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 The Department of Health and Human Services (HHS) adopted the Final Rule for the Health Insurance Portability and Accountability Act (HIPAA) National Provider Identifier (NPI) as the standard unique identifier for health care providers. The NPI is a 10-digit number that will replace all other provider identifiers currently used in HIPAA standard electronic transactions. The rule became effective May 23, 2005 and affects both individual providers (e.g., physicians, nurse practitioners and pharmacists) and organizational providers (e.g., hospitals and pharmacies) who conduct HIPAA standard electronic transactions.
The compliance date for all TRICARE providers is May 23, 2007. The NPI’s goal is to simplify health care administration by enabling more efficient electronic transmission of information related to health care claims, referrals, health plan enrollment, eligibility and other administrative health care transactions.
Any individual providers and provider organizations who have not yet obtained and submitted their NPIs to Humana Military should do so immediately to ensure a smooth transition to use of the NPI.
Individual providers can register their NPIs (Type 1) with us now through Humana Military’s Online Provider Services. Just click on “View and Update Individual Provider Information.” Humana Military is developing additional functionality that will allow providers to register their organizational NPIs (Type 2). We expect this enhancement to be available early in 2007. Check our Web site for future updates. You need to be sure that all of your NPIs have been registered with us before May 2007.
If you have not already done so, providers can obtain their NPI from the NPI Enumerator by applying through a Web-based application or by submitting a paper application to NPPES. You can also obtain a paper copy of the application by calling the NPI Enumerator at 1-800-465-3203 (TTY 1-800-692-2326).
For the latest NPI information from HHS, please visit the CMS Web site. You can also visit the TRICARE Web site for TRICARE-specific NPI information.
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