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What Is an NPI Number? And Why Do Healthcare Providers Need It?

The (NPI) National Provider Identifier number is a ten-digit number given to every healthcare provider and stakeholder under the health insurance portability and accountability act (HIPAA) as a simplification for administration. The number does not contain personal information about the healthcare provider; it is only used in financial and administrative transactions as stipulated in the HIPAA standards.

All professionals who hold certification in medicine or are simply eligible to perform a medical task for a patient or assist a patient in getting insurance for billing are qualified to obtain the NPI number.

Why Do Health Care Providers Need NPI Numbers?

NPI Number Ease the Administrative and Financial Transactions

When you become a health care provider, there are several steps that you need to take to ensure that you are compliant with the underlying standards, such as HIPAA or insurance credentialing. Also, undertaking all these steps will provide a smooth reimbursement if necessary.

And one of these critical steps is obtaining the NPI number. The HIPAA act of 1996 is a federal law accredited to creating standards to protect patient information. And such information should only be disclosed with the knowledge and consent of the patient. Yet another question arises on who needs to obtain the NPI number.

Firstly, to obtain the NPI number, you must have completed training in medical procedures and be accredited, even though formal training is not the only qualification needed for healthcare providers to obtain a  national provider identifier number. Healthcare providers who don’t have the [NPI number] will always have difficulty doing insurance billing and other financial and administrative transactions.

Helps New Healthcare Providers Appear On the Professionals’ List

The new healthcare providers who have recently graduated in their health training, such as the national institute for whole health, can obtain an NPI number to have a smooth engagement in their professionalism. Upon getting the [NPI number], recently graduated medical professionals can engage with free-standing clinics to offer their services in their field of training.

NPI number also eases the process of receiving payments for health care providers when they offer their services. It also enables patients to either make a full or partial reimbursement of their private or flexible insurance plan. The health care educators who have completed the appropriate training are also eligible to apply for the NPI number.

NPI Numbers Help to Prevent Healthcare Fraud

Besides standardizing the healthcare provider identification, the NPI number is critical in helping prevent fraud in the healthcare system. The NPI number helps to identify the specific healthcare provider who was attending to the patient, ordering supplies and equipment, and prescribing the patient.

Even though the [NPI number] does not necessarily mean that the healthcare provider is appropriately licensed, the credentials can be combined with other elements to detect and prevent fraud in the healthcare system.

Summary

The (NPI) [National Provider Identifier number is a ten-digit number] given to every healthcare provider under the health insurance portability and accountability act as a simplification for administration (HIPAA). Some of the reasons why healthcare providers need to have the [NPI number] are to ease administrative and financial transactions, help new graduates appear on the healthcare professionals list, and also help to prevent healthcare fraud.

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