National Provider Identifier (NPI)
2006 brought two important changes to the way health claims are submitted and processed. The new provider identifier number will replace all other health plan provider identifiers, and the new claim form includes a place to report the new provider identifier has replaced the current HCFA 1500 form as of April 1, 2007. The Centers for Medicare and Medicaid Services (CMS) have created a new single provider identifier. This “National Provider Identifier (NPI)” will be used in all standard electronic transactions. The purpose is to encourage electronic transmissions by simplifying the claims process. It will allow physicians to submit claims to all health plans in the U.S. using one NPI. Beginning May 23, 2007, all HIPPA-covered entities, such as health care providers, health plans and health care clearinghouses will be required to submit their claims using the NPI. In order to submit claims with the new NPI, the National Uniform Claims Committee (NUCC) has created a new 1500 Health Insurance Claim form. The new 1500 Claim Form includes a place to report the provider's NPI along with 40 other minor changes. As of April 1, 2007, the new 1500 Health Insurance Claim Form replaced the old HCFA 1500 form, also known as the CMS 1500 form. The new form was released on Dec. 1, 2005, for testing and transition preparation purposes.
For additional information on the National Provider Identifier contact the following:
Enumerator Customer Services: 1-800-465-3202 TTY 1-800-692-2326
customerservices@NPIenumerator.com
Apply at: https://nppes.cms.hhs.gov
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