Is Your Prescribing Authority Information Up-To-Date?

Highmark has seen an increase in prescriptions being rejected at the point of sale due to providers having incorrect/outdated prescribing authority on file in the National Plan and Provider Enumeration System (NPPES) for the prescriptions they write. This is especially true of controlled prescription drugs due to tighter regulations on prescribing authority for these drugs.

Please take a moment to review your NPPES data, make any necessary updates, and certify its accuracy to ensure your patients don’t experience unnecessary delays and rejections on otherwise valid prescriptions.

Review, Certify, and Update Your Data in NPPES

To review your data in NPPES:

  • Go to https://npiregistry.cms.hhs.gov/ and enter your NPI in the NPI field.
  • Click on your NPI number to access your data record.
  • Review your data for accuracy, and scroll to the bottom to the Taxonomies section to review your prescribing authority information, including your taxonomy code for your provider type.
  • CMS provides a list of accepted taxonomy codes based on provider type . NOTE: If your taxonomy code is not one of the accepted codes for your provider type, prescriptions will be rejected at the point of sale.

To update and certify your data in NPPES:

  • Go to https://nppes.cms.hhs.gov/NPPES/Welcome.do and log in using your user ID and password.
  • Update your information as needed. This includes ALL address locations for where you practice and your taxonomy code for your provider type.
  • Finalize any changes and follow the instructions to certify your information.

For More Information

Review the NPPES FAQ for additional information, including information on recovering/resetting your user ID and/or password, and changing your taxonomy code. Also, visit https://nppes.cms.hhs.gov/ .

The Centers for Medicare and Medicaid Services (CMS), as well as various states, require that providers have the appropriate prescribing authority for any prescriptions they write. Prescribing authority is based on providers’ data in the NPPES.

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Provider News, Issue 1, 2020   |   © 2020 Highmark Blue Cross Blue Shield Delaware

 

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