We're all supposed to keep track of so many numbers in the patient record. There's the social security number, the MRN, the job number. Now there's this new NPI #. What exactly is it?
I myself am just starting to learn the ins and outs of medical billing here in the U.S., which is the lifeblood of doctor's offices. Let me start with how doctors here get their money.
Unlike in the Philippines, patients here don't typically go into a doctor's office and pay for their visit. Most have insurance and their doctors are responsible for submitting what are called "claims" to the patient's insurance company to let them know that the patient came to their office for such and such a procedure or exam etc... The Insurance company, then determines whether the claim is covered in the patient's insurance policy and either rejects the claim or approves it and then sends a check to the doctor.
Enter the NPI number. Starting this year, Medicare (the government-run insurance company for older Americans 65 and up) are requiring that doctors apply for an NPI or Nationa Provider Identifier number to speed up the claims process. Doctors are having big problems with this, because imagine the headaches. First they have to apply for one. Second, the current "claims" forms don't have a spot for this NPI number, meaning there's a new version of the claim form that they have to get now. Then, for those who bought billing software to electronically send in their claims, they have to pay money to make sure the software accomodates this new NPI number.
There's more to it than that, but that's what MTs should know at least about the NPI#
What does this mean for us? Well, I suspect you will see more and more doctors wanting their NPI#s on their patient records. Now you know how important this number is for a doctor, because if it's not filled out or is wrong, the insurance will delay in sending the check and the doctor won't get paid.
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