At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
All health care providers – individuals and organizations – that are covered by HIPAA must obtain a National Provider Identifier (NPI) number. The National Plan and Provider Enumeration System (NPPES) assigns NPIs and updates information as needed. You can read more about NPI numbers in our earlier blog.
A HIPAA-covered entity is one that:
Is a health care provider conducting certain transactions electronically,
Is a health care clearinghouse, or
Is a health plan such as Medicare, Medicaid and commercial plans
Examples of individual HIPAA-covered entity health care providers include physicians, chiropractors, dentists, nurses, pharmacists and physical therapists.
Organization HIPAA-covered entity health care providers include group practices and clinics, ambulance companies, HMOs, home health agencies, hospitals and laboratories, nursing homes, residential treatment centers, suppliers of durable medical equipment and pharmacies.
Importantly – whether you are an individual or organization health care provider, if you apply for enrollment in Medicare, your NPI must be included on your application. An enrollment application that is missing an NPI will be rejected.
Two NPI Categories
There are 2 categories of health care providers for the purpose of NPIs:
Type 1 – Individual
Type 2 – Organization
Individual health care providers may receive NPIs as “Entity Type 1.” Organizational health care providers are eligible for NPIs as “Entity Type 2.” It doesn’t matter how many employees an organization has – from 1 to thousands.
Some organization health care providers have various components that function rather differently from the parent organization because they supply different types of health care or have separate physical locations. An example is a hospital that offers acute care as well as laboratory and pharmacy services. Any separate component that conducts HIPAA-standard transactions on its own must obtain its own NPI number.
Please reference the CMS online brochure NPI: What You Need To Know for more details.
Let Us Manage All Your Payer Enrollment Services
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!