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HIPAA Administrative Identifiers
In order to support standard transactions, HIPAA will mandate the
use of unique identifiers for:
- Providers. The rule is the National Provider Identifier (NPI),
originally intended for use in the Medicare system. The identifier
will probably has 10 numeric positions with a check digit as the
tenth digit. Implementation of this standard has begun. Providers
may obtain from the National Plan and Provider and Enumeration
System. Visit: https://nppes.cms.hhs.gov/nppes/welcome.do
- Health plans. The proposed rule for the unique identifier for
health plans is expected to apply the work that HCFA did for a
Medicare PayerID to all health plans nationwide. The identifier
will probably have 10 numeric positions with a check digit in
the tenth position.
- Employers. The employer identifier is based on the the Internal
Revenue Service assigned Employer Identification Number (EIN).
The EIN has nine numeric positions.
- Individuals receiving healthcare services (patients). The most
controversial of the proposed identifiers, the patient identifier
is on hold pending privacy legislation. However, industry experts
speculate that the identifier will consist of approximately 10
numeric digits with a check digit.
To review the regulations in their entirety, go to:
http://www.gpoaccess.gov/cfr/index.html
search for The Code of Federal Regulations Title 45, Section 160
through 164
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