As you may know, the Health Insurance Portability and Accountability Act (HIPAA) regulations require providers who conduct standard electronic transactions to begin using their new National Provider Identifiers (NPIs). And if you haven’t taken steps to comply with this new regulation, there’s no better time than the present to avoid cash flow disruptions.

TRICARE, like the majority of other payers, will not deny claims for failure to include the provider’s NPI on the HIPAA-standard electronic transaction before the compliance date. However, to facilitate the use of NPIs as a routine practice for the submission of HIPAA transactions, providers are encouraged to use their NPIs as their primary provider identifier as soon as possible.

Providers may continue to provide their legacy identifier in support of their NPI until further notice.

• Obtain your NPIs from the National Plan and Provider Enumeration System  (NPPES) for electronic issuance or to obtain a copy of the paper application).
  
  
• Share your NPIs (both individual and corporate) with your payers, your area’s inpatient/outpatient
  facilities, other physicians that you deal with regularly and pharmacies.
  
  
• Use your NPIs in all standard electronic transactions especially if you are a TRICARE network provider required to file
  your claims electronically (with your NPI).
  

Instructions for how to register your NPIs with Humana Military (and answers to frequently asked NPI questions) can be found on
our Web site. And please make sure your staff members work with your practice management system and/or your clearinghouse to find out exactly what you need to do to use your NPIs in standard electronic transactions.

If you need help filing your claims electronically, refer to PGBA, LLC’s XPressClaim^SM service. XPressClaim is HIPAA-compliant, it’s free, payment results are returned instantly and you can use XPressClaim to file your claims where TRICARE is the secondary payer.

Keep in mind:

• There are two types of NPIs- one for individuals and one for organizational entities. Make sure you obtain both if it’s appropriate for your practice. Individual practitioners can have only one NPI.
  
  
• The referring physician’s NPI is required only if it’s known. TRICARE will not reject claims for a failure to submit the
  referring physician’s NPI. However, all providers are encouraged to obtain the referring provider’s NPI and include it on
  the relevant transaction.
  
  
• Filing electronically gets you paid much faster!
  
  

  
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Created: May  23, 2007