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National Provider Identifier (NPI)

Avoid rejected or denied claims. All providers are urged to begin using their NPI number on all claim submissions now!

After May 23, 2008, claims submitted without NPI numbers will be rejected. If a claim has an NPI that we cannot match to our records or the Department of Public Welfare’s (DPW’s) files, the claim will be denied for invalid NPI.

NPI Resources

DPW NPI Guidance and Bulletins

If you are a health care provider who bills for services, you probably need an NPI. If you bill Medicare for services, you definitely need an NPI. Getting an NPI is easy. Getting an NPI is free.

The first step is to get your NPI. Once you obtain your NPI, it is estimated that it will take 120 days to do the remaining work to use it. This includes working on your internal billing systems, coordinating with billing services, vendors, and clearinghouses, testing with payers. As outlined in the Federal Regulation, (the Health Insurance Portability and Accountability Act of 1996 - HIPAA) you must also share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes. If you delay applying for your NPI, you risk your cash flow and that of your health care partners as well.