One Year Remains Before NPI Use is Required in All Standard Transactions

Nevada RNformation, Aug 2006

Covered health care providers have one year to obtain National Provider Identifiers (NPI). The NPI is a 10-digit, numeric identifier that does not expire or change, and is administered by the Centers for Medicare & Medicaid Services (CMS).

The NPI must be used in standard health care transactions, specified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) no later than May 23, 2007, by covered health care providers, health plans and health clearinghouses.

The identifier helps to ensure that medical claims are processed on time and payments are made correctly.

Health care providers are urged to apply for the National Provider Identifier (NPI) well before the May 23, 2007 deadline. Legacy identifiers will not be accepted after that date (except for small health plans who have until May 23, 2008 to comply).

The Medicare fee-for-service program began accepting the NPI. along with the Medicare legacy identifiers, from health care providers in HIPAA standard claims transactions in January 2006.

Health care providers may obtain their NPI in one of three ways:

1. Apply on-line by using the web (https://NPPES.cms.hhs.gov):

2. Call the NPI Enumerator (1-800-465-3203) and request a paper NPI application form, complete it, and mail it back to the address on the form; or

3. Apply for a bulk enumeration, which allows an Electronic File Interchange Organization (EFIO) approved by CMS to obtain a number of providers' NPI.

We encourage providers to go to www.cms.hhs.gov/NationalProvidentStand/to get the information they need in order to apply for this new unique identifier.