Have you ever moved offices and changed your address with the insurance payers – and then mail reverted to your old address?
Chances are, the NPI was responsible. And you didn’t even know about it.
Here’s why! And there’s something easy you can do to fix the NPI sabotaging you!
When you moved, did you update your NPI record?
What does my NPI have to do with changing a practice address? More than you might think.
This is the NPI Registry site.
Look yourself up! Is your address correct?
When did you last update it?
If you’re seeing a date like this…your information might not be correct. But if you’re wondering why I’m blathering on about the NPI when you need to change your address with commercial payers…check this out:
See that flaming red arrow by the acronym API? That’s what’s responsible for address reversion.
What the heck is an API?
API stands for Application Programming Interface. Translating the computer-ese into English, API means a way for two unrelated systems and/or programs to communicate data. Sometimes one way only, sometimes bi-directional. (and that’s about all I know – ask a techie if you want more!)
What happens if I click API on the NPI Registry site? Being the questioning medical billing geek that I am, I did. Here’s what you get that tells me this pesky API thing is responsible for the NPI sabotaging your address change.
Translation: the government offers a sort of app where any interested party can stream up to the minute NPI data to their program or service.
Who’d be interested in that? Well…I can think of a few entities. Off the top of my head…
- CAQH
- Availity
- Insurance payers (yeah – those people you’re trying to update your address with!)
- Clearinghouses
- Electronic medical records / billing programs
You’ve gone through all those painstaking, tedious steps to change your address. Filled out the online forms, faxed letters, for each insurance payer. Often more than once. And the insurance company changed your address, maybe.
But you didn’t know you needed to change your NPI!
So when that API pumps provider data over to the above list Every Single Day…guess what happens to all your hard work?
So let’s talk about how to keep your address updates free from NPI sabotaging.
You probably went here a long time ago to get your NPI in the first place. Or your first employer did. And that’s going to be the biggest challenge you face: getting access to this site. Once you’re logged in, it takes at most 10 minutes to update your information. But it can take a lot longer to regain access, if you have to do more than reset your password.
Here are some helpful tips:
- Your username and password to NPPES are the same as your login to PECOS (Medicare’s online provider enrollment system). If you’re enrolled in Medicare, that’s helpful.
- An organizational (Type 2) NPI needs to be enrolled with the same username/password as your individual (Type 1) NPI. Do not create two logins – it will cause problems if you try to enroll in Medicare.
- If you’ve already created two different accounts for the organizational and individual NPI’s – don’t worry, it can be fixed. But there’s some legwork involved. Call External User Services at 866-484-8049, option 1, then option 1. Or email EUSSupport@cgi.com.
- If you haven’t logged in recently to either NPPES or PECOS, then your credentials most likely will be suspended. The government does this for security reasons. Hit forgot password and go through the steps.
- If you forgot your username, there’s a way to look it up. Hit forgot username and go through the steps.
- When resetting, you may have to choose between entering your name, TIN, date of birth etc., or providing answers to security questions. Use your identifiers if possible. Those answers to the security questions may have been created decades ago, and maybe not even by you!
- If the system makes you answer the security questions and you can’t, you won’t be able to get in. You can get your account reset (with serious hoop-jumping). Call External User Services at the phone number listed above.
Don’t have patience with all the security rigmarole? (I understand the need for it…but I also suffer from the same frustration with it!) The government will still let you update your NPI on paper. It takes about 15-30 days to be updated once you mail in the form.
Click here for the paper NPI update form.
Once you receive confirmation that your NPI is updated, NOW you can go through the process of changing your address with commercial insurance payers. This time, the chances are a lot higher that the change will actually stick.
Are you exclusively telehealth, practicing from home? The NPI system has an update just for you!
Let’s take a closer look at that NPI registry homepage. Only this time, I’ve highlighted a couple other things.
The NPI Powers That Be now allow PO Boxes. FINALLY!
In order to block your home address, assuming it’s not already been Out There for years:
- You can have only one practice location.
- In that practice location, you designate it as a Home location.
- In the mailing address spot, list your PO Box.
And since it’s Pride Month, I’ll acknowledge the government for allowing a gender registration on an NPI listing that’s neither M or F. Quite the positive step.
