HIPAA Unique Identifiers Rule

To juxtapose HIPAA's Administrative Simplification efforts, the Centers for Medicare & Medicaid Services (CMS) introduced four unique identifiers which promise to standardize the identification numbers for providers, employers, and ensure future consistency and ease of use.

The four unique identifiers are:

  • The Standard Unique Employer Identifier - This is the standard Employer Identification Number or EIN which can be found on employee's federal Internal Revenue Service (IRS) Form W-2, Wage and Tax Statement received from their employer. With the help of using EIN, it would be easy to identify an entity acting in an employer role in standard HIPAA transactions that too without identifying the patient's health plan or insurance coverage. Moreover, EIN will not replace the group number, account number, policy number, or subscriber number.
  • The National Provider Identifier (NPI) - For covered health care providers, NPI is a unique identification number. For all HIPAA administrative and financial transactions, covered health care providers and all health plans and health care clearinghouses should use NPIs. As the NPI is a 10-position, intelligence-free numeric identifier (10-digit number), it does not disclose other information about health care providers.
  • The National Health Plan Identifier (NHI) - The NHI is a CMS proposed identifier to distinctively identify health plans and payers that is under consideration. No further information regarding the composition or length of NIH is available at this time.
  • The National Individual Identifier - As the government has stopped endorsing the development of NII, the identifier no longer is pursued. The controversy related to compromising individual privacy can be seen as the reason for discarding the NII.