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National Provider Identifier (NPI) Public Workshop 1.

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Presentation on theme: "National Provider Identifier (NPI) Public Workshop 1."— Presentation transcript:

1 National Provider Identifier (NPI) Public Workshop 1

2  Phase I- Overview Present project overview and objectives Gather information from the provider community  Phase II-Implementation of Solution Collaborate to determine system/processes to be used Employ solution 2

3  Obtain the total number of Medicaid personal caregivers within the state of Nevada and catchment areas  Ensure the number of caregivers meets the needs of the growing Medicaid population  Improve quality of care by ensuring recipients receive the care they need  Assist providers by offering a business system tool  Contain the cost of the program by avoiding inaccurate billing 3

4  Employers will provide or make available, the names of their individual caregivers that are used to provide services to Medicaid recipients  A registry IS NOT a public list of all caregivers nor are there plans to release this information publicly  A registry IS NOT a credentialing tool or verification system  Caregivers will need to have a unique personal identification number to track across agencies  One way to obtain a unique personal identification number is to obtain an NPI 4

5  A NPI is a federally issued, standard, unique identification number for health care providers and health plans.  The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty.  There is no cost associated with obtaining a NPI and the estimated time to complete the application is 20 minutes.  Turnaround time for obtaining a number is almost instantaneous. 5

6  A NPI uses personal data such as an SSN and date of birth when issuing the number ◦ Less likelihood of misidentifying or duplicating a caregiver ◦ The current Medicaid system, MMIS, does not have capabilities to capture this information  A provider's NPI is permanent and remains with the provider regardless of job or location changes.  It is a national number to assist tracking caregivers across states  Providers would no longer have to keep track of multiple numbers, NPI could be used as employee ID, etc 6

7  Provider Name  Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN)-if not eligible for SSN  Provider Date of Birth  Country of Birth  State of Birth (if Country of Birth is U.S.)  Provider Gender  Mailing Address  Practice Location Address and Phone Number  Taxonomy (Provider Type)  State License Information  Contact Person Name  Contact Person Phone Number and E-mail 7

8  You can apply on line at, by calling (800) 465-3203, by sending the completed signed application to:  NPI Enumerator  P.O. Box 6059  Fargo, ND 58108-6059  More information can be found at: 8

9  Ease of scheduling visits  Reduced administrative time to administer program  Standardization of processes  Reduction of paper-based processes  Reduction in overhead  Real time alerts of scheduling problems (missed visits, late visits, unscheduled visits, etc)  Automated claim generation and submittal  Improved billing accuracy 9

10  Increased speed of payment (most claims should be clean and approved on first pass)  Improved cash flow  Schedule only approved units  Improved accountability of service providers  Enhanced information on clients, visits and service providers to help gain efficiency in operations  Access to real-time visit data 10

11  Improved service delivery  Adherence to care plan  Improved quality of care  Improved coordination of care/allows for coordination of care across programs 11

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