National Provider Identification (NPI) - Chapter 10, 2021 UnitedHealthcare Administrative Guide

HIPAA, federal Medicare regulations, and many state Medicaid agencies require health care professionals to obtain and use a standardized NPI. You are required to use an NPI as identification on electronic transactions as outlined in the instructions for HIPAA electronic transaction X12N Implementation Guides.

State-specific regulations may also require you to submit your NPI on paper claims.

  • To avoid payment delays or denials, you must submit a valid billing NPI, rendering NPI and relevant taxonomy code(s) on all claims and encounters. In addition, we encourage you to submit the referring care provider’s NPI.

The NPI information you report on your claims and encounters helps us to efficiently process claims and encounters and to avoid delays or denials.

We accept NPIs submitted through:

  • Link: In the My Practice Profile tool, select the Provider Demographics or Group Demographics tab to make care provider updates. In the UnitedHealthcare Facility/Practice Profile tool, select the View/Update NPI Information tab to make facility updates
  • Fax: Using the fax form on UHCprovider.com/mypracticeprofile.
  • Phone: United Voice Portal (UVP) at 1-877-842-3210. Select the Health Care Professional Services prompt. Say “Demographic Changes” and your call goes to the service center to collect your NPI, health care provider taxonomy codes, other NPI-related information.
  • Credentialing/Contracting: NPI and National Uniform Claim Committee (NUCC) taxonomy indicator(s) are collected as part of credentialing, recredentialing, new provider contracting and re-contracting efforts.

How to submit NPI, TIN and taxonomy on a claim or encounter

Information is provided for the location of NPI, TIN and taxonomy on paper and electronic claims on UHCprovider.com/mypracticeprofile.