The NPI registry, also called the National Provider Identification registry, is a digital database of all Medicare providers. In a system that handles hundreds of millions of pieces of confidential data, though, you will find a couple of weaknesses. The newest NPI database discloses additional data that opens the door for Medicare fraud.
The registry of NPI
The Medicare system is a very complicated bureaucratic maze that depends on the NPI registry, which stands for National Supplier Clearinghouse numbers and Medicare Administrative Contractors. The NPI Registry database is called the National Plan and Provider Enumeration System. Payment of Medicare claims was intended to be easier with NPPES. In the end, though, the NPPES also gives out the National Supplier Clearinghouse number of a provider, which opens up both patient and provider information.
Registry information for NPI
The National Provider Identification registry works with a number of other cogs within the Medicare system. With just the NSC number and a patient’s claim number, everyone can access info on payment of claims, a patient’s diagnosis and procedures, and more. The new NPI registry opens up the bones of the Medicare payment system to possible exploitation.
Fixing difficulties with NPI registry
Contacting the 3 major arms of the Medicare payment system to ask about the NPI registry problem resulted in being given the runaround, as reported by Home Care Magazine. The suggestion of deleting the NPI information from the database, though, means that a provider might not get paid. In other words, this means that providers have to determine between being paid by Medicare for services they provide, or safeguarding the personal info of the doctors and patients. Though a number of solutions easily coded by dedicated programmers are suggested, the NPI registry has not said they will be implementing any of them.
Citations:
Home Care Magazine
homecaremag.com/news/nsc-numbers-revealed-npi-registry/
