National Provider Identifier: Contingency Plan and Data Dissemination Colleen Beier Provider Services Assistant Director WEA Trust.

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Presentation transcript:

National Provider Identifier: Contingency Plan and Data Dissemination Colleen Beier Provider Services Assistant Director WEA Trust

2 Agenda General information about the WEA Trust (the Trust) Contingency plan Data dissemination –What methods is the Trust utilizing to capture national provider identifiers (NPIs)?

3 WEA Trust The Trust is a not-for-profit insurer The Trust currently provides health, dental, life, and disability insurance coverage to public school employees throughout Wisconsin We currently have approximately 130,000 lives enrolled in one of our health plans and approximately 120,000 lives enrolled in our dental plan

4 WEA Trust (Cont.) The Trust receives approximately 2.1 million health claims annually The Trust receives approximately 325,000 dental claims annually

5 The Trust’s Contingency Plan Implemented on May 23, 2007 Allows for the continued use of legacy identifiers in electronic transactions until further notice but no later than May 22, 2008

6 The Trust’s Contingency Plan (Cont.) The Trust will continue to work with trading partners to move towards full compliance The Trust will provide a 60-day advance notice should the decision be made to end the contingency period before May 22, 2008

7 Positives of Contingency Plan Allows additional time for testing with trading partners Allows additional time collecting NPIs from providers Little or no disruption of transactions

8 Negatives of Contingency Plan  Different levels of compliance throughout the industry  Some felt that the deadline was simply extended an additional 12 months  Resources that were assigned to the NPI project were removed  Additional steps will need to be taken in April 2008 to move to NPI only

9 Data Dissemination What methods are the Trust utilizing to capture NPIs? –Larger provider systems have shared the NPIs with the Trust in an Excel format –Smaller providers have shared their NPIs in various formats –NPI registry –Paper claims –Querying the system to identify data gaps

10 Colleen Beier Provider Services Assistant Director WEA Trust Madison, WI (608)

Thank you