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  National Provider Identifier FAQ's

Q: What is NPI?
A: NPI stands for National Provider Identifier. It is a standard unique health identifier for health are providers that was adopted by the Secretary of Health and Human Services (HHS) as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Q: If a physician has His/Her own private practice and still works for a health center on a part-time basis, how do we use His/Her NPI when billing for His/Her services performed for the health center?
A: Please contact the ACS call group at (808) 952-5570 for more information.

Q: If a facility bills for different health plans, how does the NPI get shared?
A: The provider is responsible for sharing his or her NPI across plans.

Q: When I register for an NPI, how long should it take from the time I sign up to get my NPI letter?
A: The actual enumeration process is being performed by Fox Systems (the Enumerator). We would have to refer you to the Enumerator for their current processing time.

Q: Is there a processing fee to get an NPI?
A: No. Applying for and obtaining an NPI is free.

Q: Is there a soft copy of the NPI power point presentation that can be emailed?
A: Yes. Please send that request to npihi@acs-inc.com. You should receive the presentation within two business days.

Q: What is a small health plan?
A: A small health plan is defined at 45 C.F.R.§ 160.103 as “a health plan with annual receipts of $5 million or less.

Q: Do Waiver services require an NPI? Why?
A: Most waiver services will not require an NPI; however, you MUST check with us to verify whether or not one is required for your Legacy ID,

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Q: When will the updated 1500/UB92 forms be available to use?
A: The 1500 is currently available. The UB04 (new UB92 form) is available from your supplier; however, ACS will not be able to accept them until April 1, 2007.

Q: How do I obtain more information on NPI?
A: You can obtain more information on NPI by calling the ACS call group at (808) 952-5570.

Q: If a provider has several service locations, does each facility need a separate NPI?
A: No. The single NPI will encompass all locations.

Q: Does each individual employee of an office need an NPI?
A: The best rule of thumb to follow is: If a provider is required to have an NPI, that provider should obtain one.

Q: Is providing a social security number necessary to receive an NPI?
A: The actual enumeration process is being performed by Fox Systems (the enumerator). Please contact the Enumerator for application questions.

Q: How is the agency protecting personal information given for the NPI?
A: The actual enumeration process is being performed by Fox Systems (the enumerator). Please contact the Enumerator for questions in regards to their internal procedures.

Q: When I obtain an NPI do I have to share with all healthcare insurances? Why?
A: This will be your unique identifier, not sharing your NPI could lead to loss of revenue.

Q: Where can I find a sample form for the NPI application?
A: We could not locate a sample of the NPI application; however, you can apply at https://nppes.cms.hhs.gov/NPPES/Welcome.do

Q: If a provider is part of a group and also part of a private practice, will a separate application be filled out for each?
A: No. The provider will only need to fill out one NPI application.

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Q: Do Healthcare medical suppliers require an NPI?
A: DME providers do require an NPI.

Q: Will the old 1500 Form be considered if supplies/services were given out before 08/01/2007?
A: After 08/01/2007, ACS will no longer accept the old 1500 form.

Q: Does Non-Emergency Transportation require an NPI?
A: Transportation provider should not require an NPI; however, you MUST check with us to verify whether or not one is required for your Legacy ID.

Q: When are health care providers required to use the NPI?
A: Effective August 1, 2007.

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