Monday, January 11, 2016
keywords: LIPs, credentialing, privileging, Joint Commission, NPI, CMS
Acupuncturists and LIP status.
Licensed Acupuncturists (L.Ac.) are Licensed Independent Practitioners (LIPs), and recognized as such in 43 states and the District of Columbia.
LIP is a legal term. It is affected by and related to state licensing law (scope of practice by state). It is defined by The Joint Commission.
According to HIPAA (which is about insurance payment and coding streamlining and privacy protection), all LIPs must carry an NPI. An NPI (national provider identifier) is used to track insurance claims. When you are filling out employment paperwork at a hospital, you submit them your NPI (among many other forms).
The definition of NPI by CMS (Center for Medicaid/Medicare), “the NPI is a unique identification number for covered health care providers [who, along with all plans or companies who provide health care insurance] must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier.” [see related blogpost on NPI.]
Licensed Independent Practitioners (LIPs) and The Joint Commission (TJC)
The Joint Commission (TJC) and LIP. TJC’s document, The Who, What, When, and Where’s of Credentialing and Privileging discusses the particulars of said process. Related to L.Ac.s, we look at how they treat LIPs (since we are LIPs). “An ‘LIP’ is a licensed independent practitioner, defined as an individual, as permitted by law and regulation, and also by the organization, to provide care and services without direction or supervision within the scope of the individual’s license and consistent with the privileges granted by the organization.”
Credentialing as a vetting process for a new hire.
Credentialing, is a vetting process, as a hospital admin colleague of mine explains. In fact, going back to page 2 of TJC’s Who, What, When, Where document, under “credentialing”: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a health care organization. Credentials are documented evidence of licensure, education, training, experience, or other qualifications. Examples of credentials are a certificate, letter, or experience that qualifies somebody to do something. They can be a letter, badge, or other official identification that confirms somebody’s position or status. Your organization obtains primary source verification of the LIP’s education, training, certificates and licensure from the primary source, and maintains the file of information.
Credentialing of LIPs as medical staff appointments
Medical and dental staff appointments are a traditional in some hospital systems. All staff appointments are LIPs. But not all LIPs qualify for medical or dental staff appointment. Every hospital system that has this tradition of medical staff appointments has related qualification standards. For example, some centers state only full-time employee LIPs are eligible for staff appointment (not part-time). Check your local medical facility for what their written medical appointment qualifying standards are.
Generally, the LIP recognition is what we go for when looking to be hired at an institution. We are LIPs; start here.
L.Ac.-- Licensed Acupuncturist, the most common state license title
LIP--Licensed Independent Practitioner
HIPAA--Health Insurance Portability and Accountability Act
NPI--national provider identifier
CMS--Centers for Medicare and Medicaid Services www.cms.gov
TJC--The Joint Commission, an independent non-profit entity that accredits and certifies healthcare facilities and programs; a major quality assurance entity.
For more thorough information on this topic, read my article in Meridians,
Gale M, Hospital Practice: Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP). Meridians: JAOM, 2016 3(4) (accepted for publication).