Psychiatric News June 17, 2005
Volume 40 Number 12
© 2005 American Psychiatric Association
p. 13
Psychiatric Practice & Managed Care
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Apply Now for National Provider Identifier Number
The National Provider Identifier (NPI) has finally arrived after more than
a decade of discussion and planning. Since May 23 health care providers have
been able to apply for this new 10-digit number, which will eventually replace
all current health care provider identification numbers, including the Uniform
Provider Identification Number (UPIN) used by Medicare.
The creation of the NPI was mandated by the Health Insurance Portability
and Accountability Act of 1996 (HIPAA) with the goal of improving the
efficiency and effectiveness of the electronic transmission of health
information.
The NPI must be used by most HIPAA-covered entities. A health care provider
is a covered entity if the provider submits or receives transactions
electronically that are covered under HIPAA's Electronic Transactions
Standards.
Medicare, Medicaid, large private health insurers, and health care
clearinghouses must start using the NPI in all their transactions with
providers on May 23, 2007. Small health plans have a year longer to
comply—May 23, 2008.
APA members who are not covered entities under HIPAA may want to apply for
an NPI anyway, since it will eventually become the universal identifier for
all U.S. health care providers and will be used in the National Provider
System, which will include data on all U.S. health care providers.
You can apply for an NPI in three ways:
- Complete the online application form accessible at
<https://nppes.cms.hhs.gov>.
- Fill out a paper application and submit it to the Enumerator, the entity
that will be assigning the NPIs. Applications can be downloaded from
<https://nppes.cms.hhs.gov>
or obtained by calling (800) 465-3203.
- Starting in the fall, with your permission, an organization with which you
are associated will be able to submit your application electronically.
In a letter sent last month to health care providers, CMS Administrator
Mark B. McClellan, M.D., Ph.D., reminded providers not to begin using their
NPI until they receive specific instructions from health plans about when they
will start using them.
McClellan's letter is posted online at
<www.cms.hhs.gov/hipaa/hipaa2/npi_provider.asp>.
More information about the NPI and HIPAA is posted at
<www.cms.hhs.gov/hipaa/hipaa2/regulations/identifiers/default.asp>.
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