 The National Provider Identifier is also known as NPI.
This is a unique identifier for health care providers (such as Physicians, Hospitals, Pharmacists, etc.). It will be required as the only valid identifier for the health care providers in HIPAA transactions, replacing current health are provider identifiers used today such as Blue Cross ID, Medicaid ID, Medicare ID, etc.
The National Plan and Provider Enumeration System (NPPES) will operate the National Provider System (NPS) and receive NPI applications.
The following are known timelines for general compliance (Health Pals, Medicare, Medicaid, private health insurance plans, clearinghouses)
May 23, 2007 – All covered entities except for small health plans.
May 23, 2008 – Small Health plans |
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| Medicare NPI Implementation: |
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January 3, 2006 – October 1, 2006 (NPI+ Legacy OR Legacy only):
October 2, 2006 – May 22, 2007 (NPI Only OR NPI + Legacy):
- Submit NPI OR Submit NPI + existing Medicare numbers.
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If only NPI submitted then there is a problem with it, the claim may not be paid.
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Medicare will be able to send NPI as primary ID and Legacy and Secondary ID in outbound claims, claim status and eligibility response and electronic remittance advice transactions.
May 23, 2007 – Forward (NPI Only):
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| How can IGI assist you in your goals?
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Pre-Implementation Tasks:
- Education
- Identify
- Trading Partners
- Provider Types
- Provider Identifiers
- Providers with Multiple ID’s
Implementation Tasks:
- Project Planning
- Discovery
- Analysis
- Policies & Procedures
- Internal Testing
- Readiness Timeline
- Customer Testing
Post-Implementation Tasks:
- Monitor Transaction Processes
- Error Recording
- Error Analysis
- Correction and Validation
Services & Solutions:
- NPI Education
- Implementation Planning and Execution
- Re-enrollment
- Crosswalk Analysis
- Custom Crosswalk DB development
- Custom Integration Layer Development
- Testing and QA
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| Still need more information on NPI?
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IGI can further educate you on:
- Who must comply with the NPI requirement
- Who is eligible to receive an NPI
- Provider organization Subparts
- The National Plan and Provider Enumeration System (NPPES)
- NPI and Electronic File Interchange (EFI)
- NPI Formats
- Crosswalks
- Compliance Deadlines
- Group Vs. Individual NPI
- NPI Requirements / Responsibilities
- Health Plans
- Additional uses for NPI
- Paper and Electronic Claims
For more information, please e-mail info@igiusa.com
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