Question 1

What is a National Provider Identification (NPI) number?

Accepted Answer

An NPI number is a 10 digit numerical identifier for providers of healthcare services. It is national in scope and unique to the provider.

Question 2

What is the purpose of a National Provider Identification (NPI) number?

Accepted Answer

The NPI number is a single identification number that is issued by the federal government to health care providers. It is intended to improve the efficiency of the health care system and help to reduce fraud and abuse.

Question 3

Who can receive a National Provider Identifier (NPI) number?

Accepted Answer

An NPI Number will be assigned to health care providers and professionals who need them to submit claims or conduct other transactions. A “health care provider” is defined as an individual, group, or organization that provides medical or other health services.

Question 4

Can a Health Educator have a National Insurance Provider (NPI) number?

Accepted Answer

Yes, appropriately trained and credentialed health educators and patient health educators are eligible to submit an application to receive an NPI number.  They may also apply for and receive professional liability insurance for health education services.

Question 5

Can a Health Educator’s services be billed for and reimbursed?

Accepted Answer

Yes, there are two avenues for billing and potential reimbursement. Where applicable, and with the appropriate CPT codes, services of a health educator may be billed for and reimbursable through a medical practice, physician’s practice, nurse practitioner’s practice or other medical professional provider’s office. Patients who receive services directly from a health educator, with a National Insurance Identification number, may be able to submit the services to their employer’s Flex Spending or similar healthcare spending plan.

Question 6

What qualifications must the Health Educator have for billing?

Accepted Answer

The qualifications of the non-physician health care professionals who provide health education, and the content of the educational and training program, must be consistent with guidelines or standards established or recognized by a physician society, non-physician healthcare professional society/association, or other appropriate source.

Question 7

Where can I learn more about appropriate training and credentialing in patient health education for non-physician health professionals?

Accepted Answer

The National Institute of Whole Health has been providing professionally accredited/approved professional development programs and continuing education courses in patient health education since 1977. For more information about available post-professional patient health education training you may contact NIWH at 888-354-4325 or contact us.

Billing and Coding

Billing and Coding

Title

Billing and Coding

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