Proof of Concept (PoC) fields for clinician demographics:
Required Fields for clinician demographics:The following data elements are core data needs for this proof of concept.
| Line | Required | Column | Description |
|---|---|---|---|
| 1 | Required | Last Name | Last Name |
| 2 | Required | First Name | First Name |
| 3 | Required | Middle Name | Middle Name |
| 4 | Required | Suffix | Suffix |
| 5 | Required | TaxIDindividual | Tax ID number associated with the provider (individual practitioner) |
| 6 | Required | TaxIDinstitution | Tax ID number associated with the provider (institution). For employers, including state and local government agencies and non-profit organizations, TIN is the IRS issued employer identification number (EIN). EINs are public information per the FCC |
| 7 | Required | NPI | NPI |
| 8 | Required | HCPT Spec Code | Health Care Provider Taxonomy- Industry standard specialty codes (for complete code list see ) |
| 9 | Required | isAcceptingPatients | The provider is accepting the patients for the payer product: only existing patients, family members of existing patients, new patients, other per Provider/Payer |
| 10 | Required | PayerNtwkEffDate | Date - the provider joined this network (at the group level for POC purposes) |
| 11 | Required | PayerNtwkExpireDate | Date - the provider left this network (at the group level for POC purposes) |
| 12 | Required | Site/Location EffectiveDate | Provider’s start date at this location |
| 13 | Required | Site/LocationTerminationDate | Provider’s end date at this location |
| 14 | Required | PracticeStreet1 | Provider’s place of medical service, practice address street line 1 |
| 15 | Required | PracticeStreet2 | Practice address street line 2 |
| 16 | Required | PracticeCity | Practice city |
| 17 | Required | PracticeState | Practice state |
| 18 | Required | PracticeZip | Practice zip |
| 19 | Required | PracticeTelephone | Practice phone (can have multiple types by location, i.e. , appointment, business line) |
The following additional data if available, may be collected for this proof of concept:
| Line | Data Needed | Column | Description |
|---|---|---|---|
| 20 | High | PrimaryContactName | Practice contact name |
| 21 | High | PrimaryContactFax | Fax |
| 22 | High | ProviderRetireDate | Date of the provider Retired |
| 23 | High | ProviderDeceaseDate | Date of the provider deceased |
| 24 | High | ProviderProficiencyEnglish | Provider’s proficiency in the English language |
| 25 | High | ProviderOtherLanguages | Languages spoken by the provider (other than English) |
| 26 | High | StaffProficiencyEnglish | Staff proficiency in the English language |