (ID) number or Social Security number (SSN). Password to access the reporting tool Taxonomy codes associated with each provider number being reported Contact name, telephone number, and e-mail address of the provider The NPI of all rendering providers affiliated with the group accessing the tool, if applicable If additional help is needed, contact the EDS Provider Enrollment and Waiver line at 1-877-707-5750. Library Reference Number: SYAP10012 2-1
Section 2: Logging On To the Tool NPI Reporting Tool User Guide Figure 2.1 Report Your NPI Link from the IHCP Web Site Home Page 2-2 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 2: Logging On To the Tool Figure 2.2 Report Your NPI Link from the National Provider Identifier (NPI) Page Library Reference Number: SYAP10012 2-3
Section 2: Logging On To the Tool NPI Reporting Tool User Guide Links to the NPI Reporting Logon Window On the National Provider Identifier (NPI) page of the IHCP Web site, in the How do I get and report an NPI? section, there is an option labeled, Step 2: Reporting your NPI to IHCP (Figure 2.2). Selecting this link displays the How do I report my NPI to IHCP? Page (Figure 2.3). Figure 2.3 How do I report my NPI to IHCP? Page 2-4 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 2: Logging On To the Tool On this page, selecting the NPI Reporting Tool link in the second paragraph at the top of the page or the Begin NPI Reporting Process link at the bottom of the page displays the NPI Reporting Logon window. (Figure 2.3) The NPI Reporting Logon Window Figure 2.4 NPI Reporting Logon Window Table 2.1 lists the entry fields on the NPI Reporting Logon window along with a description and valid entry information. Table 2.1 NPI Reporting Logon Window Field Descriptions Field Required? Valid Entry Description User ID Required Seven to 10 characters, alphanumeric Password Required Eight to 10 characters, alphanumeric and special characters External Users: Tax ID number or SSN Internal EDS Users: Assigned and maintained by help desk External Users: Assigned in letter generation Internal EDS Users: Assigned and maintained by help desk Library Reference Number: SYAP10012 2-5
Section 2: Logging On To the Tool NPI Reporting Tool User Guide Login Button By clicking this button the following occurs: Verification that both the User ID and Password are entered. Logon information is sent to the server for validation. If the User ID and Password are correct, the user is redirected to the NPI Reporting page. If the User ID and Password combination are not correct, an error message displays: Invalid ID/password. Please try again. After three unsuccessful attempts, the User s ID and Password are disabled. The error message displays: ID has been disabled. Password must be reactivated to gain access. The User ID and Password fields clear. The following contact information is available on the NPI Reporting Logon window: Forget your password? Call the Electronic Solutions Help Desk at (317) 488-5160 to have your password sent to you again. Disabled ID? Call the Electronic Solutions Help Desk at (317) 488-5160 to have your password reactivated. Note: The User ID and Password do not expire. The user is auto-logged off after 20 minutes of inactivity. If this occurs, all unsaved updates are lost. The User ID and Password needed to access the NPI Reporting Tool are not the same as used for accessing Web interchange. Re-logon to the NPI Site Window After 20 minutes of inactivity with the Web server, the user is auto-logged off. The program displays the Re-Logon to the NPI Site window to allow the user to refresh the session (Figure 2.5). Table 2.2 lists the entry fields on the re-logon function of the NPI Reporting Logon window along with a description and valid entry information. Table 2.2 Re-logon to the NPI Site Window Field Descriptions Field Required? Valid Entry Description User ID Required Seven to 10 characters, alphanumeric Password Required Eight to 10 characters, alphanumeric and special characters External Users: Tax ID number or SSN Internal EDS Users: Assigned and maintained by help desk External Users: Assigned in letter generation Internal EDS Users: Assigned and maintained by help desk 2-6 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 2: Logging On To the Tool Figure 2.5 Re-Logon to the NPI Site Window Re-Logon Button By clicking this button the following occurs: Verification that both the User ID and Password are entered. Logon information is sent to the server for validation. If the User ID and Password are correct, the Re-logon to the NPI Site window closes and returns the user to the previous screen to continue the session. If the User ID and Password combination are not correct, an error message displays: Invalid ID/password. Please try again. After three unsuccessful attempts, the User ID and password are disabled. The error message displays: ID has been disabled. Password must be reactivated to gain access. The User ID and Password fields clear. If the new logon User ID is verified as the current user, the Re-logon to the NPI Site window closes and returns the user to the previous screen to continue the session. If the new logon User ID is different from the current user, the user is redirected to the NPI Reporting page (Figure 2.1). All screens opened by the initial user are automatically closed. The following contact information is available on the NPI Reporting Logon window: Forget your password? Call the Electronic Solutions Help Desk at (317) 488-5160 to have your password sent to you again. Disabled ID? Call the Electronic Solutions Help Desk at (317) 488-5160 to have your password reactivated. Library Reference Number: SYAP10012 2-7
