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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 ...
HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]
A unique physician identification number (UPIN) was a six-character alpha-numeric identifier used by Medicare to identify doctors in the United States.They were discontinued in June 2007 [1] and replaced by National Provider Identifier, or NPI numbers.
The NPI replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs. [61] However, the NPI does not replace a provider's DEA number, state license number, or tax identification number. The NPI is 10 digits (may be alphanumeric), with the last digit being a checksum.
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4]
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed. [1] This bill is called a claim. [2]
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Under an HCBS waiver, states can use Medicaid funds to provide a broad array of non-medical services (excluding room and board) not otherwise covered by Medicaid, if those services allow recipients to receive care in community and residential settings as an alternative to institutionalization. [1]
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