WHY ATHLETIC TRAINING STUDENTS SHOULD OBTAIN AN NPI NUMBER

recommendationsWhat is an NPI Number?

A National Provider Identifier (NPI) is a unique identification number for covered healthcare providers. It is a 10-digit numeric identifier that does not contain signifiers as to the state in which you practice or your provider type.  An NPI number does not replace certification and/or licensure. Applying for an NPI number is free of charge, and healthcare providers can apply for an NPI number HERE.

Who Needs an NPI Number and Why?

The Health Insurance Portability and Accountability Act (HIPAA – 1996) required the adoption of such an identifier for all healthcare providers, and the NPI was announced as the required identifier in 2004.   All HIPAA-covered entities are required to have an NPI number; a healthcare provider that conducts certain transactions in electronic form is a HIPAA-covered entity.  The electronic transactions that require an NPI include submission for referral and/or authorization, obtaining claims status, submitting claims and encounter information for reimbursement, payment, or remittance, or updating a patients’ electronic health record (EHR: refers to a health record that is available across authorized providers for access during patient care). Certain electronic medical records (EMR: refers to a single practice’s digital version of a patient’s chart) also require an NPI of the provider updating the patient’s information. All practicing athletic trainers should already have obtained an NPI number to remain HIPAA compliant in electronic transactions with other providers.

But What About Athletic Training Students?

There currently is no requirement for athletic training students to obtain an NPI, but they are eligible to apply for one. The healthcare provider taxonomy code for “an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care” is 390200000X. Once certified and/or licensed the athletic training student should update their NPI record to reflect their change in professional status. If an athletic training student has the potential to conduct one of the aforementioned electronic transactions during the course of patient care, then they would be required to have an NPI number to do so under HIPAA.  All athletic training students are encouraged to obtain an NPI to prevent violation of this HIPAA requirement during their clinical education.

Resources:

NPI: What You Need to Know (Department of Health and Human Service)

How to Apply for an NPI (National Plan & Provider Enumeration System)

NPI Numbers Essential for All Healthcare Providers (Board of Certification)

National Provider Identifier (NPI) (National Athletic Trainers Association)