|
|||
|
|
 |
Provider Enrollment - Identification Numbers The NHIC Provider Enrollment Unit is charged with the responsibility to accept, validate, and process Medicare provider enrollment applications within its jurisdiction. These pages will assist you in all phases of provider enrollment.
Provider Identification Number (PIN) Healthcare providers or suppliers apply for a Medicare billing or PIN number. This is the number used to bill Medicare and can vary for different circumstances. Centers for Medicare & Medicaid Services (CMS) has given Medicare carriers, including NHIC, 60 days to process an application. This time frame, however, can vary dependent upon how complete an application is. Once a PIN number is assigned, a formal notification letter is sent to the provider. National Provider Identifier (NPI) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and Human Services adopt a standard unique health identifier for health care providers. On January 23, 2004, the Secretary published a Final Rule that adopted the National Provider Identifier (NPI) as this identifier. All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain an NPI for use to identify themselves in HIPAA standard transactions. Once enumerated, a provider's NPI will not change. The NPI remains with the provider regardless of job or location changes. HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. After those compliance dates, health care providers may use only their
NPIs to identify themselves in standard transactions, where the NPI is
called for. Additional
Information is on the National Provider Identifier webpage.
06/12/2008 |
