National Provider Identifier
Over the past several years, Capital BlueCross has kept its network providers informed about the National Provider Identifier (NPI) regulations. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires NPIs to be used in all standard health care transactions. All providers who use standard HIPAA electronic transactions (claims submission, claims status, referrals, etc.) were mandated by law to obtain and use an NPI from the National Plan and Provider Enumeration System (NPPES) on or before May 23, 2008.
The NPI replaced all other provider identifiers used on standard electronic health care transactions. As we have previously communicated, effective May 23, 2008, health care providers no longer have different numbers to identify themselves to one or more health plans, and must rely solely on the NPI.
Capital BlueCross and NPI
Capital BlueCross began accepting HIPAA compliant NPI-only electronic transactions as well as paper transactions in March of 2007.
Capital BlueCross continues to work with providers to resolve the many subtle and unique challenges resulting from the NPI mandate. We also work to establish trading partner relationships with providers who intend to submit transactions electronically for the first time.
Professional and Facility Providers should contact their assigned Provider Automation Consultant to discuss testing or to address any questions about standard HIPAA compliant electronic transactions. Professional Providers may also email Professional Provider Automation at the following email address: Provider.Automation@capbluecross.com.
NPI-related Provider communications stored on this page are available as files*.
04/07/2005 NPI Provider Alert Reminder