NPI and CAQH: What They Are and How They Work
What is NPI
NPI or National Provider Identifier is a unique identification number assigned to healthcare providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
This unique 10-digit number is used to simplify the administration of healthcare billing and claims by providing a single, standardized identifier for each provider.
Who Needs an NPI?
All individuals and organizations within the healthcare field are required to have an NPI.
Types of NPI
The type of NPI needed depends on the type of healthcare provider you are:
- Type 1 NPI- Individuals
This category includes physicians, dentists, nurses, chiropractors, physical therapists, pharmacists, and other individual providers who render healthcare services.
- Type 2 NPI- Organizations
This type of NPI is needed by entities like hospitals, nursing homes, pharmacy stores, group practices, and clinics.
What is CAQH?
CAQH, or the Council for Affordable Quality Healthcare, helps to streamline healthcare administration. CAQH offers a variety of solutions to simplify processes such as credentialing, provider data management, and electronic transactions.
Who Needs CAQH?
All individuals and organizations within the healthcare field can benefit from using CAQH.
Benefits of CAQH
- Efficiency: CAQH helps healthcare providers and organizations streamline administrative processes.
- Credentialing Simplification: Healthcare providers use CAQH ProView to update their credentialing information in one secure spot, making it easier for health plans and organizations to access it.
- Data Accuracy: CAQH ProView centralizes provider information, ensuring healthcare organizations access accurate, up-to-date data, reducing errors, and improving quality
- Compliance: CAQH helps healthcare providers and organizations stay compliant with regulatory requirements by providing a standardized platform for managing administrative data.
Where does Kounsel Come In?
Kounsel provides a credentialing service designed to simplify the process for you. We understand that dealing with credentialing paperwork can be overwhelming, so we offer comprehensive support every step of the way.
Our service includes preparing all necessary documents, assisting with verification processes, and initiating and completing the registration while providing ongoing updates. By handling these tasks for you, we aim to ease the burden and ensure that your credentialing process is smooth and hassle-free.
Should you have any questions or require assistance at any point during this process, our support team is ready to help. Feel free to reach out to us at hello@kounsel.io and we'll be delighted to assist you.