HIPAA

How Long Does It Take to get NPI Number Issued?

How Long does it take to get NPI Number

Everything has some well-defined setup when we work as medical professionals in the healthcare sector. Medical practitioners and other paramedical staff have to deal with a lot of assigned numbers for undergoing different processes including administrative tasks, generating medical bills and getting reimbursement from the insurers. National Provider Number (NPI) also holds significance while dealing with medical tasks in the hospital setting.

In this article, we will discuss what is an NPI number and how long does it take to get NPI number issued. We will also learn the importance and the basic steps of applying for an NPI number.

What is an NPI Number? 

The national provider number is a unique ten-digit code assigned to medical practitioners in the US. As per HIPAA regulations, it is used to standardize the identification of healthcare providers across various systems, including electronic health records, to keep the clear and authentic details of all transactions made.

It was introduced by the Centers of Medicaid and Medicare (CMS) and used in administrative and financial transactions for each healthcare provider. It is permanent and unique for each medical professional, irrespective of their location, expertise, and employer.

Importance of NPI number

  • Standardization: NPI number provides a standard record for each healthcare professional in the electronic health record database. It is easy to identify a specific practitioner and track his transaction and claims history in legal cases.
  • Simplified transactions: NPI number makes the transaction easy and smooth without having the chance of error when multiple identifiers are used.
  • Compliance: HIPAA makes it mandatory for every healthcare provider to use NPI number while making electronic transactions and claims.
  • Reimbursement: To get reimbursement for your claims from Medicare and Medicaid, you must have the NPI number. Without it, you can not be reimbursed for the medical services you provide.

Who needs an NPI number?

Who needs an NPI number

Every healthcare provider that undergoes HIPAA-covered transactions is supposed to have the NPI number. Electronic transactions are made on the basis of a unique NPI number. Medical professionals who are affiliated with the Medicare program are also supposed to have an NPI number. You should also read this blog to learn more about who is required to have an NPI number.

Medical professionals who are working in hospital settings and use electronic health records for their transactions also need to apply for an NPI number. Medical practitioners providing mental health services, such as counseling, psychotherapy, and behavioral therapy, are recommended to get the NPI number as these specific practices demand this. There are large numbers of providers who use NPI numbers, such as:

  1. Individual healthcare providers (e.g., doctors, nurses, dentists)
  2. Healthcare organizations (e.g., hospitals, clinics, nursing homes)
  3. Healthcare suppliers (e.g., pharmacies, medical equipment suppliers)

Timeline for Obtaining NPI Number

How long does it take to get an NPI number issued? An applicant should receive his NPI number within 15 days on average, but days can extend to 20 if they ask for additional information regarding credentials or personal information. Most applicants receive their NPI number even before ten days if they apply online, submitting accurate information on time.

There are certain factors that have implications for the issuing duration of an NPI number. Incorrect or missing information can directly lead to delays in the processing time. Online applications are much faster than paper applications and help to get the NPI as soon as possible. There can also be some factors from the issuing body that can delay the process. If you are applying at high application volume times, then it is possible to take a few more days for the approval and issuing of NPI numbers.

People also show concern how much they are charged for NPI number application. The good news is the whole process is free of cost. You need to pay nothing to submit the application.

How do you Obtain an NPI Number?

You can obtain your NPI number by using various ways. Applying on the NPPES website online or through a physical paper application can be the feasible option. You can also apply through a third-party method.

To submit an online application, you need to go to the NPPES website. The online application method is efficient, and you can get your NPI number in a few days.

The paper application can be downloaded from the CMS website. The filled application should be sent to the NPI Enumerator address mentioned on the application. It takes more days to process. This method is very outdated, and only a few people use it.

Another way is a third-party method, and which is used when there is a high application volume, and you want to get the NPI as soon as possible. In this method, you give permission to the Electronic File Interchange Organization to fill out and submit the application on your behalf. It makes the overall process fast and efficient.

You need to follow the following steps to obtain an NPI number.

1. Creating an account on the NPPES website

First you need to go to the NPPES website and click on the ‘create to login’ option. You need to have the correct and working email where you will get all the updates and information about your account and application status. Complete your signup process by submitting your personal information, username and password.

2. Completing the Online Application Process

After account creation, apply for the NPI number application. Open the NPI number application form from the dashboard and fill all the required information correctly. You need to have your correct personal information, educational credentials, training certificates, licenses, and other professional credentials.

Give a thorough review before submitting the application to avoid any irregularities in the process due to incorrect or missing information. Submit the application, and you will receive a confirmation email from the website. A reference number will be sent to your email, and you can track your application status using that reference number.

3. Verification and Approval

The NPPES system is supposed to verify your personal as well as professional information. An NPI number is issued if all the given information is correct. You will receive an email from the NPPES system about the details of your NPI number. Email will also guide you on how to access and use your NPI number in electronic transactions.

Final Thoughts on How Long does it take to get NPI Number

Medical professionals who are not aware of the NPI number ask multiple queries about its application process and importance. They often question how long does it take to get an NPI number issued, or finding an NPI Number. NPI number is a unique code allotted to medical professionals, which helps them make their transactions smooth and error-free. By getting an NPI number, medical professionals comply with HIPAA regulations, and all transaction details are saved electronically. Any regulatory authority can get access to their records if needed.

You can get an NPI number by applying online or physically. It takes 15-20 days to get the NPI number if things go smoothly. Professionals can also use a third-party system to apply for an NPI number. The online method is the best as it is fast and efficient. You need to have an account on the NPPES website account, and then you can submit the application.

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