Training for Health Plans and Others on Healthcare Provider Taxonomy

(PRLEAP.COM) Provider taxonomy – a code that describes a type of healthcare facility or practitioner’s specialty or subspecialty – has taken on new significance as the healthcare industry marches toward implementation of the National Provider Identifier (NPI). Implementation of the NPI is expected to save hundreds of millions of dollars annually in healthcare costs due to vastly simplified administrative functions and quicker payment of claims.

Recently, Medicare indicated it would require provider taxonomy to be included on healthcare providers’ claims for payment.

But are healthcare providers’ billing systems and health plans’ routing and adjudication systems up to the challenge? Reports from the field suggest a perilous reliance on single-value databases, rudimentary matching algorithms and payer-assigned values. Unless both parties – and their technology vendors and service providers – grasp the challenge of dealing with the inherent ambiguities in the code set and the inevitability of conflicts between various payers’ expectations, taxonomy will become an unanticipated problem instead of a new solution.

Healthcare IT Transition Group http://hittransition.com will present two web-based seminars titled “Decoding Provider Taxonomy: A Pragmatic Approach for Providers, Payers and Partners” on February 22 and 28, 2007, and then on subsequent dates to be announced. The speaker is nationally recognized NPI authority Martin Jensen, currently involved in state Medicaid and health IT software vendor NPI remediation. Jensen presented the findings of the national survey on provider taxonomy on behalf of the Workgroup for Electronic Data Interchange (WEDI).

Bringing real-world experience in taxonomy implementation and over three years of research and analysis, Healthcare IT Transition Group will explain how the provider taxonomy code set can be used effectively in the context of multi-trading partner exchanges. Healthcare providers will learn how to evaluate whether their systems are at risk, and how to work with their payers and vendors to resolve issues. Health plans will learn what they can reasonably expect from a taxonomy-dependent NPI strategy, and how to more effectively deal with the realities of the provider universe. Vendors will learn how to sort out – literally – diverging trading partner requirements, and provide solutions that add value on both sides of the transaction.

Additional information and registration for the 90-minute webinars is available online at
http://hittransition.com/flashpoint/taxo or by calling (918) 406-3998.

Upcoming training will cover other NPI issues, including the federal NPI Data Dissemination Policy, and NPI Business Continuity Planning.

Healthcare IT Transition Group http://hittransition.com is a health technology and policy consultancy that works with the U.S. healthcare industry to reduce the cost and improve the quality of healthcare through the use of information technology. The company’s clients include healthcare providers large and small, healthcare industry software makers and technical services companies, and some of the nation’s largest health plans.

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