Final Rule Overview All HIPAA covered healthcare providers, whether they are individuals or organizations, must obtain an NPI for use to identify themselves in HIPAA standard transactions. The NPI remains with the provider regardless of job or location changes.HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Aware that health plans may lift their contingency plans (and require an NPI on claims or other HIPAA transactions) any time before May 23, 2008. Working with vendors and clearinghouses with whom they contract, to make sure the NPI is being passed to health plans. Paying close attention to how and when health plans will be testing implementation of the NPI. Aware that, for those health plans that did not establish a contingency plan, providers are required to use their NPIs now.Examples of standard transactions are:(4) Do I need an NPI if I only bill on paper or via the Web?
The NPI replaces all "legacy" provider numbers that are currently being used including:(2) What is the National Provider Identifier (NPI) Requirement?Providers should also consider letting health plans, or institutions for whom they work (e.g.a large hospital system), share their NPIs for them.A: As a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the federal Department of Health and Human Services has mandated the use of the National Provider Identifier (NPI).On January 23, 2004, CMS defined and published the Governing Rules for NPI.