NPI - National Provider Identifier
Effective May 23, 2007, NPI is the standard 10-digit identifier for healthcare providers to use when filing and processing healthcare claims and other transactions by the Centers for Medicare and Medicaid Services (CMS).
Medisoft uses four types of NPI numbers:
* Assigned Provider NPI - Provider that renders services to the patient
o Click Lists, Referring Providers, Edit the provider, click the Default PINs tab, and enter the provider's NPI number in the National Identifier field, Save
* Referring Provider NPI - The provider that refers patients
o Click Lists, Provider, Providers, Edit the referring provider, click the Default PINs tab, and enter the referring provider's number in the National Identifier field, Save
* Facility NPI - Where the services were rendered
o Click Lists, Addresses, Edit a Facility type entry, enter the facilities's NPI number in the National ID field, Save
o Click the PINs tab, enter the PIN and Qualifier numbers, Save
* Group NPI - Group of providers number
o Click Lists, Referring Providers, Edit the provider, click the PINs tab, and enter the Group ID, Save
Medisoft Provider Class ID - used if you have a single NPI number you need to associate to multiple providers
* Click Lists, Providers, Class, New, enter the following:
o Class ID
o Class Name
o Description
o National ID (available only in pre-v16 versions)
* You can reference this Class ID by the following:
o Edit a Provider in the Provider list
o Click the Default Group IDs tab
o Select the Provider Class in the drop-down field
The new CMS-1500 vs the old HCFA-1500 forms:
- CMS-1500 replaces the HCFA-1500 forms
- CMS-1500 has eight new fields:
- four for the new NPI numbers
- four for the legacy PINs
Medisoft versions that support NPI and the new CMS-1500 forms:
* Medisoft 11 Service Pack 4
* Medisoft 12 and newer (version 14, 15, 16, etc)
* Click here for Medisoft Service Packs
NPI Qualifiers:
* 0B State License Number
* 1A Blue Cross Provider Number
* 1B Blue Shield Provider Number
* 1C Medicare Provider Number
* 1D Medicaid Provider Number
* 1G Provider UPIN Number
* 1H CHAMPUS Identification Number
* EI Employer's Identification Number
* 1J Facility ID Number
* B3 Preferred Provider Organization Number
* BQ Health Maintenance Organizaton Code Number
* FH Clinic Number
* G2 Provider Commercial Number
* G5 Provider Site Number
* LU Location Number
* N5 Provider Plan Network Identification Number
* SY Social Security Number (not to be used for Medicare)
* U3 Unique Supplier Identification Number USIN
* X5 State Industrial Accident Provider Number
* ZZ Provider Taxonomy
NPI numbers can be searched on the CMS website.
