Manage contacts for Healthcare

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[Music] foreign [Music] we're going to discuss about provider related terms now the first one is tax ID which is taxpayer identification number also known as federal tax ID now this tax ID is something similar to our pan number the tax ID is used by the Internal Revenue Services Department also known as IRS in the administration of tax laws in U.S now this IRS is something similar to our income tax department the tax ID is basically a nine digit numeric number and all the providers and Facilities need to use the tax ID while billing claims to the insurance companies it is used by the IRS department to track payments received by the providers and Facilities from the insurance companies as we discussed in the earlier sessions there are two types of practice the first one is individual practice and the second one is a group practice individual practice is a sole proprietorship that means only one doctor in the practice the doctor is going to use his social security number which is also a nine digit numeric number as the tax ID While submitting claims to the insurance companies now this social security number is something similar to our other numbers and it is issued by SSA which is Social Security Administration which is something similar to our uitai [Music] you are coming to group practice it is a system in which two or more doctors collaborate to form a position group now this Physician Group will act as an employer and the doctors working for the group will be considered as salaried employees Now The Physician Group needs to register itself with the IRS department as a business entity foreign will issue an EIN which is employer identification number and it needs to be used by the position group while building claims to the insurance companies in place of tax ID [Music] Now The Physician Group as well as the providers have to file tax returns with the IRS department towards the payments they receive from the insurance companies either directly or in the form of salaries now then second one is NPI which is National provider identification number [Music] the NPI is a 10 digit numeric intelligence free number [Music] now what is intelligence free number when you look at a vehicle number plate the first two letters will indicate the state and the other two letters will indicate the district [Music] to which the vehicle belongs to but when you look at an NPI number it does not provide you any additional information about the doctor like which location the doctor practices in or what kind of a doctor he is whether he is a PCP or a specialist now this NPI is issued by CMS which is centers for Medicare and Medicaid services as per HIPAA Federal Regulations providers must share their NPI with other providers help plans Clearing Houses and any entity that may need it for billing purpose like a diagnostic Laboratory now let us assume that the PCP has referred a patient to the specialist when the specialist is submitting that patient's claim to the insurance company [Music] the name of the doctor as well as the NPI should be mentioned on the claim form here the refrain provider is the PCP in a similar way when the doctor when the PCP asks the patient to get a blood test done now when the laboratory is submitting a claim to the insurance company the name of the doctor as well as the NPI needs to be mentioned on the claim form here the ordering provider is the TCP since he is the one who ordered the blood test foreign [Music] which is provider transaction access number now this P10 is a Medicare only number issued by issue two providers by Mac which is Medicare administrative contractor upon enrollment with Medicare now what is Mac we will discuss about that in the next video the pitan is an alphanumeric number and it does not have any specific format the next one is provider id [Music] it is a number allotted to individual doctors by the insurance companies when they get into a contract with them now this provided provider numbers have been mostly replaced with NPI numbers [Music] and few insurance companies still issue provider numbers [Music] now the next one is taxonomy code the taxonomy code helps us to identify the type of doctor whether the doctor is a PCP or whether the doctor is a specialist [Music] very rarely insurance companies require this information to be furnished on the claim form [Music] foreign official request for the taxpayer identification number in by a third party who must file an information returned with the Internal Revenue Services Department is furnished or provided on a W-9 form in our process the insurance company is considered as the third party and the information that they file with IRS is nothing but the payments they made to the provider the double genome form basically requests the name address and tax ID in the form of social security number if it is an individual practice and in the form of Ein employer identification number if it is a group practice now the insurance company needs to file tax returns with the IRS department towards the revenue generated through policy holder premium payments and also towards the payments released to the providers [Music] now the next one is durable medical equipment also known as BME equipment and supplies ordered by a healthcare provider for every day or extended use things like wheelchair oxygen equipment crutches diabetic strips all of these are considered as durable medical equipment now the next one is nurse practitioner NP an advanced practice registered nurse who has additional responsibility for administering patient care than a registered nurse example family nurse practitioner also known as FMP now a registered nurse can do an advanced degree in Family Practice okay and then the family nurse practitioner can prescribe medication examine patients diagnose illness and provide treatment much like Physicians do foreign the next one is position assistant also known as PA a position assistant May assist doctors in surgical procedures but they themselves are not licensed to perform surgeries physician assistant always works under the supervision of the doctor now the next one is supplier the organizations that sell Healthcare products to provide us to be used in the delivery of Healthcare to patients things like masks thermometers syringes [Music] thank you