What is an NPI?
An NPI is a special, intelligence-free, numeric identifier with 10 digits. Intelligence-free ensures that knowledge about health care providers, such as the state in which they work, their type of service, or their expertise, is not carried by NPI. All health care providers that are considered covered entities under HIPAA, and those who file claims electronically or use a clearinghouse to bill insurance, are required to apply for an NPI.
All HIPAA-covered health care providers, whether they are individuals or organizations, must obtain an NPI to use to identify themselves in HIPAA standard transactions. Once you get an NPI number in Ohio it remains the same throughout. The NPI remains with the provider regardless of job or location changes.
How much does it cost to apply for NPI?
Applying and getting an NPI is totally free of cost. There is no charge to apply, nor is there an annual fee.
How do I apply?
There are a total of three ways of applying and these are listed below:-
- APPLY ONLINE at https://nppes.cms.hhs.gov
- MAIL APPLICATION: You may prepare a paper application and send it to the Enumerator. Download the application at the URL above or call 1-800-465-3203.
- THIRD-PARTY APPLICATION: With your permission, a professional organization or your employer can submit an electronic file with information along with others.
It will only take around 25 to 30 minutes for you to fill the application and submit it. You can get your NPI within 10 days after you submit your file and it gets processed. It also depends on the volume of applications, paper vs. electronic, and whether the application passes all edits.
So what is the purpose of the NPI?
The NPI is one of the steps that CMS is taking to improve electronic transactions for health care. Even if you do not charge for services, you may need to report your NPI to those providers who do so. Claims may be negatively affected without the NPI, with reimbursement deferred or likely refused. All health care providers and organizations are eligible to receive NPIs. Getting an NPI is free — not having one can be costly.