National Provider Identifier (NPI)

It’s Not Too Early to Prepare for NPI

The Health Insurance Portability and Accountability Act (HIPAA) requires the adoption of a standard 10 position unique identifier for health care providers effective May 23, 2007.  The unique identifier is the National Provider Identifier (NPI), which will replace health care provider identifiers used in HIPAA standard transactions today.  All health care providers who are HIPAA covered entities must obtain NPIs to identify themselves in HIPAA standard transactions by May 23, 2007.  Small health plans are allowed an additional 12 months to comply.  Please note, participating providers are HIPAA covered entities.  For more information on obtaining your NPI, you may visit the CMS website at http://www.cms.hhs.gov/NationalProvIdentStand/03_apply.asp.

Help Ensure a Smooth Transition – Contact CMS Now to Obtain NPIs

With just under a year until the new NPI requirements are implemented, providers are encouraged to obtain their new NPIs now from the Centers for Medicare and Medicaid Services (CMS).  If you have not already done so, visit the CMS website at www.cms.hhs.gov/NationalProvIdentStand/ . 

Healthy Start Program is working to comply with the federal mandate and to ensure uninterrupted operations with the provider community. 

Register Your NPIs with Healthy Start Program.

Healthy Start Program encourages providers to register their NPIs as soon as possible.  Registration ensures our internal systems accurately reflect your NPI information.  After receiving your NPI, please complete our online submission form, at https://npi.wellpoint.com, to register your NPI. 

**NEW **NPI Batch Enumeration Registration:
In order to assist provider groups and large facility providers, Healthy Start Program has created a new process for providers to submit multiple NPIs at one time.  This process, known as the NPI Batch Submission Process, allows provider groups to submit multiple NPI entries along with additional identifying information using an MS Excel file template.   The MS Excel file template is available for downloading on the NPI Online Submission Web Site at https:\\npi.wellpoint.com.    Also on this site, you will find instructions on how to complete the MS Excel file template.  The completed MS Excel File can be sent to our NPI Bulk Submission address at npi.bulk.submission@wellpoint.com, or it can be faxed to your respective Provider Network Representative at 978-474-6188. Healthy Start Program encourages providers to register their NPIs with us as soon as possible. 

 Assess System Capabilities Early

Preparation for NPI may also require providers to assess and upgrade their existing systems or have discussions with their electronic vendors to ensure compliance with NPI requirements.  Contact your vendor today. 

In addition, testing is a key component of the NPI preparation process.  A physician office or facility may be able to minimize problems by testing early with electronic vendors and Healthy Start Program.  By preparing in advance, providers can help ensure a seamless conversion to NPI, minimizing any potential payment disruptions in their operations with Healthy Start Program.

Healthy Start Program will begin accepting the National Provider Identifier effective October 1, 2006 as long as the NPI is accompanied with the provider’s current Healthy Start Program provider identification number.

HIPAA Frequently Asked Questions