Practice Affiliations
Data Dictionary
Provider, practice, and payer relationships resolved across providers.
Column added or derived by Serif Health
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Payer & Network
- Full payer name, e.g. “Blue Cross Blue Shield of Alabama”
- Full network name where delineated by payer MRF index, e.g. “Blue Choice Platinum for Business - PPO”Methodology: We keep the plan_name indicated in the table of contents file if fully defined; if not or ambiguous we may use web searches or other sources to identify the plan name.
- The state abbreviation (e.g. "TX", "CA"), or USA for nationalMethodology: If the plan name in the table of contents or the plan_id includes a HIOS state code, this is used to determine NetworkRegion. If ambiguous, we may use web searches or other sources to identify the network region.
- The yyyymm year month of this MRF postingMethodology: We use the month and year of the _index_ file, if unambiguous. If not present or obvious, we will use the month and year indicated in the in-network file name, and if that is not present or obvious, we will match it to the year and month of access.
Entity
- Group name assigned by Serif Health based on EIN for the recordMethodology: Normalized group names based on similar entity names
- EINSWill be a 9 digit un-hyphenated EIN or a 10 digit NPI number, each payer may use either format. EINs can be zero-led so this must be a text field.
- The name of the organization, practice group, or provider that was resolved.Methodology: Name tables come from NPPES as well as proprietary and public sources like EDGAR filings, IRS notices, legal filings, etc.
Provider
- NPIS10 digit NPI
- First name of NPIMethodology: Derived from NPPES database
- Middle name of NPIMethodology: Derived from NPPES database
- Last name of NPIMethodology: Derived from NPPES database
- Credential of NPIMethodology: Derived from NPPES database
Location
- Address where the NPI is registeredMethodology: Derived from NPPES database
- Extended / additional address where the NPI is registeredMethodology: Derived from NPPES database
- CitySCity where the NPI is registeredMethodology: Derived from NPPES database
- County where the NPI is registeredMethodology: Derived from NPPES database
- State where the NPI is registeredMethodology: Derived from NPPES database
- ZipS5-digit zip code where the NPI is registeredMethodology: Derived from NPPES database
Taxonomy
- An NUCC primary taxonomy code such as "207X00000X".Methodology: Derived from NPPES database
- Taxonomy group based on PrimaryTaxonomyMethodology: Derived from NPPES database
- Boolean field indicating whether NPI is Type1 or Type2Methodology: Read here for more details on the difference between Type1 and Type2 NPIs: https://help.serifhealth.com/article/23-guide-to-provider-search
| Column | Description | Methodology |
|---|---|---|
| Payer & Network | ||
| PayerS | Full payer name, e.g. “Blue Cross Blue Shield of Alabama” | — |
| NetworkNameS | Full network name where delineated by payer MRF index, e.g. “Blue Choice Platinum for Business - PPO” | We keep the plan_name indicated in the table of contents file if fully defined; if not or ambiguous we may use web searches or other sources to identify the plan name. |
| NetworkRegionS | The state abbreviation (e.g. "TX", "CA"), or USA for national | If the plan name in the table of contents or the plan_id includes a HIOS state code, this is used to determine NetworkRegion. If ambiguous, we may use web searches or other sources to identify the network region. |
| NetworkYearMonthS | The yyyymm year month of this MRF posting | We use the month and year of the _index_ file, if unambiguous. If not present or obvious, we will use the month and year indicated in the in-network file name, and if that is not present or obvious, we will match it to the year and month of access. |
| Entity | ||
| EntityGroupNameS | Group name assigned by Serif Health based on EIN for the record | Normalized group names based on similar entity names |
| EINS | Will be a 9 digit un-hyphenated EIN or a 10 digit NPI number, each payer may use either format. EINs can be zero-led so this must be a text field. | — |
| EntityNameS | The name of the organization, practice group, or provider that was resolved. | Name tables come from NPPES as well as proprietary and public sources like EDGAR filings, IRS notices, legal filings, etc. |
| Provider | ||
| NPIS | 10 digit NPI | — |
| FirstNameS | First name of NPI | Derived from NPPES database |
| MiddleNameS | Middle name of NPI | Derived from NPPES database |
| LastNameS | Last name of NPI | Derived from NPPES database |
| CredentialS | Credential of NPI | Derived from NPPES database |
| Location | ||
| Address1S | Address where the NPI is registered | Derived from NPPES database |
| Address2S | Extended / additional address where the NPI is registered | Derived from NPPES database |
| CityS | City where the NPI is registered | Derived from NPPES database |
| CountyS | County where the NPI is registered | Derived from NPPES database |
| StateS | State where the NPI is registered | Derived from NPPES database |
| ZipS | 5-digit zip code where the NPI is registered | Derived from NPPES database |
| Taxonomy | ||
| PrimaryTaxonomyS | An NUCC primary taxonomy code such as "207X00000X". | Derived from NPPES database |
| TaxonomyGroupS | Taxonomy group based on PrimaryTaxonomy | Derived from NPPES database |
| IsType1S | Boolean field indicating whether NPI is Type1 or Type2 | Read here for more details on the difference between Type1 and Type2 NPIs: https://help.serifhealth.com/article/23-guide-to-provider-search |
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