The NPI is a ten-digit number given to each healthcare provider by the Centers for Medicare and Medicaid Services (CMS). It is a requirement for Medicare services as well as for other users, such as commercial healthcare insurance. Your NPI is permanent regardless of job or residence changes. Your NPI profile includes your name, contact information for your office, and specialization.
The NPI lookup Final Ruleset is a standard for a unique health identifier for use in the healthcare system by healthcare providers. The nationwide standard streamlines operations and minimizes administrative costs for healthcare providers.
How to Keep the NPI Number Private?
If your NPI is taken, you may be allocated millions of dollars in fraudulent claims or hundreds of phony prescriptions before you or anybody else recognizes what has occurred. If this happens, you may be the subject of a government investigation to rule you out as a suspect and/or discover if you are responsible for the fraud.
While the inquiry is underway, CMS is also likely to stop paying you. This may have a severe influence on your money, reputation, and, as a result, your career. However, there are steps you can take right now to avoid having your NPI stolen and perhaps averting large-scale healthcare fraud.
Know When to Share Your NPI
Keep an eye on your surroundings. Be careful while disclosing your NPI. If you do tell your NPI, be wary of who is using it and for what purpose.
Examine how your NPI is being used. Monitor claims and refunds, for example, to ensure that the services you invoice match the money you get. If they don’t fit, it means your refunds are being sent to a fake address. Examine your credit report for any unusual activity in your name. This is another indication that your NPI has been compromised.
Scrutinize and Amend
Regularly review your enrollment information with payers to confirm that nothing has changed. When your practice location or employer changes, take the time to update any enrollment information. To that purpose, CMS requires you to notify CMS of any changes to the information you submitted to acquire your NPI within 30 days.
If your NPI is seized, the method for clearing your name and obtaining relief from alleged financial liability is complicated. CMS, on the other hand, established the Center for Program Integrity (CPI) in 2011 to help victims of NPI theft and speed up the exoneration process. If you suspect NPI theft, contact CPI immediately.
Ascertain Privacy Through Third-Party Sources
If you want more privacy, rent a property and acquire a PO Box, or buy a house under a company name. It is more difficult to identify your address when some LLC holds your residence and all your personal mail is routed to a P.O. Box. This isn’t infallible, but the intended patient will give up or follow you home when basic Internet searches yield less information.
There are a few simple steps you may take to keep your NPI number from being stolen. You should protect your NPI like you would your Social Security Number, and at the very least, check its use on a routine basis, much as you would your credit record.