Section 2: Logging On To the Tool NPI Reporting Tool User Guide Logon As Different User Button By clicking this button the Re-Logon window of the NPI Reporting Logon function closes and the new user is redirected to the NPI Reporting Logon window (Figure 2.4). All screens opened by the initial user are automatically closed. 2-8 Library Reference Number: SYAP10012
Section 3: NPI Reporting Overview The NPI Reporting page (Figures 3.1 and 3.2) is accessed by successfully logging into the NPI Reporting Tool. NPI Reporting Page Navigation and Functionality This page uses the expand! and collapse " icons to expand the information being displayed or collapse the display into a list of offerings. Field Descriptions Table 3.1 lists the fields, descriptions, and valid entries for the NPI Reporting page. Tax ID/SSN (Contact) Name (Contact) Phone Number (Contact) E-mail Address Provider Table 3.1 NPI Reporting Page Field Descriptions Field Description or Help Text Valid Entries Service Location Enter NPI Identification number on file with the State for tax purposes Name of user reporting National Provider Identifier (NPI) information Telephone number of user reporting NPI information E-mail address of user reporting NPI information Number assigned to the provider by the Indiana Health Coverage Programs (IHCP) Location where patient services are rendered National Provider Identifier (NPI) obtained from the National Plan and Provider Enumeration System (NPPES) For internal EDS employees a nine-digit numeric with no alpha or special characters is required. For external users: a nine-digit numeric is auto-populated as a read-only field from the user s logon ID. This is the user s tax identification (ID) number or Social Security number (SSN). Required 50-character alphanumeric with special characters allowed Required 10-digit numeric with no special characters allowed Optional 50-character alphanumeric with special characters allowed This field auto populates and is a read-only field. This field auto populates with the location name and address that corresponds with the service location indicator. It is a read-only field. A 10-digit number Library Reference Number: SYAP10012 3-1
Section 3: NPI Reporting NPI Reporting Tool User Guide View Reporting History Button The View Reporting History button displays at the top and the bottom of the page. It opens the NPI Reporting History window as a new window. This window lists the NPI reporting history for providers under the current Tax ID. This button only displays when the user has a history of NPIs reported. For more information see the NPI Reporting History section of this manual. Logoff Button The Logoff button displays in the upper right corner of the page next to the View Reporting History button. The Logoff button allows the user to end a session and opens a confirmation window asking the user to confirm the logoff. (Figure 3.1) The confirmation window informs the user that all unsaved changes will be lost. If user clicks the OK button, the NPI Logon page (Figure 2.4) displays. If user clicks the Cancel button, the window closes and the current session continues. Figure 3.1 Logoff Confirmation Window Query Information Section Entry of information in this section allows the user to perform a search for a provider currently in the system by Tax ID number or SSN. Entry of a valid Tax ID or SSN retrieves all associated provider/service location/npi information currently on file. Inquire Button For internal EDS employees, clicking the Inquire button causes the system to verify that the Tax ID/SSN entry is correct. If the entry is not correct, a message displays in red at the top of the page directing the user to locate other error messages displayed in red elsewhere on the page. These other messages refer to errors in specific sections of the page. If the entry is correct, a message displays stating that the Tax ID or SSN is incorrect. For external users, this button does not display because those users must supply their Tax ID or SSN as their logon ID to access the tool. Contact Information Section This section contains fields for information about the user entering or querying on the NPI information. 