POS Network Exceptions to the Provider Identifier Dual-Use Period
The provider identifier “dual-use period” has been extended beyond November 26, 2007. The transactions listed below are exceptions to the dual-use period, because they are transactions where both sets of provider identifiers (Medi-Cal/CHDP provider numbers and National Provider Indicators [NPIs]) are not supported. Where both sets of provider identifiers are not supported, providers must continue to use the Medi-Cal/CHDP provider number beyond the November 26, 2007 NPI implementation date. Providers defined by the HIPAA final rule and Medi-Cal/CHDP policy as “atypical” will also continue to use only their nine-digit Medi-Cal/CHDP provider numbers.
Modifications are being made to the following:
- POS device software
- Internet software
- Mainframe supportive software
Real-time processing transactions included are:
- Internet transactions
- Point of Service (POS)
- Automated Eligibility Verification System (AEVS)
- Supplemental Automated Eligibility Verification System (SAEVS)
POS Device Download
Beginning August 25, 2007, messages appeared on POS devices announcing an automatic software update download. This software update accommodates the 10-digit NPI in preparation for Medi-Cal’s implementation. Providers must, until further notice, continue to enter the Medi-Cal/CHDP provider number beyond the November 26, 2007 NPI implementation date.
Eligibility
For eligibility transactions, Medi-Services reservations and Share of Cost (SOC) spend down dial-up or leased-line transmissions, providers must, until further notice, continue to enter the Medi-Cal/CHDP provider number beyond the November 26, 2007 NPI implementation date. Information about sending and receiving data via leased-line and dial-up submissions is available in the ASC X12N 270/271Version 4010A1 Health Care Eligibility Benefit Inquiry and Response (Real-Time and Batch) companion guide.
Providers can download the 270/271 Overview for Leased-Line, Dial-Up and Batch Submissions section of the guide. Information about mandatory testing for the 270/271 v.4010A1 eligibility transaction using the NPI is in that section.
Note:Providers who tested 270/271 v.4010A1 eligibility transactions using their Medi-Cal/CHDP provider numbers do not need to retest using NPI numbers.
Pharmacy
Providers must, until further notice, continue to enter the Medi-Cal/CHDP provider number beyond the November 26, 2007 NPI implementation date for all National Council for Prescription Drug Programs (NCPDP) Version 5.1 dial-up and leased-line transmissions. NCPDP Version 5.1 technical publications are now available on the Web page referenced above. Test data for NCPDP transactions using the NPI are detailed in the NCPDP 5.1 specifications.
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