ALISO VIEJO, Calif. May 23, 2006 Exactly one year from today, NPI
(National Provider Identifier) regulations will take effect for healthcare
organizations across the United States. Mandated by The Health Insurance
Portability and Accountability Act (HIPAA), NPI requires one unique 10-digit
NPI for each provider, replacing the use of multiple legacy provider
identification numbers.
This deadline is a wake-up call for health plans, who have struggled with poor
provider data for decades. Now, in less than a year, they must not only solve
this long-standing problem but also chart a seamless transition to the new
Federally-mandated system. In fact, a newly published report by Forrester
Research, Inc. (http://www.forrester.com), entitled "HIPAA's Last Stand: The
National Provider Identifier," highlights the complex problems payers are
facing as they prepare for NPI compliance, along with new vendor solutions
for cleaning provider data.
"With NPI compliance just one year away, healthcare executives are starting
to lose sleep over how they can make this transition without serious
disruptions to their businesses," said Sean Downs, president and CEO of
Enclarity, Inc., an information management and analytic software company
focused on the healthcare market. "Payer organizations have struggled for
years to correct provider data errors. Lacking quality data to begin with,
attempts to use development or business rules engines alone to comply with
NPI will not work. Instead, companies must first find and use intelligent
technological solutions to clean their databases, then proceed to "crosswalk"
their legacy provider data to the NPI system."
Provider data ambiguity costs health plans an estimated $26 billion a year in
inaccurate claims and misdirected bills, as well as fraud and abuse. By fixing
this problem, health plans will not only have an easier transition to NPI but
will also benefit from improved efficiencies and operations throughout the
enterprise.
"Forward looking organizations are viewing NPI as an opportunity to optimize
their operations and give themselves a competitive edge," noted
Downs. "Provider data touches so many areas within a health plan that the
improvements made in this area can be leveraged to enhance multiple levels
throughout the enterprise, from claims management to provider and member
relations."
To help healthcare payers and organizations that work with provider data to
be ready for the NPI implementation, Enclarity offers NPI Enabler" software,
which dramatically simplifies the complexities of integrating NPI into
healthcare organizations' legacy systems. The foundation for NPI Enabler is
ProviderPoint" software, which has a proven track record with health plans
in finding the 50 to 70 percent of provider data that is inaccurate, and in
fixing those errors overnight.
Recommendations for preparation for the NPI transition are posted on the
Enclarity website, at http://www.enclarity.com/solutions/enabler.html
Enclarity will demonstrate NPI Enabler and ProviderPoint in booth 243 at
Institute 2006, the annual meeting of America's Health Insurance Plans
(AHIP), in San Diego, June 7-9.
About Enclarity
Enclarity brings new solutions to fight an old problem for healthcare and
insurance payers: provider data errors. The company's software uses
advanced analytics and proprietary technology coupled with a massive
referential database and telephone verification to clean provider files,
assuring the data is accurate and current, increasing the productivity and
profitability of our customers.
From keeping provider records correct and up-to-date with integrated
solutions to helping businesses prepare for the National Provider Identifier
mandates, Enclarity dramatically improves the integrity and reliability of
healthcare data.
Enclarity, Inc. is a privately held company headquartered in Aliso Viejo,
California. For more information, visit www.enclarity.com.
Better provider data. Right now."