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National Provider Identifier (NPI)

The National Provider Identifier (NPI) is a new 10-digit identification number that will be assigned by the Centers for Medicare and Medicaid Services (CMS) to providers who are covered by the provision of HIPAA.  Health plans, clearinghouses and covered health care providers that submit claims or other information electronically will be required to apply for and use an NPI.  Providers will apply for a single NPI that they will keep for the rest of their careers.

  • Every EqualityCare provider that meets the definition of a healthcare provider (as defined by CMS) will be required to obtain an NPI, regardless of whether they bill their claims electronically or on paper.
  • EqualityCare will require its providers to use taxonomy codes in conjunctiuon with their NPIs when billing claims electronically or on paper

NPI NEWSLETTER    

PHARMACY NPI NEWSLETTER

Key Dates to Remember:

All providers enrolled with EqualityCare are required to obtain a National Provider Identifier (NPI) regardless of whether they bill claims electronically or on paper.  INformation regarding obtaining and registering your NPI has been submitted to Wyoming medical professionals over the past 14 months and is still available on the ACS website at http://wyequalitycare.acs-inc.com/NPI.html.  The deadline is fast approaching for compliance with this requirement. 

In addition, providers must use the current claim forms (UB-04 and CMS-1500 8-05).  Claim forms received by ACS on or after September 1, 2007 for EqualityCare payment that do not meet the foregoing requirements, will be rturned, unprocessed to providers.

Getting an NPI is free - not having one can be costly!