I am currently a sole practitioner who bills under my assigned NPI number. I am in the process of turning my business into an LLC, as well as hiring an employee / independent contractor. Can you advise me as to what I need to do as far as an NPI number? Do I need a new one? I assume my employee will need to get one too?
You will need to get a type 2 (organizational) NPI for your LLC. You will then need to share that type 2 NPI with your insurance companies and tell them that you will now be submitting under the new type 2 NPI as a billing provider. You can apply for your type 2 (organizational) NPI at NPPES (National Plan & Provider Enumeration System)
Sounds simple, but here comes the headache.
For each insurance company that you submit to, you will have to submit with the billing NPI that they currently have on file for you. When you change the billing NPI with an insurance company, it doesn't happen overnight. Therefore, you will run into the fact that some insurance companies will have your type 2 NPI and some will have your type 1 NPI and you will have to submit claims to them differently (with different information in Box 33 of the CMS-1500 for the billing provider).
Luckily, Therabill does have a solution for this. To keep this clean and short, I will point you to the video, but please let us know if you have any questions after watching the video. NOTE: The part you want to pay attention to is towards the end when it comes to "Insurance Company Specific Billing Provider Info".
Yes. Each of your rendering providers will definitely have to have their own type 1 (individual) NPI. This is required by the NPI mandate, every healthcare provider should have an NPI.
You will also often need to let the insurance companies know the type 1 NPI's of the providers who you will be submitting claims for under your type 2 NPI.