Tuesday, September 4, 2007

National Provider Identifier (NPI) Alert:

National Provider Identifiers (NPIs) will be required on claims sent on or after October 1, 2007. On March 2, 2007, CMS released a memo regarding the clarification of the provider number nomenclature. Please note that following the implementation of the National Provider Identifier (NPI), the Medicare/Medicaid Provider Number will continue to be issued to certified providers/suppliers and used on all Survey and Certification, and patient assessment transactions. In order to distinguish its role from that of the NPI, the Medicare/Medicaid Provider Number has been renamed the Centers for Medicare & Medicaid Services (CMS) Certification Number (CCN).

The NPI is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. Beginning May 23, 2007 (May 23, 2008, for small health plans), the NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered entities may invoke contingency plans after May 23, 2007.

Source - http://www.cms.hhs.gov/NationalProvIdentStand/


Source -
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http://www.fdhc.state.fl.us/National_Provider_Identifier_NPI_Alert.shtml


For more information contact:

David J. Lacasse, Managing Director/President
Healthcare Collateral Consulting, LLC
Fairfield County, Connecticut
djlacasse@gmail.com

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