Claims rejections go through the roof with NPI requirement

As predicted, processing federal and state insurance claims has become something of a nightmare in the week since providers have been required to use their National Provider Identifier (NPI) number.

Healthcare industry claims processors are reporting a fourfold or more increase in rejected Medicare claims and the same (or even higher) rates for Medicaid claims. For example, claims clearinghouse and IT service provider Emdeon Services saw a rejection rate of 24 percent for all Medicare plans, representing $25.8 million in claims that were turned down, compared with an average rejection rate of 6 percent, or $10.6 million, before the NPI kickoff of May 23rd. Medicaid claims processed by Emdeon saw a 26 percent rejection rate, meanwhile, compared with a normal rate of 4 percent.

If all of this happened within one week--which included the Memorial Day holiday weekend--the next few could be pretty scary. Brace yourselves for some more heavy claims lifting, folks!

To learn more about the problem:
- read this FierceHealthcare article

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