Bulletin: July 7, 2005

NPI Implementation

By: Candace Winering, HARP Technical Writer

As of May 23, 2005, healthcare providers can apply for and obtain the National Provider Identifiers (NPI) that will be required by HIPAA regulations for standard transactions. NPI will replace payer-specific identifiers by May 23, 2007 (2008 for small health plans). During the 24-month implementation period, healthcare payers must phase out their current identification system and transition to the NPI for electronic transactions. Both a payer-specific provider number and NPI may be used during this period.

Since some providers might currently use multiple provider numbers when submitting claims to a payer, depending on the enrollment plan, location, service, etc., payers must devise a way to map these multiple provider numbers to a single NPI. Once payers have developed and published their requirements for NPI, Quadax will make the necessary programming changes to our systems to accommodate the new requirements. Quadax is committed to making this a smooth transition and will inform you when NPI can be accepted into HARP and Xpeditor.