The purpose of the two types of NPIs becomes clear if you think about them in the context of a patient receiving treatment in a large hospital. The insurance company not only wants to know which particular hospital the patient visited as identified by the NPI Type 2, but also which of the many hundreds of doctors who work there actually saw the patient, identified by their individual Type 1 NPI.
You can see this in practice on the standard CMS claim form. You will notice that there are spaces for both types of NPI on the form. Many small group practices commonly only include a Type 2 or group NPI on their superbills. It is very common that health insurance companies will not be able to process these claims because the individual rendering provider that treated the patient is not sufficiently identified on the claim.
From the point of view of an insurance company, it is not the group that provides the care but the individual licensed healthcare provider. To successfully process the claim, the insurance company wants both pieces of information. If you have questions about how to obtain an NPI number or what is right for your practice, get in touch! We are happy to share references and help you through the process.
Applying as: Upon selecting the Apply for an NPI for another individual Button, the system will display a popup window asking you to identify whether you are applying for an NPI as an employee of the provider or a surrogate for the provider.
Upon selecting the employer you will be navigated to Provider Profile Page. Apply for an NPI for another an Organization if you are applying for an NPI for an Organization that render health care services or a group practice or furnish health care supplies to patients. If you are applying for an NPI for a sole proprietor please complete an Individual Provider application. Users will be able to view or modify NPI applications for the providers they have access to listed in a grid.
If the provider has more than one NPI application, select the file icon in the Action column to view all NPIs associated with the provider. Users can filter the records provided in the grid by using the Search and Filter box functionality.
You may also write to us at Delta Dental of California P. Box Sacramento, CA Understanding the National Provider Identifier. About the NPI Every health care provider transmitting health information in connection with a standard transaction in electronic form must obtain an NPI.
NPIs are: digit numbers unique to each health care provider or organization. Random numbers that contain no coded information about the provider or organization. Permanent identifiers that do not change over time or expire. Not a replacement for social security numbers, DEA numbers, taxpayer ID numbers, taxonomy specialty numbers or state license numbers. Who needs an NPI? Do you submit claims electronically? Do you use a clearinghouse? Do you submit claims attachments electronically?
Do you use the Internet to verify eligibility or check on the status of claims? Value to you and your practice One simple identifier eliminates the need to maintain and match identification numbers to specific payers for transactions. Allows you to relocate your practice or change specialties without requiring new identifiers from multiple payers.
Helps reduce costs and simplify health care transactions. Faxes are not accepted.
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