The Health Insurance Portability and Accountability Act of 1996 (HIPPA) mandated the adoption of standard, unique identifiers for both health care providers and health plans. On January 23, 2004 the U.S. Department of Health and Human Services (HHS) formally adopted the National Provider Identifier (NPI) as the official unique identifier for all healthcare providers. The compliance date for all covered parties is May 23, 2007 except for small group health plans who have until May 2008 to comply.

ppoNEXT is working diligently to ensure that all of our providers and clients experience a smooth transition to the NPI requirements. We are already accepting and transmitting NPI numbers, fully five months ahead of schedule. And our claims repricing system can presently accommodate the new CMS-1500 claim form. We will be conducting internal testing to ensure that our systems and processes are operating appropriately in advance of the implementation due date.

ppoNEXT understands the importance of adhering to all deadlines established by HHS for implementing NPI, and is committed to being 100 percent compliant. For additional information, please review the “NPI Frequently Asked Questions” section of our website.

About ppoNEXT:
ppoNEXT is a leading provider of nationwide healthcare management and network services. With its focus on providing consumers with the utmost in quality healthcare, ppoNEXT selects only providers and facilities of uncompromising quality and excellence. Based in Dallas, Texas, ppoNEXT offers clients access to over 450,000 physicians, over 3,700 hospitals, and thousands of leading ancillary care providers in key markets such as Texas, California, Florida, New Jersey, and Pennsylvania. ppoNEXT serves self-funded employers, third party administrators, insurance carriers, HMOs, and various managed care firms. ppoNEXT also offers disease management, utilization review, case management, independent medical review and claims negotiation services through its subsidiary, NEXTcare Management.

For more information about ppoNEXT, please contact:
Gene Gerard
Corporate Marketing
214.267.3412