CMS-10175 - 83-C Justification

Justification for Revision to Form CMS-10175

0938-0984 - Certification Statement for Electronic File Interchange Organizations that submit NPI Data to the National Plan and Provider Enumeration System

Certification #3 of Form CMS-10175 (Electronic File Interchange Organization (EFIO) Certification Statement) was recently amended to require EFIOs to notify “via letter or e-mail” each provider of the latter’s newly-issued NPI or the rejection of the provider’s application. The change in question involved the insertion of the phrase “via letter or e-mail.” Previously, EFIOs were permitted to make such notification to providers in any matter they deemed appropriate. CMS has since uncovered situations where providers have not been properly notified of their NPIs by their EFIOs. The purpose of written notification is to ensure that EFIOs are in compliance with the requirements of Certification #3 and that providers are duly notified of their NPIs; such notice will save time and money for all interested parties.