The National Provider Identifier (NPI) is a unique 10-digit number that individually identifies all health care providers. Prior to 2004, the primary identifier for health care providers was either a state license number or a unique physician identification number (UPIN). Because different health care providers used various types of identifiers, Medicare required NPIs for all health care providers. All HIPPA compliant health care providers, including athletic trainers, are required to use the NPI as their identifier in all EMR systems when transmitting health information.
The athletic training profession is positioned to be a leader in health care reform, since our team based approach to health care is the model on which the future is based. As the health care industry moves to adopt prevention as a key component of patient care, athletic trainers must be at the forefront. Missing this opportunity would be extremely detrimental to the future of our profession.
As health care providers, athletic trainers should have an NPI, regardless of setting. The reasons are varied:
AMA Recognition—A little over a decade ago, the profession of athletic training was recognized by the American Medical Association (AMA), but with an acknowledgement that was not setting specific. NATA battled for years to obtain this recognition and yet have been unable to progress further while the health care arena has continued to evolve.
CMS Recognition—CMS considers approved providers based on a number of factors- one of which is the penetration of the provider throughout the country. The most common searchable data is the NPI of the profession. If all 43,000 NATA members had NPI numbers, our market presence would be more impressive to those accessing the data. However, we currently only have 54% of certified members who have obtained their NPI.
Regulatory—As with CMS, when regulatory agencies or legislators are attempting to identify the market presence of a particular health care profession, an NPI search is the industry standard.
Value and Credibility—There is strength in numbers. Using NPI statistics gives athletic trainers more power in legislative, regulatory, and health care initiatives, increasing our value as an allied health care provider.
Third Party Reimbursement–The most commonly understood reason to have an NPI is its necessity when billing third party payers for services performed by a health care provider. Any claim submitted to an insurance company must identify the athletic trainer by an NPI or the claim will be rejected.
NATA/COPA/COR—Multiple attempts to increase NPI participation have been carried out on the national, district, and state levels. Unfortunately, to date, there has been only an 8.8% increase in overall member NPI enrollment, most of which are occurring with recent graduates.
For further information or for step-by-step instructions on how to apply for your NPI, see http://www.nata.org/NPI