3-2 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 3: NPI Reporting Clear Contact Info Button Clicking the Clear Contact Info button resets the contact information to blank in all three contact fields. Name This field is for the name of the user reporting the NPI information. The field is a required field and can contain a 50-character alphanumeric with special characters allowed. Phone Number This field is for the telephone number of user reporting the NPI information. It is a required field that contains a 10-digit numeric with no special characters allowed. E-mail Address This field is for the e-mail address of user reporting NPI information. This field is optional and can contain a 50-character alphanumeric entry with special characters allowed. Provider/NPI Information Section In this section the user can perform several activities regarding each service location currently on file for the provider. Expand All Provider/Service Locations Button This button, used in conjunction with the search results achieved by using the Inquire button in the Query Information section, expands the page to show all service locations currently on file for this provider number. Provider Subsections In each provider subsection, the provider number (nine-digit number) and service location code (alpha character) displays in the green, red, or blue header (Figures 3.2 and 3.3) and the status of the provider/service location/npi record. Table 3.2 explains the colors and status. Table 3.2 Provider Subsection Header Information Color Explanation Status Error Messages Green Indicates an active NPI reporting. Displays Active in the colored header. The provider number, service location, and NPI combination on file is unique. No conflict. Active No error message or instructions display Red Indicates a pending NPI reporting. Displays Pending in the colored header. The provider number, service location, and NPI combination is in conflict with another record currently on file. Pending Error (conflict) message displays with instructions (Continued) Library Reference Number: SYAP10012 3-3
Section 3: NPI Reporting NPI Reporting Tool User Guide Blue Table 3.2 Provider Subsection Header Information Color Explanation Status Error Messages Indicates a provider that has not been reported. Displays Not Reported in the colored header. No provider number/service location/npi record is on file for this provider. Not Reported No error message or instructions display Only providers that are currently active display for providers and read-only access users. Provider Enrollment is able to see and report on both active and inactive providers. All providers must have at least one active program and group providers must have at least one service location with at least one rendering provider. Billing providers, group providers, and dual providers are displayed and sorted by provider number/service location alpha character. Selected Taxonomy codes display for Active and Pending provider records. Error Messages and Instructions If no provider is found, the error message, No Active Service Locations, displays. If a conflict exists (Pending), the error message, Conflicts Exist. See below, displays (Figure 3.2). For each billing provider, group provider, or dual provider, the information that displays is read-only information. The user is given instructions to complete and mail a Provider Update Form to EDS at the address indicated on the form. This form is available on the IHCP Web site at http://www.indianamedicaid.com/ihcp/providerservices/pdf/providerupdate.pdf. Conflict Error For NPIs that are reported, but conflict with an identical NPI reported for other provider(s), an error message displays describing the problem. The error message may contain references to one or more providers that are in conflict with this provider s reporting. Error messages only display for Pending records. Each reference to a conflicting provider includes the following information: Provider Number and Service Location Rendering Provider Number, if applicable List of Taxonomy codes that are in conflict The error message states that if the information reported is correct, and cannot be changed, the user must contact EDS Provider Enrollment (1-877-707-5750) for more options. By doing this, the conflict can be researched and resolved. The following are the error messages that display for conflicts: 1. At this same address has already reported this NPI with Taxonomy code(s) 2. This NPI has been reported by another provider 3-4 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 3: NPI Reporting Step 1) Enter NPI Type in the NPI number to be associated with this provider number/service location combination. Entries in this field are only allowed for provider records with a status of Not Reported (blue). Users are not required to report every NPI for every provider the first time they access this page. Additional NPIs may be reported at a later time. For provider records with a status of Pending or Active, any change to the NPI must be done by contacting EDS Provider Enrollment at 1-877-707-5750. Library Reference Number: SYAP10012 3-5
