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Did You Remember to Include Your NPI?  (Article 5)

As of May 23, 2007, providers are required to use their National Provider Identifiers (NPIs) when submitting claims to TRICARE.
This 10-digit number is the standard unique identifier now used to recognize providers in standard electronic claims. As a requirement of the Health Insurance Portability and Accountability Act (HIPAA), all providers, including those in the Military Health System, are to now comply with this rule.

The HIPAA NPI rule affects both individual and organizational providers including:
 
  • Physicians
  • Nurse practitioners
  • Pharmacists
  • Hospitals
  • Pharmacies
Using the NPI eliminates the need for providers to utilize multiple identifiers when submitting claims for various health plans. This simplifies health care administration by enabling more efficient electronic transmissions of health care claims, referrals, enrollment and eligibility information and many other managerial transactions.

For TRICARE-specific NPI information, please log on to www.tricare.mil/hipaa/identifiers.html. Getting an NPI is free. For information on how to obtain your NPI, please visit the Centers for Medicare and Medicaid Services Web site at
www.cms.hhs.gov.

  
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Created: July 9, 2007