Why NPI Numbers are RequiredThe National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI will replace the unique provider identification number (UPIN) as the required identifier for Medicare services, and will be used by other payers, including commercial healthcare insurers. The transition to the NPI was mandated as part of the Administrative Simplifications portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and is slated to begin taking effect in August 2007. HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans must use only the NPI to identify covered healthcare providers by August 2007. Small health plans have one additional year to comply. All individual HIPAA covered healthcare providers (physicians, nurses, dentists, chiropractors, physical therapists, etc.) or organizations (hospitals, home healthcare agencies, nursing homes, residential treatment centers, group practices, laboratories, pharmacies, medical equipment companies, etc.) must obtain an NPI for use in all HIPAA standard transactions, even if a billing agency prepares the transaction. Once assigned, a provider's NPI is permanent and remains with the provider regardless or job or location changes. For more information about SK&A’s NPI Verified™, please call: 800-258-9479 |
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