decisionhealth Newsletters, Part B News - 2008 Issue 7 (July)
NPPES/IRS mismatch could cause deactivation in 15 days
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Article Overview
This article discusses CMS correspondence about discrepancies between NPPES enrollment information and IRS records, including the notice timeline, the possibility of NPI deactivation, and the documentation providers may be asked to submit. It is relevant to billing and compliance staff, practice managers, and provider enrollment personnel who maintain organizational identification data and monitor CMS communications.
Why This Topic Matters
Incorrect or inconsistent NPPES and IRS information can trigger administrative action affecting a provider’s NPI status. The article helps readers understand the general compliance issue, who may receive notices, and the types of documentation and contacts involved.
What You Will Learn
- How CMS is using NPPES and IRS data matching in provider record review
- What kinds of notices providers may receive when records do not match
- Why the timing of CMS correspondence matters for organizations
- What documentation or follow-up contacts may be involved in responding to a mismatch notice
Who Should Read This
- Billing and coding professionals
- Practice managers
- Provider enrollment staff
- Compliance staff
- Healthcare administrators
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