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National Provider Identifiers can be stolen and used for fraud

On Behalf of | Aug 23, 2018 | Blog |

National Provider Identifiers (NPI) are used to help streamline the medical billing process, and these 10-digit numbers function much like a social security number.

Unfortunately, like a social security number, a NPI is also vulnerable to theft. This is because NPI are not confidential and can be publicly accessed through National Plan and Provider Enumeration System, as well as by your employees and possibly through online attacks.

Physicians Practice states that thousands of NPIs are stolen each year and used for fraud, especially Medicare and Medicaid fraud. However, there are some things you can do to protect your NPI from being stolen and used fraudulently.

Stay aware

Only share your NPI with those who require it and who you trust. If someone asks for your NPI, make sure you know why and who will be using it.

Remain alert

When claims and reimbursements come in, compare these to your billed services and make sure your income matches up. If these numbers do not agree, it is possible someone is stealing your reimbursements. You can also check your credit report to look for unusual activity. If someone has stolen your NPI, it could be reflected on your credit report. If you do not handle your own billing, ask your accountant or whoever does balance your books to keep an eye out for unusual activity.

Keep updated

Review your enrollment periodically to make sure all your information is updated. If you do move or switch employers, you are required to report any changes to information that was used to create your NPI within 30 days of that change.

If you suspect your NPI was stolen, you can reach out to the Center for Program Integrity. This center was created to assist victims of NPI theft. If fraud did occur, you will need to contact anyone who accessed the affected patient records and report the data breach to the appropriate resources.

You may also want to consider filing a lawsuit against the perpetrators of the fraud, since they have essentially stolen your identity. Depending on who committed the fraud, they may have also engaged in breach of contract.