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National Provider Identifier The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and Human Services (HHS) adopt a standard unique health identifier for health care providers. HHS has created the National Provider Identifier (NPI) in response to this mandate. All HIPAA covered health care providers, whether individuals or organizations, must obtain an NPI for use on all HIPAA electronic transactions. It is also recommended that providers sending paper claims use the new HCFA 1500 professional claim form that became available in October 2006, and the UB04 institutional claim form, which will become available in April 2007. These new forms will have a field specifically for the NPI. Humana is implementing the use of NPIs earlier than the nationally mandated date in order to work through any issues that may arise. This time frame, known as the dual identifier period, began on October 20, 2006. Providers may send in their NPI(s), Tax ID and any Humana proprietary IDs they have sent in the past on electronic transactions. Upon the complete implementation of NPI by May 23, 2007, it will be the sole provider identifier, replacing the multiple provider identification numbers that have been used in the past. Use of Medicare UPINs, proprietary payer IDs, CHAMPUS numbers, Medicaid IDs, etc. will no longer be permitted as of May 23, 2007. To submit NPI(s) to Humana, visit www.humana.com and click on “Providers,” then “Provider Resource Center.” Then, select “National Provider Identifier” to see NPI FAQs and the NPI submission forms. Providers can print the forms from this site and complete them. Completed forms can be faxed to (800) 626-1686 or mailed to:
Providers who have not yet applied for an NPI can do so in one of the following ways:
To have an application form mailed or for more information about the NPI application process, contact the NPI Enumerator directly at (800) 465-3203. |
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