National Provider Identifier (NPI)
The Centers for Medicare & Medicaid Services (CMS) recently announced that it is implementing a contingency period for entities that will be unable to comply with the National Provider Identifier (NPI) regulatory requirements of the Health Insurance Portability and Accountability Act (HIPAA) by May 23, 2007.
The new compliance date for these entities is May 23, 2008. Until then, providers may continue sending claims using the provider’s SSN or federal tax ID as the primary identifier, until they are ready to submit claims using their NPI number.
What is NPI and how will it affect my business with NetCare?
The National Provider Identifier (NPI) is a standard unique identifier, mandated by the Health Insurance Portability and Accountability Act (HIPAA), for health care providers to transmit health information electronically in connection with HIPAA standard transactions. The NPI will replace health care identifiers that are currently in use, and eliminate the need to use different identification numbers with multiple plans.
The following are eligible to apply for and receive an NPI:
 Individuals: physicians, dentists and pharmacists
Organizations: hospitals, nursing homes, pharmacies and group practices
You may contact NetCare’s Provider Relations Department to coordinate using your NPI in your transaction with us.
How do I apply for an NPI?
Apply for your NPI in one of three ways:
Online. The online application process is fast and easy. Apply now at https://nppes.cms.hhs.gov.
By Mail. Complete a paper application and send it to the Enumerator. A copy of the application and instructions are available at https://nppes.cms.hhs.gov or you can call the Enumerator at 1-800-465-3203 or TTY 1-800-692-2326 to receive a copy.
Third Party Organization. With your permission, an organization may submit your application in an electronic file. This could mean that a professional association, or perhaps a health provider who is your employer, could submit an electronic file containing your information or the information of other health care providers.
When gathering information for your application, be sure that all of your information is current. Once you receive your NPI, communicate this to NetCare’s Provider Relations Department for processing and then safeguard its use.
For more information an complete details on obtaining an NPI or learning more about its use, go to https.//www.cms.hhs.gov/NationalProvIdentStand/.
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