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National Provider Identifier: Contingency Plan and Data Dissemination

National Provider Identifier: Contingency Plan and Data Dissemination. Colleen Beier Provider Services Assistant Director WEA Trust. Agenda. General information about the WEA Trust (the Trust) Contingency plan Data dissemination

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National Provider Identifier: Contingency Plan and Data Dissemination

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  1. 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 DirectorWEA TrustMadison, WIcbeier@weatrust.com(608) 661-6635

  11. Thank you

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