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Measure Name | % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 2 (NPI) |
---|---|
File Type | PRV |
Measure ID | PRV-2-002-2 |
Measure Type | Non-Claims Percentage |
Content area | PRO |
Validation Type | Longitudinal |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Provider identifiers |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0.01 |
---|---|
Maximum | 0.999 |
TA Minimun | 0.01 |
TA Maximum | 0.999 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | SUBMITTING-STATE-PROV-ID • PROV-IDENTIFIER-TYPE |
---|---|
DD Data Element Number | PRV075 • PRV077 |
Annotation | Calculate the percent of submitting state provider IDs that have an NPI |
---|---|
Specification |
STEP 1: Provider enrolled on the last day of DQ report month Define the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria: 1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month 2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing 3. SUBMITTING-STATE-PROV-ID is not missing STEP 2: Provider identifier is active on the last day of DQ report month Of the providers that meet the criteria from STEP 1, further refine the population using segment PROV-IDENTIFIER-PRV00005 by keeping records that satisfy the following criteria: 1a. PROV-IDENTIFIER-EFF-DATE <= last day of the reporting month 2a. PROV-IDENTIFIER-END-DATE >= last day of the reporting month OR missing OR 1b. PROV-IDENTIFIER-EFF-DATE is missing 2b. PROV-IDENTIFIER-END-DATE is missing STEP 3: Provider classification type is "NPI" Of the providers that meet the criteria from STEP 2, keep records that satisfy the following criteria: 1. PROV-IDENTIFIER-TYPE = 2 STEP 4: Calculate percent that have NPI Divide the count of unique SUBMITTING-STATE-PROV-IDs from STEP 3 by the count from STEP 2 |