HCFA 1500 Claim Forms Processing:

Centers for Medicare & Medicaid Services (CMS 1500) updated the HCFA1500 claim form accommodating National Provider Identifiers (NPI) along with appropriate boxes like referring physician and billing details.

According to CMS 1500, to improve the efficiency and effectiveness of the health care system, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which included a series of "administrative simplification" provisions that required the Department of Health and Human Services (HHS) to adopt national standards for electronic health care transactions and code sets and identifiers to be used in those transactions. The final rule adopting the NPI as the standard unique health identifier for health care providers was published on January 23, 2004, and became effective on May 23, 2005. All covered entities must be in compliance with the NPI provisions by May 23, 2007, except for small plans, which must be in compliance by May 23, 2008.

Compliance, in this context, means in part that the NPI must be used by covered entities to identify providers on all HIPAA covered transactions that call for health care provider identifiers. Covered transactions that require a health care provider's identifier that are transmitted containing only legacy identifiers (identifiers in use today) or containing both legacy identifiers and NPIs would be noncompliant.

Processes at VeeInsure would seamlessly fit into this latest requirement of CMS; there would not be any major changes in the process of data lift.

VeeInsure will be happy to answer your questions. Please contact us on 1-312-373-9346 or email at