Get the free National Provider Identifier Submission Form rev ... - United Concordia

Internal Use Only DOC NPI CCI#: National Provider Identifier Submission Form Please print this form, fill in the requested information below and fax to 866-223-2770 or make a copy for your records

How to fill out national provider identifier submission

How to fill out national provider identifier submission:

1. Obtain the necessary form: Start by obtaining the national provider identifier submission form. This form is available on the official website of the National Plan and Provider Enumeration System (NPPES).
2. Provide your personal information: Begin by entering your personal information accurately. This may include your full name, contact information, social security number, and date of birth. Make sure to double-check the accuracy of the information provided.
3. Include your professional details: Provide information about your professional background, such as your medical license number, specialty, and any certifications or accreditations you may have. It is important to provide accurate and up-to-date information.
4. Specify your practice location: Indicate the physical location where you primarily practice. This would include the complete address, city, state, and zip code. If you have multiple practice locations, you may need to fill out additional sections.
5. Determine the type of submission: Choose the appropriate type of national provider identifier submission based on your individual circumstances. Options typically include initial application, change request, or renewal.
6. Attach supporting documents: Depending on the type of submission, you may be required to include supporting documents such as copies of your medical license, certifications, or any other relevant credentials. Make sure to include all necessary documents as per the instructions provided.
7. Review and submit the form: After completing all the required sections, take the time to review the form thoroughly. Make sure all information is accurate and complete. If everything looks correct, submit the form as per the instructions provided.

Who needs national provider identifier submission?

1. Healthcare practitioners: Physicians, dentists, chiropractors, therapists, and other healthcare practitioners who provide services to patients may need to obtain a national provider identifier. This is required for insurance billing purposes and for identification within the healthcare system.
2. Healthcare organizations: Hospitals, clinics, nursing homes, and other healthcare organizations may also need to acquire national provider identifiers. These identifiers help in the administration and coordination of healthcare services, ensuring accurate billing and identification of providers within the system.
3. Medical billing professionals: Those involved in medical billing and coding, such as billing companies or individuals working in medical billing departments, may require a national provider identifier submission to accurately process insurance claims and coordinate payment for services rendered.

For pdfFiller’s FAQs

What is national provider identifier submission?

National Provider Identifier (NPI) submission is a process of submitting an application or update for an NPI, which is a unique identification number assigned to healthcare providers. It helps in efficiently identifying providers and their unique details in electronic transactions.

Who is required to file national provider identifier submission?

All healthcare providers, including individuals and organizations, who meet the definition of a HIPAA-covered healthcare provider, are required to file national provider identifier submission.

How to fill out national provider identifier submission?

National provider identifier submission can be filled out online through the National Plan and Provider Enumeration System (NPPES) website. The application or update form requires the provider's personal information, practice details, and other necessary data to generate or update the NPI.

What is the purpose of national provider identifier submission?

The purpose of national provider identifier submission is to create a standard and consistent identification system for healthcare providers. It facilitates efficient electronic transactions, reduces paperwork, and improves accuracy in healthcare administrative processes.

What information must be reported on national provider identifier submission?

The information required to be reported on national provider identifier submission includes provider's legal name, practice address, contact details, taxonomy codes, healthcare specialties, and other relevant professional information.

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