FAQS about Getting an NPI Number for Unlicensed MHR Providers
Date: 04/09/18
Effective August 1, 2018, all unlicensed MHR providers will be required to submit claims using their own NPI number.
Below are answers to some common questions to help unlicensed MHR providers apply for an NPI. The process is free and it's a Federal requirement for all healthcare providers... so let's get started!
How do I obtain an NPI from the Center for Medicare and Medicaid Services (CMS)?
If you do not yet have an individual NPI number, there are two ways to apply for one from CMS:
- Online Application
The web-based application is available at the National Plan & Provider Enumeration System (NPPES) website, https://nppes.cms.hhs.gov. This is the fastest way to get an NPI number.
- Application Form
Download Form CMS-10114, NPI Application/Update Form, from the CMS website. You can also request a paper form from the NPI Enumerator by calling 1-800-465-3203. The completed form must be returned to:
NPI Enumerator
P.O. Box 6059
Fargo, ND 58108-6059
Does it cost anything to apply for an NPI number?
No. There is no cost to apply for or obtain an NPI number.
How long will it take to receive an NPI?
CMS cannot predict how long it will take to obtain an NPI. The time can vary based on:
- volume of applications being processed at a given time
- whether the application is submitted electronically or on paper
- whether the application is complete and free of errors. When gathering information for the application, be sure that all provider information, such as social security number and federal employer identification number, are correct.
CMS estimates that, in general, a health care provider who submits a properly completed, electronic application could have an NPI within ten days.
We recommend you apply for an NPI as soon as possible. That way you will have plenty of time in case there is an error in your application.
Where do I go for more information about NPI numbers?
For more information about NPI numbers, visit the National Plan and Provider Enumeration System website.
If I get an NPI, do I still have to complete the Attestation process to verify qualifications?
Yes, unlicensed roster staff that have not completed the Attestation process verifying they meet the qualifications to provide MHR services will still be required to submit an Attestation packet. The Attestation packet verifies that you meet State requirements for MHR providers. The NPI number is your unique identifier as a healthcare provider. Both are required.
What do I need to do after I get my NPI?
Agencies employing unlicensed MHR providers must submit updated rosters including NPI numbers for their unlicensed providers. This information should be included in the regular monthly roster update to LHC_PROVIDER_CREDENT@CENTENE.COM.
The behavioral health facility roster template can be downloaded here. Each unlicensed practitioner and their NPI number should be submitted via the roster.
We recommend submitting updated roster information, including unlicensed MHR provider NPI numbers, by June 1, 2018 in order to be ready for the August 1 NPI requirement.