The Difference Between PTAN and NPI
Because Medicare’s vast system is prone to fraud, it is crucial to know and verify providers. Because these businesses, suppliers, and consumers rely on Medicare involvement for their healthcare requirements, using a pair of PTAN and NPI numbers in their respective positions helps the healthcare institutions remain in line and protects Medicare from corruption and theft. Providers and suppliers who have received queries to reverify their enrollment information had also asked CMS to clarify the distinctions between a national provider identifier (NPI) and a provider transaction access number (PTAN). An NPI is required for all entities offering services and charging Medicare for services given to Medicare enrollees. A PTAN will be provided to the physician or supplier upon submission to a Medicare supplier. Whereas only NPI can be presented on requests, the PTAN is a significant number directly connected to the NPI of the service or supplier. The NPI is a federal mandate under the Health Insurance Portability and Accountability Act, per the Department of Health and Human Services (HIPAA). The NPI of the provider is a oneof-a-kind identifying number provided by the National Plan and Provider Enumeration System (NPPES), which is utilized by all health plans and health care intermediaries when reporting HIPAA standards transactions. The NPI is a 10-digit number that does not include any provider information. The NPI is designed to be shared as an identifying number with other suppliers and providers, health care plans, clearinghouses, and any other institution that may require it for monitoring and billing. A PTAN, on the other hand, is exclusive to Medicare and is granted to providers when they participate in the program. As a result, in order to participate in Medicare, a provider must have both an NPI and a PTAN number. While a practitioner has a single NPI, he or she may have numerous PTAN numbers, indicating enrollment in various practices or with multiple Medicare vendors. While using MAC self-help resources, an authorized person should utilize the NPI to charge the Medicare program and the PTAN to verify the provider. The NPI and PTAN numbers allow the provider or supplier in the Medicare program to be recognized and track the activities. Read more at npi-lookup.org