A lot of effort has been put forth in mastering the patient/member and rightfully so. When effective, patient duplicates drop, the chances of administering the incorrect drugs decline, claims processing improves, the patient member experience enhances and so on. Now the challenge becomes provider or physician mastering. On the surface, that would seem to be a relatively easy task, but the devil is always in the details.
Providers wear many hats. They can be a solo practitioner, a physician as a part of a practice, a hospitalist, credentialed at many hospitals, and even the possibility of a single physician having two different National Provider Indexes (NPI’s). Some specialists, even within the same practice, will serve patients at different locations. To compound it further, information about a physician (e.g. – fax number) is spread across the 20+ systems that may be housed even within a single hospital system.
The impacts affect many different areas. Incorrect physician information could inhibit or delay notification when a patient has been discharged from either Emergency Department (ED) or inpatient services. When the patient presents for follow up, physicians are commonly surprised to learn they even went to a hospital. If the patient presented at both ED and subsequently Inpatient, one or both of the encounters may not be communicated to the PCP due to erroneous contact… Read More »