Which component of the 837P/CMS-1500 claim form identifies the practitioner who provided the submitted services?

The National Provider Identifier (NPI) is a unique identification number assigned to healthcare providers in the United States. This number is crucial because it distinctly identifies individual practitioners or groups of health care providers who offer medical services. When a claim is submitted using the 837P or CMS-1500 form, the NPI allows insurers and payers to accurately recognize and process the claims related to services provided by specific practitioners.

The use of the NPI on the claim form ensures that the healthcare service rendered can be easily linked back to the correct provider, facilitating reimbursement procedures and maintaining accurate records in the healthcare system. This system minimizes confusion and helps prevent issues such as billing errors or fraud by ensuring that claims are associated with verified providers.

In contrast, other components like the patient’s insurance number, billing code, and procedure date do not identify the practitioner who provided the services. The patient’s insurance number serves to link the claim to a specific patient’s insurance policy rather than to a provider. Billing codes describe the services provided but do not serve to identify the provider delivering those services. The procedure date indicates when the services took place but does not provide identification of the provider.