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The NPI must be used in connection with the electronic transactions identified in HIPAA. In addition, the NPI may be used in several other ways:
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by health care providers to identify other health care providers in health care transactions or on related correspondence;
by health care providers on prescriptions (however, the NPI will not replace requirements for the DEA number or state license number);
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The MICR forms are the main form – it is printed in magnetic ink, and is machine-readable; it appears at the bottom left of a check, and consists of nine digits.
The fraction form was used for manual processing before the invention of the MICR line, and still serves as a backup in check processing should the MICR line become illegible or torn; it generally appears in the upper right part of a check near the date.
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Sometimes a branch number or the account number are printed below the fraction form; branch number is not used in processing, while the account number is listed in MICR form at the bottom. Further, the Federal Reserve Routing Symbol and ABA Institution Identifier may have fewer than 4 digits in the fraction form. The essential data, shared by both forms, is the Federal Reserve Routing Symbol (XXXX), and the ABA Institution Identifier (YYYY), and these are usually the same in both the fraction form and the MICR, with only the order and format switched (and left-padded with 0s to ensure that they are 4 digits long).
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In the check depicted above right, the fraction form is 11-3167/1210 (with 01 below it) and MICR form is 129131673 which are analyzed as follows:
the prefix 11 corresponds to San Francisco,
3167 (common to both) is the ABA Institution Identifier,
1210 and 1291 are the Federal Reserve Routing Symbols (generally equal, here different probably due to obfuscation, see image file history for more information), with the initial "12" corresponding to the Federal Reserve Bank of San Francisco, the third digits ("1" and "9") corresponding to check processing centers, and the fourth digits ("0" and "1") corresponding to where the bank is located – "0" indicates "in the Federal Reserve city of San Francisco", while "1" indicates "in the state of California".
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Apr 13, 2023
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Apr 13, 2023
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Prior to the implementation of NPI numbers health plans and federal payers assigned identification numbers to healthcare providers and suppliers. The identification numbers were not standardized, resulting in a single provider using multiple identification numbers issued by the various health plans with which a provider was enrolled. This complicated the provider’s claim submission processes, often resulting in the same identification number being assigned to different healthcare providers by the different health plans.
The NPI Final Rule established a standard for a unique health identifier for healthcare providers to use in the healthcare system. The national standard simplifies the claims process and reduces the administrative burdens on healthcare providers.
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