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NPI and P10 legacy medicare numbers

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healthcarehiring:
Hello everybody, perhaps this belongs in the NPI forum, but it is more of a general question so here goes...

I manage a large number of websites, including healthcarehiring.com, our flagship site, which posts millions of health sector jobs and has about 5.5 million records of contact information for medical and healthcare providers.

We recently re-designed the site, and re-gathered a lot of data.  We now publish the NPI database, updated monthly, and offer a cross-reference search by "legacy" codes including oscar, upin, medicaid and state license number.

We also have hospital, home health and nursing home databases.  Previously all of these offered a search by medicare number.

With our re-design, we replaced some data for the home health and nursing homes -- and now some of our users, medical billers, are saying "where did the old medicare search go?"

My understanding is that for over a year, all billing must include NPI numbers.

Here is the question:  Why do they still want to search by old numbers?

Make no mistake, I am going to replace the old data and re-instate the medicare number search, that's today's project, we listen to our users.

But, I am trying to understand the overall medical billing process to see how I can make this site the very best resource for everybody who uses it.

Thanks a bunch
Mike Clark
Coconut Island Software, Inc.
coconutisland.com
healthcarehiring.com

Michele:
Even though Medicare has required the use of NPI only for over a year, the provider must still know their PTAN, or legacy number when making any contact with Medicare.  However, those numbers are private, so I'm confused as to how you can post them.  Medicare will not even give those numbers to the provider themselves if they call in and request it.  They must send a written request.

 ???

Michele

healthcarehiring:
Thank you Michele

I am not 100% sure what PTAN is, however HHS does provide a medicare number for home health, nursing home and dialysis in downloadable databases.  Hospital medicare numbers are also available. 

The NPI database includes up to 50 separate "other identifiers" (upin, bluecross, medicaid, etc.) plus up to 15 "license" numbers per record.  I believe these may be entered at the discretion of the registrant.

The NPI database is public information under the Freedom of Information Act. http://www.cms.hhs.gov/NationalProvIdentStand/06a_DataDissemination.asp

The way I understand it, in the medicare claims submission process, if there are multiple claimants for a patient within the billing period, the claimants need to coordinate with each other.  Is this correct?  What info about the other claimants does medicare give you?

I know that billers use our site to locate other providers in this process -- I am trying to get a better handle on exactly what our users need.  Transcriptionists also use us, I think more to locate physicians in the course of their work.

Cheers
Mike

PMRNC:
The PTAN is the Medicare Provider Transaction Access Number and Michele is right, it cannot be accessed via any online database, below is the MLM Article on this.


 http://www.cms.hhs.gov/MLNMattersArticles/downloads/mm5597.pdf 

healthcarehiring:
Thanks Linda

I am looking at the pdf file for HomeHealthCompare, available from http://www.medicare.gov/Download/DownloadDB.asp

ProviderNum: text(6)
Lists the numeric code used to identify the provider listed.

This must be some other medicare identifier, not the PTAN.

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