In the excitement of starting your own business, it may be easy to forget essentials such as identifier numbers that will establish your business as legitimate. While not the best aspect of starting a business, without them, you will not be able to operate.
Employer Identification Number
To get paid by any third party payer, such as an insurance company, you need to obtain a tax ID number. Technically called an Employer Identification Number (EIN), your tax ID number is issued by the Internal Revenue Service (IRS) and identifies a business entity. If any company or business pays your business more than $650 in 1 year, they must issue you a 1099 form (like a W4 for a business) and report the income you received from them to the IRS.
You can obtain an EIN at http://www.irs.gov. Beware of Web sites that offer a tax ID number in seconds. They charge a hefty fee for a service that is free. Also, check your state's requirement for a state number or charter. This can also be done on the IRS Web site.
National Provider Identifier
Life just got a lot easier for self-employed NPs. When I started my own practice, I had to fill out forms to get a Unique Provider Identification Number (UPIN), a Medicare number, a Medicaid number, and had to apply to each individual insurance company for separate provider numbers as well. Now, you can apply for a National Provider Identifier (NPI) number that you will use for life. This unique, 10-digit number is assigned to healthcare providers and healthcare organizations, and must be used after May 23, 2007 for all entities who use Health Insurance Portability and Accountability Act standard electronic transmissions for payment. All NPs should apply for a NPI. If you don't have one yet, apply online at https://nppes.cms.hhs.gov. You can also obtain a paper copy of the application by calling 1-800-465-3203.
Your NPI will not replace your tax ID number. It will replace all of your previous numbers-UPIN, Medicare, Medicaid, and insurance company ID numbers. When you get your NPI, if you already receive payment from any payers, make sure you update your profiles with each by giving them your NPI.
CLIA Number
In 1988, the federal government enacted the Clinical Laboratory Improvement Amendments (CLIA) regulations that established quality standards for all laboratory testing in the United States, including office laboratories. These standards are designed to ensure accuracy and reliability of results and are based on the complexity of the test, not the type of laboratory that performs the test. The CLIA regulations require all facilities that perform even one test, including waived tests, to meet certain federal requirements and obtain a CLIA certificate. You will need a Certificate of Waiver to perform waived tests, and you may need a Certificate for Provider Performed Microscopy Procedures if you look under a microscope for anything in your office. For a complete listing of CLIA waived tests, visit the U.S. Food and Drug Administration's Web site: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfClia/testswaived.cfm.
The CLIA certificates are good for 2 years at a time and must be obtained even if you only perform waived tests. To obtain the application for a CLIA number, visit http://www.cms.hhs.gov/clia. You will have to pay a fee of about $200 to $300 for your 10-digit CLIA number, even if you apply for a Certificate of Waiver. Remember, you will not get paid for any laboratory test you do without this number. If you buy a practice, you can keep the CLIA number, but need to notify your state's Medicare agency of any changes in ownership, name, location, or directors. This information is also available at that Web site.