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Glossary

NPI

The National Provider Identifier: the ten-digit number HIPAA assigns to every health care provider, individual or organization, for use in standard transactions. On the exchange networks it is how a querying provider identifies itself, and a treatment query is made under a provider's NPI.

Also National Provider Identifier, NPI number

The NPI exists because HIPAA required one identifier for every provider in every transaction, in place of the separate numbers each payer issued. 45 CFR 162.406 adopts it; CMS’s NPPES issues it. A Type 1 NPI belongs to an individual, a physician or a nurse practitioner; a Type 2 NPI belongs to an organization, a hospital, a practice, a home health agency or a PACE organization. Most organizations have both kinds in use: the organization’s own, and those of the clinicians who bill under it.

On the exchange networks the NPI does a second job. A network query carries the identity of the organization asking, and under Carequality and TEFCA a treatment query is made by a health care provider, which the NPI establishes. The responding organization logs who asked and why, and the audit trail runs on that number.

Two things follow for an agency and the vendor acting for it:

  • The query is the provider’s, not the vendor’s. A records service queries as the agency’s business associate, under the agency’s NPI and its treatment purpose of use. A vendor with no provider behind it has no treatment purpose and no NPI to query under, which is one of the ways the networks keep non-treatment requests out.
  • An organization without an NPI cannot query for treatment. A case management agency, a payer or a law firm has none in the relevant sense, and that absence is the practical edge of the treatment route.

For a home health agency, PACE organization or caregiving provider the NPI is already on file for billing. Connecting it to a query service is a configuration step, not a new credential.

Where it is defined

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Send your details and the calendar opens right here. Book thirty minutes and we will walk a record through the view you would actually use, or skip the call and we will come back in writing.

  1. Send your detailsTwo minutes. Your organization, name, email and phone, and the time records cost you; the rest is optional and helps us reply with something specific.
  2. Pick a timeThirty minutes, live, over synthetic records in the shape your team works in. No slides, and no discovery call before the demo.

Who this is for, and who it is not

  • Coverage comes firstVivlio retrieves from providers, hospitals and health systems it can reach through national exchange networks and direct connections. Name the facilities your patients come from on the form and we check coverage before anyone spends thirty minutes on a demo.
  • You can say what the chasing costsThe form asks how many hours a week your team loses to chasing records. If nobody can put a number near it, the case for Vivlio is not there yet, and we would rather say so than sell you a demo.
  • Patients and files at volumeThis is built for intake that runs every day. For one record, once, your patient can request it from the provider directly, and that will be faster than going through us.
  • Treatment, with the paperwork doneProduction access needs an NPI, a declared purpose of use and a signed BAA. Nobody swipes a card onto live PHI.

If none of those describe you, say so in the last field and we will come back in writing instead of booking a call.

Or call sales directly at 404-777-5772

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