In an effort to streamline and create added protection for the healthcare industry's way of handling claims, National Identifiers were adopted under the HIPAA Regulations.
The purpose of HIPAA was to:
- Ensure the portability of your medical records if you switch doctors, health insurance company, or job;
- Protect your personal health information that your doctor or health insurance company has in their files;
- Streamline the process of how your doctors process medical requests or payments from your health insurance company; and
- Simplify how medical providers do business with health insurance companies and other medical providers.
National Provider Identifier (NPI)
NPI is a special number just for your doctor to be used nationwide to identify them. Currently doctors obtain an ID number from the state, health care companies they do business with or other related companies. With the NPI, doctors will have one number that will be used by all companies. It will also keep their practice safely identified.
By May 23, 2007, doctors will have applied for the NPI from The Center for Medicare and Medicaid Services (CMS) to be used for claims, claims payments, eligibility, enrollment, claim status, etc. The one identifier will flow from the doctor through health plans electronically to maintain consistency with processing. Small health plans have until May 23, 2008.
Employer Identifier Number (EIN)
The EIN is the taxpayer number used for businesses to identify payment. All health care claims will have the EIN from your employer as they administrate your coverage.
All businesses operate under an EIN. Back in January of 1988 this practice was enacted via the Internal Revenue Service (IRS). Currently employers use different numbers to identify their processing of health plan coverage for employees. That will change once the EIN Regulation is implemented. However, it's still in development as part of HIPAA.
National Health Plan Identifier (NHPI)
The NHPI is a special number just for your health plan to be used nationwide to identify them. So if you change health plan coverage your claims will be paid by who covered you.
Again, currently health plans user different numbers to identify them to facilitate plan coverage's for employees through all plans available. No date has been identified for adoption yet, but is soon to come.
National Individual Identifier (NII)
The NII is on hold currently but it would be a special number unique to each person that has health plan coverage of any type. Each person would have this special number that will keep their identification consistent across the health care network. Used by employers, doctors, health plans to replace your social security number keeping your identification safer.