HHS OIG Recommends CMS Require NPIs for Ordering Providers

HHS OIG recommends that CMS require MAOs to submit NPIs for ordering providers. Explore the reasons why this information would be helpful to prevent FWA, and the concerns from payers in regard to the accuracy of CMS encounter data.

Quick Guide to Understanding National Provider Identifiers (NPI)

Understanding NPIs

Most healthcare professionals are familiar with the term NPI (National Provider Identifier) because it is commonly used to validate and verify a wide range of authentication, process control, individual claims, contracts/agreements, and much more. With so many NPI searches happening on a daily basis, we want to help quickly identify the framework and functionality of […]

Three Things to Know about NPI in Healthcare

Three Things to Know about NPI in Healthcare

Covered entities under HIPPA must use NPI’s to identity health care providers in HIPPA standard transactions. The NPI number is required to submit claims or conduct other transactions specified by HIPPA. By definition, a health care provider” is an individual, group or organization that provides medical or other health service or supplies.”  This would include physicians an other practitioners, physician/practitioner groups, institutions such as hospitals, laboratories and nursing homes, health maintenance organizations and suppliers such as pharmacies and DME companies. However, it does not include health industry workers such as admissions and billing personnel, housekeeping staff, orderlies and those who support the provision of health care, but do not provide health care services.