Ensuring NPI compliance during electronic transactions

Due to HIPAA, all healthcare organizations – including small medical facilities and private doctors – need to use 10-digit numbers assigned to them by DHHS to simplify their communications with health plan providers. While many medical facilities weathered this transition smoothly before the 2007 deadline, some newer doctors and practices may be wondering exactly how they can ensure NPI compliance with all of the recent technological upgrades, such as electronic medical billing, that they've been implementing.

One common question asked by doctors is whether they're able to send other identification numbers – such as PVN, PIN or TIN – through certain types of electronic transactions. However, facilities may only use one of these identifying numbers in certain situations, and by doing this correctly, hospitals could save the time and effort that occurs with multiple filings.

For example, the use of a TIN is allowed when these facilities are processing billing for providers in claims and payees in remittance. But, an NPI must still be used to identify healthcare providers that are covered in these situations, according to the health insurance products company Aetna. In addition, providers that are simply submitting information or utilizing a management organization don't need to be identified with this number.

While these are just a few examples, doctors and medical facility mangers who want to understand how they can better comply with these provisions may want to turn to an experienced consulting firm. By talking with a company that can provide installation and support during the process of switching to new eprescribing and medical billing software from trusted vendors like Medisoft and Practice Choice, these organizations can ensure their employees will continue to process transactions according to federal and state mandates.