Section 3: NPI Reporting NPI Reporting Tool User Guide Figure 3.2 NPI Reporting Page, Upper Portion 3-6 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 3: NPI Reporting Figure 3.3 NPI Reporting Page, Lower Portion Step 2) Select Taxonomy Codes Button Clicking this button opens the NPI Reporting Taxonomy Code Selection window (Figure 3.4). This window allows the user to select Taxonomy codes for the NPI that is being reported. Taxonomy codes are selected by expanding the Taxonomy type by clicking on the expand! icon. The Taxonomy code specialty list displays and allows for selection of the appropriate Taxonomy codes by clicking on the corresponding checkboxes. One click to mark the box, a second click to remove the mark. Once Taxonomy codes are chosen, click the Save and Close button to retain the choices or changes. To reject the choices or changes made on this window, click the Cancel button. Upon returning to the Provider/NPI Information section, the Taxonomy codes are listed in the Taxonomy Codes area. When the provider is a Waiver provider (Provider type = 32), a message displays: Waiver Provider No Taxonomy Codes needed (Figure 3.3). Library Reference Number: SYAP10012 3-7
Section 3: NPI Reporting NPI Reporting Tool User Guide Figure 3.4 NPI Reporting Taxonomy Code Selection Window 3-8 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 3: NPI Reporting Step 3) Submit Changes for this Provider Button Clicking this button opens a confirmation box that asks the user: Do you really want to continue with the submission of the reported NPI information? (Figure 3.5). Selecting the Cancel button returns the user to the NPI Reporting page and does not submit the changes. Selecting the OK button submits the reported NPI information to the NPI crosswalk. Figure 3.5 Submit Changes for this Provider, Response The NPI information is sent to the server to be evaluated for possible conflicts with other providers who might have submitted the same NPI. For each taxonomy code that is reported, the system returns an indicator as to whether or not there is a conflict. If there is a conflict, the system returns a list of the providers involved in the conflict. Only providers under the same Tax ID display. Add an NPI to the NPI Crosswalk Database If the NPI does not have a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Active. The effective date is the current date and the end date is open. If the NPI has a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Pending. The effective date is the current date and the end date is open. The user is returned to the NPI Reporting page and the page is populated with all of the NPI information that is being stored in the database. A confirmation message displays to inform the user about the status of the reported NPI(s). The confirmation message varies, based on the status of the reported NPI. NPIs that are submitted and everything under the Tax ID is Active returns a message that states, The NPI information reported is now available for use. NPIs that are submitted, but one or more recent reportings are in a Pending status returns a message that reads, The NPI information reported contains a conflict and needs to be resolved before the NPI can be used. Please review messages in red fonts for more information on a conflict restriction. The generic message that informs the user who to contact with questions about the NPI information reported is displayed: For all questions concerning reported NPI information, please contact EDS Provider Enrollment (1-877-707-5750). Library Reference Number: SYAP10012 3-9
Section 3: NPI Reporting NPI Reporting Tool User Guide Step 4) Report Rendering Providers Button Clicking this button opens the NPI Reporting Rendering Providers page (Figure 3.6) that allows the user to report NPI information for all rendering providers. This button only displays when rendering providers exist for the group provider. For more detailed information, see the NPI Reporting Rendering Providers section in this manual. 3-10 Library Reference Number: SYAP10012
Section 4: NPI Reporting Rendering Providers Overview To access the NPI Reporting Rendering Providers page (Figures 4.1 and 4.2), click on the Step 4) Rendering Providers button in the appropriate provider record displayed on the NPI Reporting page. This button only displays when rendering providers exist for the group provider. If a conflict exists with a rendering provider, a message displays: Conflict with Renderings. NPI Reporting Rendering Providers Navigation and Functionality This page uses the expand! and collapse " icons to expand the information being displayed or collapse the display into a list of offerings. Field Descriptions On the NPI Reporting Rendering Providers page the following fields display (Table 4.1): Table 4.1 NPI Reporting Rendering Provider Page Field Descriptions Field Group Provider Contact Information (Rendering) Provider (Number) Provider Name Enter NPI Taxonomy Codes Description The group provider number, service location, and the group provider s name and address. The name, telephone number, and e-mail address of the current user logged in to the tool. Displays in the header. No service location code displays because the service location code is part of the group provider number. Auto populates with the provider name associated with this rendering provider number. Auto populates with the NPI submitted for this rendering provider. All of the Taxonomy codes currently associated with this rendering provider. Return to Group Provider Button The Return to Group Provider button displays at the top and bottom of the page. It returns the user to the NPI Reporting page for the group provider for this rendering provider. Any changes made to the page are retained for the duration of the session, however, they are not saved unless the Save Changes for this Provider button is used. For more information on the NPI Reporting page, see the NPI Reporting Page section of this manual. Library Reference Number: SYAP10012 4-1
