NPI Number or National Provider Identifier is a 10-digit number that is assigned to healthcare organizations and individual care providers. It is shared with patients, health plans, employers, and the third-party payer when applicable. Recent administrative simplification provisions of the HIPAA have encouraged all care providers to get NPI numbers. So, if you have not signed up for it yet, you have been missing out on the following benefits.
Electronic Transmission of HIPAA Standard Transactions
Transmission of the information is done in a matter of minutes thanks to high-speed communication lines and the internet. However, HIPAA prevents healthcare providers from transmitting patient-sensitive information via means that are available to the common public. Healthcare organizations and providers require separate software that is used to communicate with other organizations and practices.
Care providers must also get an NPI number since it is now the norm in the United States. You may not be entertained by other organizations if the information is sent without an NPI number.
With the NPI number, practices can report data electronically, claim payment from health plans, and get paid directly into the practice’s accounting software.
Efficient Coordination of Benefit Transactions
Some patients have multiple health plans and each of those offer a varying set of benefits. For example, a certain health plan may not allow MRI for elective procedures whereas another can offer it to the patients. As per the latest HIPAA regulations, such patients are eligible for coordination of benefits. It essentially means that all of the patient’s plans can be clubbed together.
For example, if a patient is admitted under a plan which covers medical costs but not the surgical and he has another plan which covers surgical but not medicine. The latest regulations will compel the providers to provide both types of care. Now, this would be a problem as keeping track of all plans simultaneously is a taxing task. However, with the NPI this can be made easier. You just have to enter an NPI number in the system and it will show you all the details that you need.
Unique Identifier for Healthcare Plan
NPI number is also assigned to healthcare plans which makes it easier for providers to determine which services will be paid. You don’t have to be in constant contact with the plan every time there is a need for a procedure or expensive medication.
Understand Profitability of Practice
HIPAA transactions are saved in the system. It means all the records related to procedures and their payment is available to practitioners at all times. You can log in to the system and find the details of procedures against the collected payment anytime. This can help you determine which procedures or treatments are making most profit and those that are making loss. You can optimize the practice for more profitability with this information.
Protects Patients from Fraud
NPI number helps patients identify the providers which creates trust between both parties. This bond will help the patients and the providers in exchange for information related to patients’ health. It will also help in getting the patient to comply with the prescribed treatment.