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American
Music Therapy Association, Inc. |
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 National
Provider Identifier (NPI) |
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Most people are aware of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as the law which protects patients’ medical records privacy and protects access to health insurance coverage for certain situations. But another mandate from HIPAA and its Administrative Simplification provisions is for the Department of Health and Human Services (HHS) to adopt a standard identification system for all health care providers, facilities, and health plans to help with the processing of standard transactions. This system, developed by CMS, is called the National Plan and Provider Enumeration System (NPPES). The NPPES assigns National Provider Identifiers or NPIs to each provider through an application process that can be completed online. Current practice requires healthcare providers and facilities to obtain different identification codes for each health plan they bill for reimbursement. Often times, payment for services previously approved is delayed because of confusion over so many different identification codes. This new system was designed to improve the billing and payment process through more effective transmission of health information. All covered entities under HIPAA (anyone billing electronically) must obtain an NPI by May 23, 2007, although some health plans may use them earlier. This number will not change and will stay with the provider regardless of job or location changes. The same provider number will be used by all health plans. Obtaining an NPI does not replace the enrollment process that is often required to be a provider with a specific health plan. In other words, just having the NPI will not insure reimbursement, as the provider will still need to communicate with the particular payer to receive pre-authorization and potentially be included on that plan’s provider list. Having the NPI will allow providers to identify themselves in standard transactions such as billing claims and referral authorizations. Music therapists can apply and receive (at no cost) their individual NPIs for use in billing private and public third party payers through the following website: https://nppes.cms.hhs.gov/NPPES/Welcome.do. All providers must list a taxonomy code that is available on the application. Music Therapists are listed under #22 “Respiratory, Rehabilitative and Restorative Service Providers,” code 225A00000X. The application process takes approximately 15 minutes and most providers receive their individual code within 2-3 weeks. This national opportunity for music therapists to be recognized as service providers is an exciting example of the increased awareness of music therapy’s role in healthcare. |
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Important
Update for Music Therapists Working in New
York State |
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AMTA, CBMT, MAR, and NYSTF have been working closely with
Legislative Consultant Diana Georgia to address practice issues related
to the New York Creative Arts Therapist License. Representatives from
these groups have conducted extensive reviews of potential legislative
and regulatory remedies to protect the right of NY music therapists to
practice music therapy. The clarification letter, along with an earlier clarification letter from the Senator who originally sponsored the licensure legislation, is included below for your information. This letter outlines services that music therapists can provide without the creative arts therapist license (’LCAT‘). Because of the overly broad definition of psychotherapy in Article 163 of the Education Law, AMTA, CBMT, MAR, and NYSTF are continuing their advocacy, seeking potential exemption language for qualified music therapists to practice music therapy without the need for the CAT license in New York. If the CAT license is impacting your ability to practice music therapy in New York, we would welcome your comments. Specific examples of decreased or restricted access to music therapy services because a music therapist does not have the CAT license will provide important data as we work with legislators to seek exemption language. Please forward your comments to: Please include your name, address, and if you are willing to be contacted for additional information. |
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AMTA
Members Eligible for Professional Liability Insurance through HPSO |
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| AMTA is pleased to announce its
sponsorship of Healthcare Providers Service Organization (HPSO) as our
new professional liability insurance provider. HPSO is one of the top
specialists in administering professional liability insurance coverage
to over 800,000 healthcare providers. The HPSO plan is underwritten by
American Casualty Company, a CNA company and has received an "A" rating
from A.M. Best for its financial strength and stability. For more information or to apply, click here. |
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American
WholeHealth Networks Established Music therapy Network Program |
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| American WholeHealth Networks, Inc. (AWHN), America’s leading company for integrating complementary and alternative medicine (CAM) into mainstream health care, today announced its Music Therapy Network Program. The program was launched, in collaboration with the American Music Therapy Association, to respond to requests from several of AWHN’s client health plans for a broader variety of practitioners to participate in its national specialty care affinity network. To read more in the member area, click here | ||
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| AMTA is a 501(c)3
non-profit organization and accepts contributions which
support its mission. Contributions are tax deductible as
allowed by law. Copyright © 2003, American Music Therapy Association. |