The National Provider Identifier is an Administrative Simplification Standard under the Health Insurance Portability and Accountability Act “HIPAA”. The NPI is a one-of-a-kind identifier for covered health care providers. All health insurers covered health care providers, and clearinghouses need to use NPIs in HIPAA-compliant regulatory and financial transactions.
The NPI is a 10-position numeric identifier with no knowledge (10-digit number). This indicates that the figures do not provide any additional detail about the healthcare provider, such as their state of residence or medical specialty. In the HIPAA standard transactions, the NPI must be used instead of legacy vendor identifiers.
How Do I Apply for a National Provider Identifier (NPI)?
Obtaining an identifier is a quick process that saves the healthcare provider’s time. You may apply online, by mail, or by contacting a CMS contractor.
To apply online, go to the National Plan and Provider Enumeration System (NPPES) website, carefully read the directions, fill out the questionnaire, and submit your application. The website has commonly asked questions as well as other useful material.
You can receive your NPI by e-mail from customerservice@npienumerator.com once your data has been verified as received. If your e-mail interface has spam filters, the address from the NPI Enumerator with your NPI and confirmation message will be intercepted and routed to a spam archive. After submitting your results, make sure to update this folder on a regular basis.
It is advised to use the online application because it is usually faster and easier to monitor the status. However, if you want to file a paper application, you can also call the NPPES customer support hotline at 800.465.3203 and ask for a paper application form.
Get Your NPI
NPIs can be obtained from health care providers in one of three ways:
● Using the web-based development process for the most effective application processing and the quickest receipt of NPIs. Simply visit the National Plan and Provider Enumeration System (NPPES) and download online (see the ‘Apply Now’ page in the Related Links section below).
● If an EFIO demands their consent, health care providers may consent to make an Electronic File Interchange entity (EFIO) send application data on their behalf via a bulk enumeration process.
● Health care providers can receive a paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator in Fargo, ND, where workers will enter the application data into NPPES.
The time it takes to achieve an NPI is determined by the number of applications processed at any given time, whether the application was submitted online or on paper, and whether the application was complete and passed all edits.
An NPI could be issued to a contractor who submits a duly completed electronic application within 10 days. The paper submission procedure takes about 20 business days.
Why Should I Consider Getting an NPI Number?
If your office conducts some HIPAA-related regular electronic transactions, an NPI is required. Validating applicant eligibility, confirming enrollee privileges, filing electronic claims (online or via a clearinghouse), and monitoring your claim status are some of the key practices that include an NPI. If you don’t even have an NPI, you can get one as soon as possible. Here are some of the reasons we think it’s a brilliant idea:
● It is simple and free to apply for an NPI.
● It frees up office workers time, allowing them to focus enrollees
● Streamline your office operations with easy, NPI-required online resources.
● Insurance companies recognize it as a legitimate identifier, which leads to more effective profit coordination.
● Allows you to move your practice or change specialties without having to get new identifiers from different payers.
