Sage Medical Manager and NPI

As many of you are aware, May 23, 2008 is an important deadline for all of us. That is the date when healthcare providers will be required to provide only their National Provider Identifiers (NPIs) on all Medicare paper and electronic claims for reimbursement. For more information about Sage Medical Manager and the handling of legacy IDs please visit the Sage Medical Manager: Legacy ID Update page.

To allow you to comply with NPI requirements, your version of Sage Medical Manager must be 10.00 or higher AND you must have the correct formats. Additionally, RIS users must have RIS version 3.5 or above. RIS users, to determine which RIS version you are using, please use /RIS.

Use these instructions to check your version and format numbers for Sage Medical Manager. (To print a copy of these instructions, download this PDF.)

Step 1 - Check your version of Sage Medical Manager

  1. The version number can be located on the Sage Medical Manager log-in screen where you accept the system date
  2. If your version of Sage Medical Manager is 10.00 or higher then proceed to Step 2
  3. If your version of Sage Medical Manager is not at least 10.00, your best option is to upgrade. Please contact us at 1-877-932-6301 and choose option 1. However, we have a temporary crosswalk solution for electronic claims transactions, in conjunction with our clearinghouse, available if you are not able to upgrade before May 23, 2007.

The crosswalk will "translate" your legacy identification numbers to your new NPI, so that you are able to comply with the regulation. We will be sending more information about the crosswalk option to affected customers soon.

Step 2 - Check your format number

  1. From the MMNS main menu, enter /nsutl
  2. From the MMNS Setup and Utilities menu, select Post-Install Task List
  3. From the MMNS Post-Install Task List, select MMNS Statistical Analysis
  4. Once the Statistical Analysis Tool has finished, please note the name of the report file.

    NOTE: The file name is case sensitive, so be careful to write it down exactly as it displays (upper and lower case.)

  5. From the MMNS Setup and Utilities menu, enter/view
  6. To view the report file from the Statistical Analysis Tool, enter the report file name. Do not precede the file name with "a:" to ensure the entire file name will fit. If the view command returns with "File Does Not Exist" or "Permissions are Incorrect," please contact us at 1-877-932-6301 and choose Option 2.
  7. Once the report file has loaded, select End to navigate to the bottom of the report
  8. In the section of the report file entitled, "Active Format Files," the format files displayed represent the active format files

    The minimum requirements are:

    Professional Claims
    - for version 10 or 10.10 - must use NSF + format 30.00g (or higher)
    - for Version 10.30 or above - must use NSF + format 3.00g (or higher)

  9. If you are on a current format version please proceed to Step 3
  10. If you are not using a current format version, please contact Technical Support at 1-877-932-6301 and choose option 2

    Radiology or multi-specialty sites using RIS, you must also check your RIS version number. You must be on RIS version 3.5 or higher to ensure NPI compliancy. To check your RIS version number, use /RIS.

Step 3 - Transmit your number

With the combination of Network Services for the transmission of claims and the Business Services clearinghouse to send claims to payers, Network Services users do not need to worry about which payers are ready to accept NPI. The clearinghouse, Emdeon Business Services, will complete all necessary testing with payers and will transmit the appropriate identifiers (either legacy or NPI) to payers.

Transmitting Paper Claims
We have a HCFA 1500 to CMS 1500 paper format conversion utility which will be shipped on CD to all customers who are using Sage Medical Manager version 9.10 and higher in March. More information about transmitting paper claims using Sage Medical Manager and the new CMS 1500 is coming soon.

Institutional Claims
The electronic institutional claims solution for Sage Medical Manager requires version 10.30 or higher. If your practice sends electronic institutional claims and you are not on version 10.30 or higher, please call 877-932-6301 and choose option 1. In addition to being on version 10.30 or higher, in order to accommodate sending NPI for electronic institutional claims, you must be using the correct Network Services institutional format. If you are on Sage Medical Manager version 10.30 or above and currently send electronic institutional (UB) claims, please call 877-724-3007 to be added to the list of customers needing this format. You will need to use the NPI Crosswalk for an interim period while you are being upgraded and implemented with the correct Network Services institutional format.

Next Steps
For further information on NPI, visit the NPI information area of the CMS website at www.cms.hhs.gov/apps/npi/01_overview.asp. Additionally, CMS is maintaining - and regularly updating - a frequently asked questions (FAQ) page regarding NPI. Be sure to check it often for information as it becomes available.

This communications is not designed to provide explanation or education on the CMS announcements. If you are unclear on CMS communications or policies surrounding NPI, please refer to CMS at: www.cms.hhs.gov/apps/npi/01_overview.asp.