NPIs are being used to identify health care providers on prescriptions and in internal files to link proprietary provider identification numbers and other information, coordination of benefits between health plans, patient medical record systems, program integrity files, and other ways as well. How can health care providers obtain an NPI? Providers who have not yet obtained their NPI may apply in one of the following ways:. How many NPIs do health care providers need?
An individual is eligible for a single NPI. An individual cannot have subparts and cannot designate subparts. Organizations must also apply for a single NPI. Registering your NPI with Independence is easy. Different online registration forms are available for all types of providers participating and nonparticipating. What is my Primary Provider Taxonomy Code?
The Provider Taxonomy is an alphanumeric code, ten characters in length, that allows a single provider individual, group, or institution to identify its specialty category.
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How long will it take to receive an NPI? There are several reasons for that. Such factors CMS considers include:. CMS estimates that, in general, a health care provider who submits a properly completed, electronic application could have an NPI within ten days. How can health care providers report NPIs to Independence? All providers participating and nonparticipating may register using the appropriate online form. This form has been included in mailings to participating provider offices. How do I enumerate?
Where are the Independence billing instructions and companion guides? Billing information can be found in our Claims submission toolkit for proper electronic and paper claims submissions as well as in our companion guides. Additional information can be found in issues of Partners in Health Update as well as in the current Provider Manual for Participating Professional Providers.
What happens if a claim comes in without an NPI? If a claim is submitted without a valid, registered NPI, the claim will reject. In accordance with the reimbursement terms of your provider contract, you may continue to provide your digit legacy number. Only a valid NPI will be accepted by us as the primary identifier on the claim. Will Independence require NPIs on paper claims? Paper claims must be submitted with an NPI as the primary identifier.
Tax ID is required for all claims. Some of these providers may not have an NPI, and others we may not be able to obtain. Independence requires NPI identifiers in the following four provider fields:. Is Independence planning on requiring a nine-digit zip code on the claim form?
Do I Need a New NPI? (And Other NPI Questions)
The nine-digit zip code is currently not required. If providers choose to enumerate their subparts further than they currently have today with payer legacy ID numbers, will Independence require enrollment of their additional subparts? Hi, If you are a fill-in doc and have not found a place to fill-in as of yet…can you still obtain an npi number? This article is so helpful! As a new graduate it is hard to figure out all the logistics of becoming a doctor and this website is a useful guide!
When applying for the NPI , I was not given any option to add another practice location……. Hi Kera, nope! You only have 1 NPI as a provider. What is the purpose of listing the practice location to apply for the NPI? Will this address need to match the practice address I use when applying to insurance panels? Applying for the NPI requires that you put an address.
It does not need to match the practice address you use when applying for insurance panels. When I graduated, I did not yet have a job so I used my home address at the time. After I got a job and knew where I was practicing, I used those addresses for credentialing purposes.
Unfortunately if you register with your home address, you are very easily google-able if thats a word. Great question.
As optometrists, we are physicians and therefore Individual Providers. Thanks for the reply Matt, Turns out I was referring to something different.
National Provider Identifier (NPI)
Evan — thanks so much! Which were you referring to? I might know the answer or can ask someone on our team! I only find ophthalmology. You must be logged in to post a comment. What is an NPI Number? Why do you need an NPI Number? Because health care plans are required to identify you, an optometrist, by your NPI number. To keep a record of any unlawful activity as a health care practitioner. Sign in with Facebook.
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