Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS President

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Presentation transcript:

National HIPAA Audioconference: Analysis of the National Provider Identifier Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS President Boundary Information Group www.boundary.net January 11, 2006

Strategic IT business process planning ROI/benefits realization Project management and oversight Workflow redesign Education and training Vendor selection and enhanced use of vendor products Facilitate collaborations among organizations to share/exchange health care information Business process consultant focusing on electronic health records, and electronic transactions between organizations Former positions with MGMA, University of Denver, Dartmouth College Active leader in the Workgroup for Electronic Data Interchange (WEDI) Speaker and author (two books on HIPAA Security and one on electronic health records) Co-Founder of Health IT Certification Steve Lazarus. Boundary Information Group Strategies for workflow, productivity, quality and patient satisfaction improvement through health care information

History of NPI 1993 WEDI Report recommended four Standard Identifiers Patient Provider Payer Employer 1996 HIPAA legislation includes these four identifiers 1998 National Provider Identifier NPRM 2004 National Provider Identifier Final Rule May 2007 NPI use required by all CEs except small health plans (May 2008)

Simple NPI: The Vision Most health care providers receive one unique number for life No cost to apply for the number All health plans must use the number and stop requiring proprietary numbers by May, 2007 (May, 2008 for small health plans) NPIs are obtained from NPPES (NPPES.cms.hhs.gov/NPPES/WELCOME.do) Provider NPI application process NPI dissemination to health plans and others

Types of NPIs Type 1 – Individual NPI: An individual health care provider may obtain a single NPI to identify the person for life Type 2 – Organizational NPI is a provider that is not an individual. It is a legal entity such as government, corporation, partnership. It obtains one NPI for the whole, and it may obtain NPIs for its Subparts.

What are the Barriers? Obtaining the numbers Distributing the NPIs Only a few hundred thousand numbers issued so far Bulk enumeration not available yet Distributing the NPIs Health plans, hospitals and others need to access the new numbers Information processing issues Matching current provider/identifier to the NPI Designing and implementing new data flows and uses without proprietary number Determining subparts (for Medicare) and their Type 2 NPIs

NPIOI WEDI established the National Provider Identifier Outreach Initiative in 2005 Established the WEDI National NPI Resource Center www.wedi.org/NPIOI/index.shtml

Contact Information Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS President Boundary Information Group (303) 488-9911 sslazarus@aol.com www.boundary.net www.healthitcertification.com