Section 4: NPI Reporting Rendering Providers NPI Reporting Tool User Guide Figure 4.1 NPI Reporting Rendering Provider Page, Upper Portion 4-2 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 4: NPI Reporting Rendering Providers Figure 4.2 NPI Reporting Rendering Provider Page, Lower Portion Provider/NPI Information Section In this section the user can perform several activities regarding each service location currently on file for the rendering provider. Expand All Rendering Providers Button This button expands the page to show all rendering providers currently on file for this group provider number. Rendering Provider Subsections In each rendering provider subsection, the rendering provider number (nine-digit number) and service location code (alpha character) displays in the green, red, or blue header (Figures 4.1 and 4.2) and the status of the rendering provider/npi record..table 4.2 explains the colors and status. Library Reference Number: SYAP10012 4-3
Section 4: NPI Reporting Rendering Providers NPI Reporting Tool User Guide Table 4.2 Rendering Provider Subsection Header Information Color Explanation Status Error Messages Green Indicates an active NPI reporting. Displays Active in the colored header. The provider number, service location, and NPI on file is unique. No conflict. Active No error message or instructions display Red Blue Indicates a pending NPI reporting. Displays Pending in the colored header. The provider number, service location, and NPI is in conflict with another record currently on file. Indicates a provider that has not been reported. Displays Not Reported in the colored header. No provider number/service location/npi record is on file for this provider. Pending Not Reported Error (conflict) message displays with instructions No error message or instructions display Only rendering providers that are currently active display. All group providers must have at least one service location with at least one rendering provider. Billing providers, group providers, and dual providers are displayed and sorted by provider number. Selected Taxonomy codes display for Active and Pending provider records. Error Messages and Instructions If a conflict exists (Pending), the error message, Conflicts Exist. See below, displays (Figure 3.2). For each billing provider, group provider, or dual provider, the information that displays is read-only information. The user is given instructions to complete and mail a Provider Update Form to EDS at the address indicated on the form. This form is available on the IHCP Web site at http://www.indianamedicaid.com/ihcp/providerservices/pdf/providerupdate.pdf. Conflict Error For NPIs that are reported, but conflict with an identical NPI reported for other rendering provider(s), an error message displays describing the problem. The error message may contain references to one or more rendering providers that are in conflict with this provider s reporting. Error messages only display for Pending records. Each reference to a conflicting provider includes the following information: Provider Number and Service Location Rendering Provider Number, if applicable List of Taxonomy codes that are in conflict The error message states that if the information reported is correct, and cannot be changed, the user must contact EDS Provider Enrollment (1-877-707-5750) for more options. By doing this, the conflict can be researched and resolved. The following are the error messages that display for conflicts: 4-4 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 4: NPI Reporting Rendering Providers 3. At this same address has already reported this NPI with Taxonomy code(s) 4. This NPI has been reported by another provider Step 1) Enter NPI Type in the NPI number to be associated with this rendering provider number/group provider number/service location combination. Entries in this field are only allowed for rendering provider records with a status of Not Reported (blue). Users are not required to report every NPI for every provider the first time they access this page. Additional NPIs may be reported at a later time. For rendering provider records with a status of Pending or Active, any change to the NPI must be done by contacting EDS Provider Enrollment at 1-877-707-5750. Step 2) Select Taxonomy Codes Button Clicking this button opens the NPI Reporting Taxonomy Code Selection window (Figure 4.3). This window allows the user to select Taxonomy codes for the NPI that is being reported. Taxonomy codes are selected by expanding the Taxonomy type by clicking on the! (Expanded view) icon. The Taxonomy code specialty list displays and allows for selection of the appropriate Taxonomy codes by clicking on the corresponding checkboxes. One click to mark the box, a second click to remove the mark. Once Taxonomy codes are chosen, click the Save and Close button to retain the choices or changes. To reject the choices or changes made on this window, click the Cancel button. Upon returning to the Provider/NPI Information section, the Taxonomy codes are listed in the Taxonomy Codes area. When the provider is a Waiver provider (Type = 32), a message displays: Waiver Provider No Taxonomy Codes needed (Figure 4.2). Library Reference Number: SYAP10012 4-5
