NATIONAL PROVIDER IDENTIFIER (NPI)
The National Provider Identifier is here! In the coming months, we will need your help to ensure a smooth transition for your account.
What's New?
CMS has issued updates on its NPI program. Click here for more information.
As of March 1, 2008:
- Medicare claims submitted with just a Medicare Part B legacy number (PIN or PTAN) will not pay on/after March 1.
- Medicare claims submitted with both an NPI and a Medicare Part B legacy number will continue to reject if the pair is not found on the Medicare NPI Crosswalk.
- Medicare claims need to be submitted with an NPI in all provider fields or they will reject.
Background
The National Provider Identifier (NPI) is a new 10-digit identifier available from the Centers for Medicare & Medicaid Services (CMS). Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the NPI must be used by covered entities to identify health care providers in standard transactions, including claims, eligibility inquiries and responses, claim status inquiries and responses, referrals, and remittance advices. The NPI will replace other health care provider identifiers that are in use today. All health plans and all health care clearinghouses must accept and use NPIs by May 23, 2007 (small health plans have until May 23, 2008).
InstaMed has supported the NPI since our inception, but we are dedicated to ensuring a smooth transition for you and your business. Please expect to work closely with your InstaMed Customer Service Representative in preparation.
Getting your NPI
To obtain your NPI from CMS, you may apply online at https://nppes.cms.hhs.gov. A paper application is available at that link or by calling 1-800-465-3203 or TTY 1-800-692-2326.
Please visit http://www.cms.hhs.gov/NationalProvIdentstand for more information.
Sharing your NPI
As your gateway for HIPAA transactions, InstaMed requires that you report your NPI to us. You may download and submit our NPI Submission Form via mail, fax, or secure upload.
Health plans may require that you report your NPI before submitting transactions. Please contact the health plans with which you participate to determine requirements and reporting methods. Forms and links to information for some health plans are available at our Payer Information about NPI page.
Using your NPI
Modifications to your InstaMed account may be required depending on which HIPAA transactions you are submitting, your submission method and file format. Upon receipt of your NPI, a customer service representative will contact you with a determination of whether any changes are required. If changes are required, InstaMed will provide a recommended course of action and timeline for ensuring compliance.
Again, please don't hesitate to contact us with questions or comments. We remain committed to ensuring a high quality experience for you as we continue to simplify the healthcare payment process.
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