National Provider Identifier FAQs
If you are a physician or are in a support role for a private practice, you should know the facts about the National Provider Identifier Directory (NPI) and how it affects your medical practice. Partnering with AdvancedMD helps you avoid the confusion about the implementation of the new NPI. Our software is continuously and automatically updated, which helps ensure that the highest levels of compliance are met for your practice. Your NPI automatically appears on all claim submissions making the process simple and compliant.
Learn the Facts about NPI Registry, NPI Directory & National Provider Identifier
What is the National Provider Identifier Directory?
After providers complete their NPI application, they need NPI Number directories for NPI lookup and Unique Physician Identification Number (UPIN) crosswalks to complete medical claims.
How Does the Medicare and Medical NPI Affect Me?
Effective May 23, 2008, all medical providers are required to submit their medical National Provider Identifier (NPI number) on all claims, both paper and electronic, as stated by the Centers for Medicare & Medicaid Services (CMS).
What Are the Compliance Requirements?
The U.S. Centers for Medicare & Medicaid Services (CMS) mandated that effective May 23, 2008 all medical providers are required to include their medical National Provider Identifier number on all claims, both paper and electronic.
How Do I Make Sure I Am Compliant?
Many electronic claims and billing systems – including AdvancedMD – automatically include your National Provider Identifier number on all claims in compliance with applicable requirements. If you are submitting claims on paper, you will need to make sure your National Provider Identifier is included in the appropriate locations on the forms.
Is my National Provider Identifier (NPI) Confidential?
The National Provider Identifier number is “intelligence free”, meaning it does not carry any information that could be used to recognize a particular provider, such as city, state or medical specialty, thus maintaining confidentiality.
As outlined in the Federal Regulation, The Health Insurance Portability and Accountability Act of 1996 (HIPAA), covered providers must also share their National Provider Identifier with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes.
How Do I Obtain a National Provider Identifier (NPI)?
AdvancedMD includes National Provider Identifier numbers in claims submissions when claims are sent using our medical billing software. For the latest information about NPI requirements and application forms please visit the following resources:
- If you are a new doctor or need to obtain a National Provider Identifier number, please download and complete the PDF application from the CMS website.
- Additional information is available from the CMS website.