The use of National Provider Identifiers (NPIs) was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It is designed to ease the electronic transmission of HIPAA-standard transactions and simplify the administration of the health care system. TRICARE is now collecting NPI numbers in preparation for implementing this requirement later this year.

If you need to get an NPI, Humana Military is here to help. Our Web site offers current information on the NPI transition along with frequently asked questions and directions for you, our providers, to obtain NPIs. The directions include links to the National Plan and Provider Enumeration System (NPPES) Web site and the correspondence address. We also have a web page for direct entry of NPI numbers for network physicians and facilities.

Your 10-digit NPI is an intelligence-free numeric identifier that does not carry information about you, such as the state where you practice, your provider type or specialization. Your new NPI will replace other health care provider identifiers, including Medicare legacy IDs, which are used in HIPAA-standard transactions.

Once you have an NPI, it will not change and will remain with you regardless of job or location changes. Here are some things to remember about NPIs:
      

• The NPI must be used in all HIPAA-standard transactions.
   
• You must communicate to the NPPES any changes to the data elements in your NPPES record within 30 days of the change.
   
• You may receive and use only one NPI if you are an individual provider (physician).
   
• A designated health care component may be assigned multiple NPIs if they are made up of multiple health care providers or subparts.
   
• There will be two categories of health care providers for enumeration purposes:

We are working very closely with our fiscal intermediary, PGBA, LLC, to ensure coordination of TRICARE provider NPI collection for electronic claim filing and to make this a smooth process.

  
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Last Update:  February 20, 2008