Introduction:
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.
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 include NPIs on electronic transactions. There are two types of NPIs
- Type 1 NPI is designated for an individual provider. If the office bills insurance carriers under a single provider’s name and therefore, receive insurance reimbursement for the office using the individual provider’s name, the individual billing provider’s entry in Denticon should be recorded using the Type 1 NPI.
- Type 2 NPI is designated for a corporate entity. If the office will bill insurance carriers under a corporate name and, therefore, receive insurance reimbursement for the corporate entity, a corporate provider entry should be entered into Denticon. The Type 2 NPI will be recorded for this provider entry.
Process description:
If the office bills insurances under a corporate billing provider, the NPI 2 number will need to be entered in the provider setup for the billing provider.
Prerequisites:
The user must have obtained the NPI 2 number for the location.
The user must have the necessary security right. "Setup-Provider Screen Full Control"
Step-by-step instructions:
- Go to Setup>Providers>Provider Setup.
- Locate the billing provider for the office.
- Enter in the NPI 2 number into the field labeled "NPI #"
Additional information:
Our office is obtaining National Provider Identification Number (NPI) for our providers. What is the difference between the Type 1 and Type 2 NPI? – Planet DDS