HIPAA Compliance

NPI and HIPAA Compliance

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and Human Services adopt a standard unique health identifier for health care providers. On January 23, 2004, the Secretary published a Final Rule adopting the National Provider Identifier (NPI) for this requirement. All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain an NPI to identify themselves in HIPAA standard transactions. Once established, a provider's NPI will not change. The NPI remains with the provider regardless of job or location changes.

Effective May 23, 2007, the Centers for Medicare & Medicaid Services (CMS) claims processing systems will only accept claims that include NPI numbers.  At the same time, all providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use the NPI to identify covered healthcare providers in standard transactions. 

Now is the time to prepare and to ensure that providers using Lytec can continue to send electronic claims successfully.   

To apply for an NPI number please visit: https://nppes.cms.hhs.gov/NPPES/Welcome.do 

For more information on NPI and other industry changes, please visit:
http://www.cms.hhs.gov/hipaageninfo