CarePrecise to Continue Monthly PECOS-NPI Data Releases
PR Log - Jan 29, 2012 - CarePrecise has announced that, despite the federal decision to redact vital data from the monthly PECOS Ordering and Referring Report, the company will continue to release the PECOS data as part of its CarePrecise Access Complete database (visit http://www.careprecise.com/cpac for details) of U.S. healthcare providers. In effect, this provides the link between the PECOS enrollment data and each enrolled provider’s NPI (National Provider Identifier) number. PECOS is the acronym for the federal Provider Enrollment, Chain and Ownership System, where healthcare providers are enrolled to be eligible to bill Medicare.
CarePrecise is a leading provider of data products used by health plans, major hospitals and provider groups, governments, industry researchers and companies that market to the healthcare industry.
The PECOS data is used by healthcare administrators, medical billers and health products vendors to determine whether a physician is eligible to order anything from basic supplies to expensive durable medical equipment (DME) to be billed to Medicare. The redaction of the NPI number from the monthly report is a blow to companies who need to link the information to internal systems, most of which use the NPI as a unique identifier, or key.
CarePrecise has included providers’ PECOS enrollment status, for both physicians and non-physicians, in its CarePrecise Access Complete monthly data releases since mid-2009, and was prepared for the action by Centers for Medicare and Medicaid Services (CMS) to remove direct keying from the PECOS Ordering and Referring Report. The company’s advanced record linkage system has long been used to incorporate data from multiple sources that lack unique identifiers, and obtaining a link between the PECOS enrollments and a complete NPI number became a top priority when CMS made the announcement in December. The current CarePrecise Access Complete database, available at www.CarePrecise.com, includes the PECOS data, as well as hundreds of additional details on the 3.5 million U.S. HIPAA-covered healthcare providers in the federal NPI database (National Plan and Provider Enumeration System).
Concerning accuracy, the company has tested its PECOS record linkage protocols against historical data, and reports 0.008% false positives and 0.0003% false negatives, claiming “near perfect” matching of PECOS and NPI data. In November of 2011, the company announced major advances in its SQUIRRelate record linkage system, which employs historical data modeling and proprietary data outreaching, conformation and disambiguation processes to in-match data from otherwise disparate sources.