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NATIONAL PROVIDER IDENTIFIER (NPI) CLOSEOUT PHASE

NATIONAL PROVIDER IDENTIFIER (NPI) CLOSEOUT PHASE. Human Services Department Mark Pitcock, Bureau Chief Program Information Systems Bureau Liz Shaw, IT Project Manager Information Technology Department. NPI Project Overview.

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NATIONAL PROVIDER IDENTIFIER (NPI) CLOSEOUT PHASE

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  1. NATIONAL PROVIDER IDENTIFIER (NPI) CLOSEOUT PHASE Human Services Department • Mark Pitcock, Bureau Chief • Program Information Systems Bureau • Liz Shaw, IT Project Manager • Information Technology Department

  2. NPI Project Overview • Meets the Federal requirement for a National Provider Identifier for HIPAA-covered health care providers and insurers • NPI will generate efficiencies in the health care system • Changes were required for the existing Omnicaid (Medicaid claims adjudication system) and the Transaction Interface Exchange (HIPAA transactions translator) • Omnicaid is hosted by ACS, fiscal agent for HSD’s Medicaid Management Information System. The software is maintained by ACS. • TIE is hosted at NM DoIT Data Center. The software is maintained by HSD/ITD. • Funded from the computer enhancement fund reauthorized • Laws 2007, Chapter 28, Section 7, Subsection 20 • Dept. of Health & Human Services; Centers for Medicare & Medicaid Services. Grant # 0805NM5028

  3. NPI Accomplishments • Initiation Phase: Completed by December 2006 • NPI System Assessment completed – this assessment was to determine which identification number locations and logic must be modified to accommodate the new HIPAA standards) • High Level Project Plan • Advanced Planning Document • Initiation Phase Certification • Implementation Phase: Completed by June 2008 • NPI software changes to Omnicaid put into Production - May 23, 2007 • IV&V reports for Omnicaid-related work - completed by June 2007 • IV&V reports for TIE-related work – completed by June 2008 • TIE-related coding and configuration and end-to-end testing – completed by June 2008 • System documentation and training – completed by June 2008 • TIE software changes put into Production – June 30, 2008

  4. NPI Next Steps • Update system documentation, November 2008 • PCC approval of project certification for Close-out Phase, November 2008 • Submit close-out report to DoIT, December 2008 • Submit APD Update to CMS, December 2008

  5. Lessons Learned • A solid project plan should be created and followed • Stronger contractual management • Create a Project Management Office for such large projects that involve several groups. This would also help to control off-site, disparate teams and to create a more collaborative effort. • Make sure that the project has adequate, cross-functional resources • HSD needs to be part of an integrated coding team, to ensure that our coding requirements are met

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