Master Provider Identification Best Practices


Tuesday, July 10, 2018

Master Provider Identification Best Practices

Master Provider Identification Best Practices

Jul 10, 2018

Author: Lisa Rothmuller

A standard master provider ID across the system ensures that applications that share data will always update information as desired. As applications merge and change, industry standards change, and technology changes, it is easy to see how the master provider identification can become misaligned.


Common Causes

Merging Databases Without Universal ID in Place: The best matching criteria are preferred IDs. However different systems use different elements from a provider record as their preferred ID.

No Written Policies or Procedures: No universal methodology in place for setting up unique numbers to be used as preferred IDs for each new or imported entries.

Data Entry Error: Using a first and last name or DOB as the unique ID can be difficult when a provider’s name changes or misspellings are introduced.


Example

A health system with multiple entities used Social Security Numbers as the Master ID. This proved problematic when over 60% of records did not include a SSN and therefore could not compute a preferred ID.


Ramifications

Security Breach of Patient Privacy: Using sensitive information such as a Social Security Number or a Medical License number as a provider ID can present security and privacy risks for the provider. When such information is fed downstream to less secure systems or are included in communications outside the system, they are made vulnerable to exploitation at the provider’s expense and possibly to their detriment.

Data Duplication: Mismatching preferred IDs can cause duplication whenever a database merges imports or feeds downstream systems. Appropriate and unique provider IDs are crucial to identifying the correct provider without inciting duplication within the system.


Best Practice

Employ a Universal Physician ID Number: Set a standard during implementation for users to follow when importing or entering providers into the database. This number could be a health system standard. Avoid the following as unique identifiers: Social Security Number, first and last name or DOB and NPI.

Communication with Other Departments: It is possible the health system already has a standard in place or is in the process of implementing a standard. It is a good idea to communicate with IT or other corporate departments to insure your standards match and are in line with health systems goals.

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