David E. Mann, Would You Have Identified Him Correctly?

By Ben Carmel

David E. MannOn August 4th, it was reported that the Centers for Medicare and Medicaid Services (CMS) had temporarily suspended the open payments verification system after at least one doctor, Dr. David E. Mann, an electrophysiologist in Louisville, KY, discovered payments attributed to him that were actually for an entirely different David E. Mann, an oncologist in Crestview, FL.

David Edwin Mann has a different address, different middle name and different NPI number from David Eben Mann, however, Medical Device and Pharmaceutical companies that do not use a 3rd party data validation service to identify and verify the correct physician risk making a mistake like this one.

A cornerstone Polaris recommendation has been to avoid system vendors and processes that rely solely on a single Healthcare professional (HCP) database, especially the NPPES registry, which is flawed. The mistake that brought down the CMS open payments system could be shoved under the rug as a single point of failure with transactional data, but we feel that it highlights the need for access to robust HCP data, combined with an audit of your aggregate spend processes, data integration rules and reporting business rules.

You need multiple checks and balances to verify and validate other credentials to be able to locate the correct doctor. A real-time system with data being refreshed to the cloud every 4 hours, like Healthcare Data Solutions’ HDSverify, crosswalks NPI, DEA, State License and other sources to correctly identify doctors and help prevent mistakes like this from occurring.

Do you have confidence in the database you’re using to report payments to CMS? Would you have correctly identified David E. Mann?