Residency

Ask the expert: Should residents have NPI numbers?

Residency Program Insider, April 24, 2007

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In January 2004, the Federal Government published the final rules around the implementation of a standard unique health identifier for health care providers, or national provider identifier (NPI). The final rule, published by The Centers for Medicare & Medicaid Services, and in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), requires the adoption and use of a standard unique identifier for all covered health care providers. CMS' original deadline for covered entities to use NPIs to identify providers in standard transactions was May 23, 2007. However, CMS recently released an NPI contingency period. The enforcement delay allows the industry to continue using legacy numbers on claims to ensure payment. These plans must not extend past May 23, 2008.

 

According to CMS, all health care providers are eligible for NPIs and may apply for them. Because they are health care providers, medical students, interns, residents, and fellows are eligible for NPIs. If they do not transmit any health data in connection with a transaction for which the Secretary of Health and Human Services has adopted a standard, they are not "covered" health care providers under HIPAA and are not required by the NPI Final Rule to obtain NPIs. If they do, however, they would be covered health care providers and they must get NPIs.

 



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