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Administrative Healthcare Data by Renu Gehring, Craig Dickstein

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Chapter 4: The Providers

Introduction

Types of Providers

Facility

Professional

Pharmacy

Ancillary

National Provider Registry

NPI

Taxonomy

Other Provider Identifiers

Case Study: Standardizing Provider Names from the National Provider Registry

Case Study: Using Taxonomy Code to Identify Primary Care Physicians

Conclusion

Introduction

Providers of health care are the initiators in the flow of administrative healthcare data. They provide a variety of services for the members of a health plan and therefore seek reimbursement by that health plan. This claim for service reimbursement, and its subsequent payment, generates much of the administrative healthcare data that we analyze. It therefore makes sense to view our data in the context of who initiated ...

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