Tuesday, August 20, 2013

What's your number?

As athletics trainers, our field is so vast and covers so many aspects of health for our student athletes, yet the federal government and primarily insurance companies refuse to let AT’s bill for their services.  This is why it’s important for each AT to attain their NPI (National Provider Identification) number. The NPI numbers were developed from “the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard unique identifier for health care providers. The National Plan and Provider Enumeration System (NPPES) collects identifying information on health care providers and assigns each a unique National Provider Identifier (NPI).” (nppes.cms.hhs.gov)

In plain English, it is the “social security number” of health professions. Without one, insurance companies, including government sponsored programs like Medicaid, do not recognize the medical professional as a provider of health care services. They don't recognize you!
NATA strongly encourages all Athletic Trainers to register for their National Provider Identifier number (NPI)
“NATA views having an NPI number like having a state license: it’s a professional requirement and adds credibility to both the individual and the profession,” says Cate Brennan Lisak, director of external affairs.“Once ATs get their NPI number, it will be theirs forever -- no matter where they work. There’s no downside to having an NPI number.”
Many AT’s are wondering what in for me, how will I benefit from having this number?  The number one benefit is showing legislators and insurance companies, how many qualified health care providers in each category are available. As it stands, about half of practicing ATs have it. Therefore, insurance only sees a small population of us out there. It’s hard to get someone to fight a battle for us if the group they are fighting for is appears to be so small. We, ATs, are not small.

If every AT acquires their NPI number it will give the CMS (Centers for Medicare & Medicaid Services) a reason to take a look at other healthcare professionals (AT’s ) to provide services for their patients.  Once CMS approves AT’s as health care providers for billing purposes on the national level, all other insurance companies will follow. CMS sets the standards for insurance and insurance policies. Therefore, AT’s will be able to bill for the services they provide.  If a clinical athletic trainer is billing for services, it is assumed that salaries will rise to meet our allied health peers. If clinical ATs are making more money, those in the traditional setting will follow suit.  This is important for all of us.

All healthcare providers are eligible to receive NPI’s, all CMS covered healthcare entities are mandated to use the NPI as the sole provider identifier on all HIPAA electronic transactions.
Obtaining an NPI number is simple.  
The NATA has a link with step by step instructions http://www.nata.org/NPI

You will need to know Provider Code 22 (Respiratory, Rehabilitative & Restorative Service Providers) and Taxonomy Code 2255A2300X (Athletic Trainer) to complete the process.

NPI’s are FREE and once assigned it’s yours for life. No fees, no upgrades, nada. Its hassle free, but it might be wise to change you address when you move!


So now it’s your turn, go ahead and help the profession take giant step forward. It only takes about 10 minutes of your day and it can do so much for our profession. 

-Julie Ellena

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