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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
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
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
npi accomplishments
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
npi next steps
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
lessons learned
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