Section 4: NPI Reporting Rendering Providers NPI Reporting Tool User Guide Figure 4.3 NPI Reporting Rendering Provider Taxonomy Code Selection Window 4-6 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 4: NPI Reporting Rendering Providers Step 3) Submit Changes for this Provider Button Clicking this button opens a confirmation box that asks the user: Do you really want to continue with the submission of the reported NPI information? (Figure 4.4). Selecting the Cancel button returns the user to the NPI Reporting Rendering Provider page and does not submit the changes. Selecting the OK button submits the reported NPI information to the NPI crosswalk to verify the uniqueness of the information being submitted. Figure 4.4 Submit Changes for this Provider, Response The NPI information is sent to the server to be evaluated for possible conflicts with other rendering providers who might have submitted the same NPI. For each Taxonomy code that is reported, the system returns an indicator as to whether or not there is a conflict. If there is a conflict, the system returns a list of the rendering providers involved in the conflict. Only providers under the same Tax ID display. Add an NPI to the NPI Crosswalk Database If the NPI does not have a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Active. The effective date is the current date and the end date is open. If the NPI has a conflict in the NPI crosswalk process, the NPI is added to the database and is assigned the status of Pending. The effective date is the current date and the end date is open. The user is returned to the NPI Reporting page and the page is populated with all of the NPI information that is being stored in the database. A confirmation message displays to inform the user about the status of the reported NPI(s). The confirmation message varies, based on the status of the reported NPI. NPIs that are submitted and everything under the Tax ID is Active returns a message that states, The NPI information reported is now available for use. NPIs that are submitted, but one or more recent reportings are in a Pending status returns a message that reads, The NPI information reported contains a conflict and needs to be resolved before the NPI can be used. Please review messages in red fonts for more information on a conflict restriction. The generic message that informs the user who to contact with questions about the NPI information reported is displayed: For all questions concerning reported NPI information, please contact EDS Provider Enrollment (1-877-707-5750). Library Reference Number: SYAP10012 4-7
Section 5: NPI Reporting History Overview The NPI Reporting History reports on provider history through the NPI Reporting History page. The NPI Reporting History page (Figure 5.1) is accessed from the NPI Reporting page by clicking on the View Reporting History button. NPI Reporting History Navigation and Functionality This page uses of the expand! and collapse " icons to expand the information being displayed or collapse the display into a list of offerings. Field Descriptions Table 5.1 lists the fields, descriptions, and valid entries for the NPI Reporting page. All entries are auto populated and read-only. History for Tax ID/SSN NPI Updated Provider (Contact) Name (Contact) Phone Number (Contact) E-mail Address Table 5.1 NPI Reporting History, Expanded Page, Field Descriptions Field Description or Help Text Valid Entries Service Location Identification number on file with the State for tax purposes National Provider Identifier (NPI) obtained from the National Plan and Provider Enumeration System (NPPES) History list of dates and times the record has been updated. Number assigned to the provider by the Indiana Health Coverage Programs (IHCP) Name of user reporting NPI information Telephone number of user reporting NPI information E-mail address of user reporting NPI information Location where patient services are rendered This field is auto populated with the user s nine-digit numeric login ID which is also the user s tax identification (ID) number or Social Security number (SSN). A 10-digit number. Displays as HH:MM:SS AM/PM on MM/DD/YYYY. Required 50-character alphanumeric with special characters allowed. Required 10-digit numeric with no special characters allowed. Optional 50-character alphanumeric with special characters allowed. Location name and address that corresponds with the service location indicator. (Continued) Library Reference Number: SYAP10012 5-1
