Tuesday, October 2, 2007

So much for standardization :Study pokes holes in NPI data

A recent study of standardized provider identification numbers released by the federal government calls into question the accuracy of the data associated with those numbers. Some 19.7 percent of the business addresses associated with National Provider Identifiers are invalid because physicians have moved, retired or are deceased, according to a recent audit by SK&A Information Services.

SK&A is an Irvine, Calif. -based company that sells a product that provides telephone-verified NPI numbers. It conducted a phone survey of nearly 7,000 providers to assess the accuracy of the numbers, said Mike Green, vice president of products and research for the company. Each provider in the country is expected to have an NPI that will serve as a unique identifier, replacing legacy provider numbers that payer organizations have assigned to providers. NPIs eventually will be required on all claims forms. Nearly 1.8 million NPIs have been issued, SK&A contends. .

The company contends that NPI data is as much as 28 months old, because the Centers for Medicare & Medicaid Services began issued standardized NPIs in May 2005. Its research also shows that 68 percent of the NPI numbers were assigned more than eight months ago. SK&A contends that the average age of an NPI is 13.2 months. The government originally had set May 23 for when it would require NPI use on claims forms, but in April developed a contingency plan to delay implementation of NPIs as long as one year. NPIs were supposed to be available from the federal government in mid-summer, but the government delayed release of NPIs until September to give providers time to correct information associated with their NPIs. NPI and associated data is critical to the industry; optional data fields associated with the NPI contain legacy provider identification numbers, which payers can use to link existing data in their information systems with the new NPIs.

SK&A is continuing its study of NPI data released by the government to see if other anomolies show up, said Jack Schember, the company’s director of marketing. “This study on NPI data quality highlights the challenges that healthcare payers and marketers will face when trying to accurately match or link their provider legacy information to the new federally mandated NPI number,” said Dave Escalante, President and COO of SK&A Information Services Inc.

source: Healthcare IT News

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