The NPI (National Provider Identifier) Number, which stands for National Provider Identifier, is an alphanumeric code issued by the Centers for Medicare and Medicaid Services (CMS) to healthcare providers in the United States. The number identifies you as a healthcare provider to other providers, employers, health plans, and payers so that they can bill your insurance company or other entity on your behalf. An NPI number cannot be used to identify you personally or to identify your patient information; instead, it provides third parties with important identifying information about you so that they can properly bill your insurance company.
Healthcare Providers Must Use NPI Numbers
In a move to improve healthcare data sharing between providers, health plans, and payers, CMS requires that all covered healthcare providers obtain and use a National Provider Identifier (NPI). Using an NPI will eliminate duplicate records and allow for more accurate billing and claims processing. What does that mean for you? For one thing, it means fewer administrative errors: fewer claims denied because of incorrect or missing information. It also means better care coordination, which can lead to better patient outcomes. And it should make your life easier: no more searching through your paperwork to find your provider's identifying number.
Can I Be Denied Payment Without One?
If you have no healthcare provider number, then it’s possible that you could be denied payment when you try to bill for your services. The NPI is used by all covered health care providers for billing purposes.
How Do I Get an NPI Number?
You can get your free NPI number online by visiting www.cms.gov and choosing Provider Enrollment, Chain and Ownership System from its homepage menu. Next, you will enter information about yourself and your healthcare entity to be verified. After you create a username and password, follow instructions to complete verification of your identity and proceed with verifying any of your organization’s existing healthcare providers who already have NPIs assigned. Once completed, you can apply for NPIs for new providers as well as request them for others that do not yet have them assigned. Simply click on Next at each stage of verification until it is complete.
Are There Any Fees Involved in Obtaining My NPI Number?
There are NO FEES associated with obtaining an NPI number. Obtaining your number only requires that you complete a simple application form and submit it along with documentation proving your identity, authority to practice in your state, and your Tax ID or Social Security Number. Once verified, you will receive a notification email within 1-2 business days notifying you that your number has been issued. From there you simply download it by entering in all 10 digits on any healthcare claims system. That's all there is to it!
How to Look Up an NPI
An NPI number is a unique 10-digit identifier that helps healthcare providers track their claims. The first step to looking up your provider's number is to find his/her name or NPI number. Start by looking for your doctor in the NPI Dashboard online directories. If you're still having trouble finding your physician's information, look them up using the NPI Dashboard NPI Lookup.
Summary
The National Provider Identifier (NPI) number, issued by CMS's National Plan and Provider Enumeration System to health care providers in all 50 states, identifies healthcare providers in order to ensure quality healthcare reimbursement. Your National Provider Identifier acts as a primary identifier for you to participate in Medicare. With your NPI number you will be able to participate in all sorts of programs like Medicare, Medicaid, CHIP, and other federal health programs.