Section 5: NPI Reporting History NPI Reporting Tool User Guide Status Table 5.1 NPI Reporting History, Expanded Page, Field Descriptions Field Description or Help Text Valid Entries Status of active or pending for each NPI The Status of this provider record with text the color of the header for this provider record on the NPI Reporting page. NPI NPI obtained from the NPPES Matches the NPI displayed in the header. Classification Effective Date End Date Taxonomy Codes The IHCP has four provider classifications: billing, group, rendering and dual Date the NPI number is effective Date the NPI number is no longer effective Code describing the provider s type and specialty Billing, Group, Rendering, and Dual are valid entries for this field. Displays as MM/DD/YYYY. Displays as MM/DD/YYYY or Open. Displays as Open unless the NPI is enddated. Displays selected Taxonomy codes or No Taxonomy codes Available when no Taxonomy codes exist. Close Button The Close button closes the NPI Reporting History page and returns the user to the NPI Reporting page. Figure 5.1 NPI Reporting History, Collapsed View 5-2 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 5: NPI Reporting History Expand Latest Reportings Button Clicking this button expands the latest entry (most recent timestamp) for each billing or group provider. This is based on the time that the provider s NPI information is written to the NPI history database. View Rendering Provider History Button The View Rendering Provider History button redirects the user to the NPI Reporting History Rendering Provider page. The NPI Reporting History Rendering Provider section of this manual contains detailed information about this feature. Figure 5.2 NPI Reporting History, Expanded View Library Reference Number: SYAP10012 5-3
Section 6: NPI Reporting History Rendering Providers Overview The NPI Reporting History reports on rendering provider history through the NPI Reporting History Rendering Providers page. The NPI Reporting History Rendering Providers page (Figure 6.1) is accessed from the NPI Reporting History page by clicking on the View Rendering Provider History button. NPI Reporting History Rendering Providers Navigation and Functionality This page uses the expand! and collapse " icons to expand the information being displayed or collapse the display into a list of offerings. Field Descriptions Table 6.1 lists the fields, descriptions, and valid entries for the NPI Reporting History Rendering Providers page. All of the fields are auto populated and read-only. Table 6.1 NPI Reporting History Rendering Providers, Expanded Page, Field Descriptions History for Tax ID/SSN NPI Updated Provider (Contact) Name (Contact) Phone Number (Contact) E-mail Address Field Description or Help Text Valid Entries Identification number on file with the State for tax purposes National Provider Identifier (NPI) obtained from the National Plan and Provider Enumeration System (NPPES) History list of dates and times the record has been updated. Number assigned to the provider by the Indiana Health Coverage Programs (IHCP) Name of user reporting NPI information Telephone number of user reporting NPI information E-mail address of user reporting NPI information This field is auto populated with the user s nine-digit numeric login ID which is also the user s tax identification (ID) number or Social Security number (SSN). A 10-digit number. Displays as HH:MM:SS AM/PM on MM/DD/YYYY. Required 50-character alphanumeric with special characters allowed. Required 10-digit numeric with no special characters allowed. Optional 50-character alphanumeric with special characters allowed. (Continued) Library Reference Number: SYAP10012 6-1
Section 6: NPI Reporting History Rendering Providers NPI Reporting Tool User Guide Table 6.1 NPI Reporting History Rendering Providers, Expanded Page, Field Descriptions Field Description or Help Text Valid Entries Service Location Status Location where patient services are rendered Status of active or pending for each NPI Location name and address that corresponds with the service location indicator. The Status of this provider record with text the color of the header for this provider record on the NPI Reporting page. NPI NPI obtained from the NPPES Matches the NPI displayed in the header. Classification The IHCP has four provider classifications: billing, group, Billing, Group, Rendering, and Dual are valid entries for this field. rendering and dual Effective Date Date the NPI number is effective Displays as MM/DD/YYYY. End Date Taxonomy Codes Date the NPI number is no longer effective Code describing the provider s type and specialty Displays as MM/DD/YYYY or Open. Displays as Open unless the NPI is enddated. Displays selected Taxonomy codes or No Taxonomy codes Available when no Taxonomy codes exist. Return to Group History Button This button returns the user to the NPI Reporting History page for the current Tax ID. Expand Latest Reportings Button Clicking this button expands the latest entry (most recent timestamp) for each billing or group provider. This is based on the time that the provider s NPI information is written to the NPI history database. 6-2 Library Reference Number: SYAP10012
NPI Reporting Tool User Guide Section 6: NPI Reporting History Rendering Providers Figure 6.1 NPI Reporting History Rendering Providers, Collapsed View Figure 6.2 NPI Reporting History Rendering Providers, Expanded View Library Reference Number: SYAP10012 6-3
