Twenty percent of the addresses associated with the National Provider Identification numbers issued by the federal government this year are wrong, a new report contends.
Some 19.7 percent of the business addresses associated with NPIs 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.
"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.
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 said.
Some NPI data is as much as 28 months old, SK&A said, because the Centers for Medicare & Medicaid Services began issued standardized NPIs in May 2005.
SK&A research also shows that 68 percent of the NPI numbers were assigned more than eight months ago - making the average age of an NPI 13.2 months.
The government originally had set May 23 as the deadline for requiring NPI use on claims forms, but in April a contingency plan was developed to delay implementation of NPIs as long as one year.
The release of NPI-related information was delayed 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.
Incorrect associated data might slow payers' remittances to providers, Green said. Communications from other companies, such as pharmaceutical companies, medical device manufacturers and medical equipment suppliers, might be delayed.
Physicians are required to update the information associated with their NPIs, but it's not a top-of-mind concern for most providers, Green added.