Accurate patient identification is crucial. Knowing who a patient is and matching their information to identify them correctly is paramount. Without accurate identification, data integrity is compromised, and patient safety is of concern.
By: April Smith, CCS
Errors in identification are expensive. 35% of all denied claims result directly from inaccurate patient identification or inaccurate/incomplete information, costing the average healthcare facility $1.2 million per year.
What is NPI?
NPIs (National Patient Identifiers) could be the answer. If NPIs were issued to every citizen of the United States, they would be used across the healthcare continuum to assure data accuracy.
Why Implement NPI?
When HIPAA was implemented in 1996 it called on the Department of HHS to develop a standard, unique identifier for health plans, providers, employers and patients. In 1999, further legislation prohibited the use of Federal funds to implement the standard for patients “until legislation is enacted by Congress specifically approving the standard.” This has yet to be accomplished. The reason for this delay is multifocal:
- It is estimated that the cost related to this system could be between $1.5 billion and $11.1 billion.
- Potential for fraud. An article on Carecloud.com stated, “the system would become a magnet for illegal activity, such as drug seekers and medical identity theft.”
- Privacy concerns. A patient’s entire electronic health history would be easily accessible, including substance abuse treatment and mental health records.
The American Health Information Management Association (AHIMA) is a proponent of the NPI system. However, large obstacles stand in the way and many questions must be answered before moving forward.
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