Index A Accessing the tool... 2-1 Add an NPI... 3-9, 4-7 Add an NPI to the Crosswalk Database... 3-9, 4-7 B Begin NPI Reporting Process... 2-4 Button Clear Contact Info... 3-3 Close... 5-2 Expand All Provider/Service Locations... 3-3 Expand All Rendering Providers... 4-3 Expand Latest Reportings... 5-3, 6-2 Inquire... 3-2 Logoff... 3-2 Logon... 2-6 Logon as Different User... 2-8 Query Information... 3-2 Re-Logon... 2-7 Return to Group History... 6-2 Return to Group Provider... 4-1 Sign In... 2-6 Step 2) Select Taxonomy Codes... 3-7, 4-5 Step 3) Submit Changes for this Provider 3-9, 4-7 Step 4) Report Rendering Providers... 3-10 View Rendering Provider History... 5-3 View Reporting History... 3-2 C Clear Contact Info... 3-3 Clear Contact Info button... 3-3 Close... 5-2 Close button... 5-2 Conflict... 3-4, 4-4 Conflict Error... 3-4, 4-4 Contact e-mail address... 3-3 Contact Information... 3-2 Contact name... 3-3 Contact phone number... 3-3 Crosswalk Database... 3-9, 4-7 E E-mail Address... 3-3 Enter NPI... 3-5, 4-5 Error... 3-4, 4-4 Error Messages... 3-4, 4-4 Error Messages and Instructions... 3-4, 4-4 Expand All Provider/Service Locations... 3-3 Expand All Provider/Service Locations button... 3-3 Expand All Rendering Providers... 4-3 Expand All Rendering Providers button... 4-3 Expand Latest Reportings... 5-3, 6-2 Expand Latest Reportings button...5-3, 6-2 F Field Descriptions History...5-1 History - Rendering Providers...6-1 NPI Reporting...3-1 NPI Reporting Rendering Providers...4-1 NPI Reporting History...5-1 NPI Reporting History Rendering Providers 6-1 NPI Reporting Logon...2-5 Re-logon to the NPI Site...2-6 Rendering Providers...4-1 Functionality History...5-1 History - Rendering Providers...6-1 NPI Reporting...3-1 NPI Reporting Rendering Providers...4-1 NPI Reporting History...5-1 NPI Reporting History Rendering Providers 6-1 Rendering Providers...4-1 G Group History...6-2 H Header information...3-3 Rendering Provider...4-4 History Field Descriptions...5-1 History - Rendering Providers Field Descriptions...6-1 History - Rendering Providers functionality...6-1 History - Rendering Providers navigation...6-1 History functionality...5-1 History navigation...5-1 How do I get and report an NPI?...2-4 How do I report my NPI to IHCP?...2-4 I Inquire...3-2 Inquire button...3-2 Instructions...3-4, 4-4 Introduction...1-1 L Latest Reportings...5-3, 6-2 Links NPI Reporting Tool...2-4 Links to the NPI Reporting Logon window...2-4 Login...2-5 Logoff...3-2 Library Reference Number: SYAP10012 I-1
Index NPI Reporting Tool User Guide Logoff button... 3-2, 3-3 Logon... 2-1, 2-5 Logon as Different User... 2-8 Logon as Different User button... 2-8 Logon button... 2-6 N Name... 3-3 Navigation History... 5-1 History - Rendering Providers... 6-1 NPI Reporting... 3-1 NPI Reporting Rendering Providers... 4-1 NPI Reporting History... 5-1 NPI Reporting History Rendering Providers 6-1 Rendering Providers... 4-1 Navigation and functionality...3-1, 4-1, 5-1, 6-1 NPI Crosswalk Database... 3-9, 4-7 NPI Information... 3-3, 4-3 NPI Reporting... 3-1 Field Descriptions... 3-1 NPI Reporting Rendering Providers Field Descriptions... 4-1 NPI Reporting Rendering Providers functionality... 4-1 NPI Reporting Rendering Providers navigation4-1 NPI Reporting functionality... 3-1 NPI Reporting History... 5-1 Field Descriptions... 5-1 NPI Reporting History Rendering Providers Field Descriptions... 6-1 NPI Reporting History Rendering Providers functionality... 6-1 NPI Reporting History Rendering Providers navigation... 6-1 NPI Reporting History functionality... 5-1 NPI Reporting History navigation... 5-1 NPI Reporting Logon Field Descriptions... 2-5 NPI Reporting Logon window... 2-5 NPI Reporting navigation... 3-1 NPI Reporting page... 3-1 P Password... 2-5 Phone Number... 3-3 Provider Information... 3-3, 4-3 Provider subsection Header information... 3-3 Provider subsections... 3-3 Provider/NPI Information... 3-3, 4-3 Q Query Information...3-2 Query Information button...3-2 R Re-logon...2-6 Re-Logon...2-7 Re-Logon button...2-7 Re-logon to the NPI Site window...2-6 Field Descriptions...2-6 Rendering Provider...4-3 Header information...4-4 Rendering Provider History...5-3 Rendering Provider subsections...4-3 Rendering Providers Field Descriptions...4-1 Rendering Providers functionality...4-1 Rendering Providers navigation...4-1 Report Rendering Providers... 3-10 Report your NPI...2-1 Report your NPI to the IHCP...2-1 Return to Group History...6-2 Return to Group History button...6-2 Return to Group Provider...4-1 Return to Group Provider button...4-1 S Select Taxonomy Codes...3-7, 4-5 Sign In...2-6 Sign In button...2-6 Step 1...3-5, 4-5 Step 1) Enter NPI...3-5, 4-5 Step 2 Reporting your NPI to IHCP...2-4 Step 2) Select Taxonomy Codes...3-7, 4-5 Step 2) Select Taxonomy Codes button...3-7, 4-5 Step 3) Submit Changes for this Provider...3-9, 4-7 Step 3) Submit Changes for this Provider button3-9, 4-7 Step 4) Report Rendering Providers... 3-10 Step 4) Report Rendering Providers button... 3-10 Submit Changes for this Provider...3-9, 4-7 U User ID...2-5 V View Rendering Provider History...5-3 View Rendering Provider History button...5-3 View Reporting History...3-2 View Reporting History button...3-2 I-2 Library Reference Number: SYAP10012