Health Information Management

Improve MPI data integrity to prepare for unique identifier rules

HIPAA Weekly Advisor, November 1, 2002

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Analyzing your master patient index (MPI) data now will help you improve the accuracy and timeliness of clinical treatment, reduce risks associated with billing errors, improve system performance, and prepare your facility for HIPAA's unique identifier rules.

"If you can focus on the huge implementation effort for whatever new [identifier] system comes along, instead of problems you never addressed, you'll be in much better shape," says Vicki Wheatley, RHIA, vice president of MPI professional services for the health information management (HIM) services division of QuadraMed, in Plano, TX. "Don't wait until [HHS] tells you what you have to do."

The following four rules deal with unique identifiers:

1. Employer identifier rule
The final rule was published in May 2002, and the compliance date is July 30, 2004, for providers, health care clearinghouse, and most health plans. The deadline for compliance for small health plans is August 1, 2005.

In the past, health plans, clearinghouses, and providers used different numbers to identify the same employer. The rule provides the employer identification numbers (EINs) facilities must use as unique identifiers when filing and processing all health care claims and other transactions.

Having multiple identifiers for a single employer slows activities such as health plan enrollment and premium payment, according to CMS. The agency says standard unique identifiers will help eliminate paperwork and save money overall.

Employers will use their EINs in all transactions covered under HIPAA, such as enrolling an employee in a health plan. Health plans, clearinghouses, and providers that conduct standard electronic trans actions must use EINs when identifying the employer. The Internal Revenue Service (IRS) issues and maintains EINs.

2. Health care provider identifier rule
The proposed rule was published in May 1998, and the final rule is currently under development.

3. Health plan identifier rule
The proposed rule is currently under development.

4. Individual identifier rule
All work on this rule was suspended in 1998, pending federal privacy protections.

Go to http://www.himinfo.com/news/feature.cfm?content_id=24555 to read more.



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