Using NPI Number to Look for Excluded Providers
An NPI is a one-of-a-kind identification number designed to improve the efficiency and effectiveness of electronic health information transmission.
Doctor
NPI Number
How To Apply 📝 For An NPI, What Is An NPI, ❓
The NPI Final Rule, published on January 23, 2004, established the NPI as the administrative standard for the Health Insurance Portability and Accountability Act (HIPAA). As NPI numbers are free and easy to obtain, they are usually used to authenticate and verify a variety of authentication, individual claims, contracts or agreements, and much more.
Also, it is critical to carry out comprehensive monitoring of referring providers and physicians to be in compliance with CMS payment eligibility and avoid the risk of HHS OIG fines and penalties. Because monthly exclusion checks can be a significant challenge for healthcare organizations due to a lack of information, NPI numbers can be a valuable asset in this process.
When screening and monitoring for excluded parties, as well as referring providers and physicians, searching NPI records provides critical data, resulting in complete transparency.
NPI lookup tool
NPI numbers can be a valuable asset in the monthly exclusion screening process of your business. In the lack of a clear indication that a potential match can be cleared, conducting an NPI Lookup on your providers can help with resolving in many situations.
There are 33 exclusion databases that contain NPI numbers in total. As a result, expanding its application can improve your chances of identifying excluded individuals. In some cases, having the NPI may allow you to identify those excluded parties even before the exclusion period begins.
By conducting an NPI search, the hospital can make a more informed decision with this piece of information. An NPI Lookup can be used to create a profile to determine whether their provider is the same person listed as excluded.
