Welcome to the provider section of Atlantis Health Plan. Atlantis Health Plan's objective is to provide affordable, quality care to our members through access to our provider network while providing management services to enhance the process.

Final Rule adopting the National Provider Identifier (NPI)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and Human Services adopt a standard unique health identifier for health care providers. On January 23, 2004, the Secretary published a Final Rule adopting the National Provider Identifier (NPI) as this identifier.

All HIPAA covered health care providers, whether individuals or organizations, must obtain an NPI for use on all HIPAA electronic transactions. These transactions include claims, eligibility/claim status inquiries and responses, referrals and remittance advices. NPIs are generated using the National Plan and Provider Enumeration System (NPPES). Once enumerated, your NPI, which is a unique ten-digit numeric identifier, will not change, and will remain with you even if you move, change specialties or practice affiliations or locations.

The compliance date for covered entities to obtain and use an NPI in HIPAA covered transactions is May 23, 2008. Upon the implementation of NPI, it will be the sole provider identifier that replaces the multiple provider identification numbers you currently use. In anticipation of this effective date, we are asking our contracted providers to report practice and individual NPIs to us at this time so that we can record them in our processing systems. If you already have your own NPI, please notify Atlantis in one of three ways:

• E-mail to Provider-Related Issues on the contact us portion of this website
• Fax your NPI confirmation letter to 212-747-0843, Attn: Credentialing Department
• Call Atlantis Health Plan directly at 866-747-8422

If you have not already done so, you can apply for your NPI in one of the following ways:

1. Online Application: The Web address is http://www.cms.hhs.gov/.
2. Mail: You may prepare a paper application and send it to:

NPI Enumerator
P. O. Box 6059
Fargo, ND 58108-6059

A copy of the application is available on https://nppes.cms.hhs.gov. If you need the application form sent to you, or have questions regarding your NPI application and the application process, please call the enumerator directly at 1-800-465-3203.

Learn more about NPI and its implications. Over the next several months we will share a more specific timetable regarding when, where, and how we intend to receive and communicate NPI in all covered standard electronic transactions. The Centers for Medicare and Medicaid Services (CMS) has an NPI Resource online at http://www.cms.hhs.gov/apps/npi/01_overview.asp. You can also check for updates on the Atlantis Web site at www.atlantishp.com, or in our provider newsletter. If you have any questions, please call Atlantis Health Plan at 866-747-8422.