On a second related note, you may or may not be aware that there is a new CMS 1500 claim format, this new format was to have been implemented on Oct 1, 2006 and full and exclusive utilization of the new format by Jan 2007. Those of us that followed this regulation in the last quarter of 2006 were forced by most payers, including Medicare where paper claims had to be submitted- to abandon our implementation efforts of the new format and return to the old format. This has impacted the payment cycle for thousands of providers, including CRNAs and/or their employers. Furthermore, there are more changes to this format than simply the addition of the NPI data, this format has numerous changes in it that when finally fully implemented will force providers nationwide to comply in all detail or risk losing reimbursement. Practice managers must make absolutely certain they are intimately familiar with the details of these changes and make certain their Information Systems analysts are also on board so that all claims preparation requirements are met by their patient account/billing software.