According to the American Dental Association’s website (http://www.ada.org/prof/resources/topics/npi.asp), the NPI is described as:
The National Provider Identifier (NPI) is a unique, government-issued, standard identification number for individual health care providers and provider organizations like clinics, hospitals, schools and group practices. The government has contracted with an external company for processing applications and developing these random 10-digit numbers for applicants. Applications to obtain an NPI began on May 23, 2005.
Any health care provider who uses standard electronic transactions, like electronic claims, eligibility verifications, claims status inquiries, and claim attachments, will be required by federal law to start including NPIs on electronic transactions not later than May 23, 2007. In addition, those dentists who use only paper, voice and fax to transmit these communications may find NPIs useful or necessary for other reasons. Many dental plans will require dentists to include NPIs on paper claim submissions, so even paper based dentists may find it a necessity to have NPIs. The ADA encourages all dentists to apply for NPIs, particularly those using (or planning to use) electronic transactions. The NPI has some advantages over identifiers now in use:
· Once implemented across the health care industry, the NPI will be accepted by all dental plans as a valid provider identifier on electronic dental claims and other standard electronic transactions.
· Dentists will not have to maintain multiple, arbitrary identifiers required by dental plans, nor will they have to remember which number to use with which dental plan.
· Introduces an important element of standardization to electronic transactions that should improve transaction acceptance rates.
However, the NPI does not do any of the following:
· Replace the DEA number when required for prescribing controlled substances or other DEA-regulated activities.
· Replace state-issued licenses and certifications verifying a provider's licensing or qualifications.
· Replace Social Security Number, Individual Tax ID, or Employer ID for tax purposes.
Prepare your practice for the NPI transition period by obtaining all necessary NPIs, share your NPI data with your patients’ health plans, your clearinghouse, your system vendor, and fellow health care providers who will need it for billing purposes.
Applying for an NPI is free and relatively easy: To apply via a secure web-based process, visit the National Plan and Provider Enumeration System (NPPES) Web site, read the instructions carefully, complete the questionnaire, and submit your application. This takes about 20–30 minutes. After confirmation of your data’s receipt, you should receive your NPI via e-mail in one to five business days. Please note that if you have spam filtering on your email interface, the reply from the NPI Enumerator with your NPI and confirmation message may be intercepted and diverted to a spam folder. If your email service supports such a feature, please be sure to check this folder regularly after submitting your data. The message will come from [email protected]. If you prefer to submit a paper application, contact the NPPES customer service hotline at 800-465-3203 to request a paper application form. The paper application process takes approximately 20 business days.
Questions about the status of an NPI application may be e-mailed to [email protected].