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  2. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...

  3. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

  4. ANSI 834 Enrollment Implementation Format - Wikipedia

    en.wikipedia.org/wiki/ANSI_834_Enrollment...

    An example layout of an X12 834 Version 005010 file is shown below. Each line starts with a code to identify the type of data that follows, with individual pieces of data separated by an asterisk. The tilde indicates the end of that section.

  5. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    HIPAA replaced various identifiers used by health plans, Medicare, Medicaid, and other government programs with an NPI. [62] The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. However, the NPI does not replace a provider's DEA number, state license number, or tax identification number.

  6. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions.

  7. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Step 3: Assigning Codes [4] This is where medical billing departs from medical coding. Medical coders are responsible for this step and they rely on two standardized coding systems to document and classify the services provided, which will eventually be put into a bill by medical billers.

  8. A $310,000 Fort Lauderdale healthcare fraud: selling 2.6 ...

    www.aol.com/310-000-fort-lauderdale-medicare...

    If you think your Medicare or medical information has been stolen, call either the Health and Human Services Office of the Inspector General at 800-HHS-TIPS (800-447-8477) or the Centers for ...

  9. Protected health information - Wikipedia

    en.wikipedia.org/wiki/Protected_health_information

    Names; All geographical identifiers smaller than a state, except for the initial three digits of a zip code if, according to the current publicly available data from the U.S. Bureau of the Census: the geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; the initial three digits of a zip code for all such geographic units ...