Having your NPI number should be a top priority for every physical therapist, whether you’re just starting out or a seasoned pro.
This 10-digit identifier is the number that must be used on claim forms submitted to payers by individual and organization health care providers who meet a broad definition of a “covered entity” under the Health Insurance Portability and Accountability Act, or HIPAA.
All Medicare-eligible providers must also have an NPI. For both public and private health insurance programs, the NPI replaces any legacy or billing numbers.
Who Can Get an NPI
All HIPAA-covered health care professionals, whether individuals or Providers of health care who do certain transactions electronically.
A clearinghouse for health-care information organizations, must obtain an NPI registry options. A “covered entity” is a health care provider who transmits any health information in an electronic format, such as when filing a claim. This includes the following:
Even if you utilize a business associate to do so, you are considered a “covered entity” if you electronically transmit health information in connection with a HIPAA standard transaction.
Applying for NPI
A web-based application process, a file exchange system, or ordinary mail are all options for obtaining an NPI number from CMS.
We suggest using CMS’ web-based application because it is the most efficient.
See CMS’s page on how to apply for an NPI number for further information. Once you’ve gathered the relevant documentation, such as your social security number and state license information, filling out this online application takes less than 30 minutes.
What is the purpose of an NPI NUMBER?
NPI came into existence with the intensions to improve the efficiency of healthcare. The following are some of NPI’s other goals:
- It comes in handy when it comes to billing.
- It is beneficial to process claims.
- The National Plan and Provider Enumeration System will provide you a full record of yours by entering your NPI number.