What is NPI ?
10-position all-numeric identification number by the National Plan and Provider Enumeration System (NPPES).
Healthcare providers must have an NPI number, which is used for a variety of purposes including billing, insurance, Medicare and Medicaid, pharmacy
For HIPAA-covered providers, the National Provider Identifier (NPI) is a public, unique identifier. Each health care provider is assigned a information, and state-specific medical boards.
NPIs have replaced the health care provider identities used in standard transactions under HIPAA. A provider’s NPI will remain the same regardless of work or geographical changes.
Who needs an NPI number?
An NPI is required for all HIPAA-regulated healthcare services, including but not limited to individual physicians, groups, and associations. HIPAA requires covered entities to use NPI numbers in standard transactions.
How do you get an NPI number?
The National Plan and Provider Enumeration System is the quickest way for health care providers and organisations to obtain an NPI number (NPPES).
It should take about 20 minutes to complete the application, and an NPI number can be obtained in as little as 10 days.
Individual providers must first create a username and password in the Identity & Access Management System (I&A) and then use those credentials to log into NPPES.
Providers can also apply for an NPI number on their own or through a third-party entity. The CMS website has detailed instructions available on it.
For accurate medical billing and faster revenue cycle management, NPI numbers are essential.
Any claim submitted without a valid, registered NPI will be denied by any health plan, as it is required by HIPAA regulations to track healthcare services and reimbursement.
Cost to obtain NPI number ?
Getting an NPI number is free of cost. You simply have to apply for it through NPPES website.
NPI registry search?
CMS has created an online NPI registry search (nppes.cms.hhs.gov) where a physician, other health care provider, or organization can access NPI information.