National Provider Identifier

Misinformation about the National Provider Identifier (NPI) is spreading.

miércoles, 21 de junio del 2006

Just as we experienced with HIPAA, misinformation about the National Provider Identifier (NPI) is spreading. Dentists considering purchase of commercial NPI implementation guides should know that NPI enumeration is free to all eligible health care providers. In addition, dentists should avoid falling prey to NPI myths:

  • 2006 compliance deadline. The deadline is May 23, 2007.
  • Dentists are required to have NPIs. Technically, only dentists who use HIPAA standard electronic health care transactions will be required to use NPIs. It’s possible some health plans may require the NPI on paper claims, but current indications are that many won’t, at least for now.
  • Claims won’t be paid without an NPI. Possibly, if a claim is submitted electronically without an NPI on or after the May 23, 2007, deadline. It’s impossible to say with certainty how much a paper-based dentist will need to use NPIs. Many paper claims doubtless will be processed and paid normally without NPIs up to the deadline and probably for some time after. For this reason, paper-based dentists may want to consider applying for NPIs. But they don’t have to pay anyone to do that for them and in most cases won’t need to pay anyone to teach them how to use their NPIs.
  • Prescriptions won’t be honored without NPIs. While it’s true that some states may require provider identifiers on pharmacy transactions, federal law doesn’t require use of the NPI on prescriptions, whether electronic or paper.
  • More information about the NPI is on and in an ADA News article online.


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