SOURCE: Enclarity Inc.

February 25, 2008 12:00 ET

Enclarity Is First to Deliver NPI Type 1 and Type 2 Solutions Just in Time for May Medicare Deadline

Enhancements to Flagship ProviderPoint and New NPI Match Solutions Dramatically Reduce the Risk of Rejected Claims

ALISO VIEJO, CA--(Marketwire - February 25, 2008) - Enclarity Inc., a leading healthcare information solutions company, is helping healthcare organizations meet the May Medicare deadline for HIPAA- mandated National Provider Identifier (NPI) compliance with its enhanced ProviderPoint® and new NPI Match™ solutions. The healthcare industry is looking for a way to identify and match the data in the National Plan and Provider Enumeration System (NPPES) file to legacy provider records and claims for the Type 1 (individual providers) and Type 2 (entities) information. In addition to matching, the industry must assign sub-parts to Type 2 organizations, associate taxonomy information with each provider and continuously synchronize legacy provider files, claims processing and the NPPES data. Enclarity's solutions answer the industry's need by providing the most correct, current, comprehensive information available.

Although many payers, PPOs, clearinghouses, hospitals and labs believe that lack of a correct NPI number will not prevent electronic claims from being processed, the potential consequences of discounting NPI are substantial. Economic risks associated with rejected electronic claims include lost revenue and delayed cash flow due to higher rejection rates, increased costs associated with manual claims processing, and their combined effect on earnings and valuation, especially during the first quarter rejections occur.

Information Changes Too Fast for Providers to Keep Up

The NPPES data published in Oct. 2007 was immediately out of date: each year, more than 20 percent of providers change their addresses, five percent change their status and 30 percent change their affiliations. Providers are expected to keep their demographic information in the NPPES database up-to-date. Thus far, the actual rate of updates is less than 20 percent of what would be expected given the industry's usual rate of change. In order for the industry to process claims effectively it is important to use more than the NPPES data, especially because the data does not provide important information such as the Tax ID Number (TIN). Enclarity has matched 95 percent of Type 1 NPI data and 80 percent of Type 2 NPI data to providers in Enclarity's own database, assuring its clients the most up-to-date information available.

"The complexities of meeting the NPI deadline are more than most internal IT staffs can handle on their own. To completely handle it internally means starting a massive IT installation, spending unnecessary money and time, and diverting resources from other projects," said Sean Downs, president and chief executive officer, Enclarity. "Enclarity provides the same service in a much more cost-effective way. We found the right solution to the healthcare industry's need for ongoing NPI compliance using the Enclarity Master Provider Referential Database."

Two Solutions for Reliable NPI Compliance

Both the enhanced ProviderPoint and the new NPI Match solutions are able to match Type 1 and Type 2 NPI to legacy provider files. ProviderPoint is Enclarity's complete provider information solution, and the new NPI Match solution offers an option for quick NPI compliance.

--  ProviderPoint - ProviderPoint is enhanced to offer Type 1 and Type 2
    NPI matching, confidence scoring for the provider file and persistent keys
    for easy ongoing file augmentation. The sophistication of ProviderPoint's
    NPI matching capabilities extends to the grouping of all the NPIs
    associated with an entity. For example, ProviderPoint can match under one
    inclusive NPI, every department at a hospital. This allows payers to see
    exactly which services at an entity are used and when. The confidence score
    is based on statistical rankings using Enclarity's experience with
    delivering correct, current, comprehensive healthcare provider information.
    Enclarity simplifies ongoing data cleansing and augmentation by providing a
    code, or persistent key, that stays with the record over time that allows
    the provider file to automatically update based on the key.
--  NPI Match - Enclarity introduced NPI Match, an affordable solution to
    quickly meet the NPI mandate in as little as 10 business days, without
    buying new equipment or undergoing a lengthy IT installation. NPI Match
    augments Type 1 and Type 2 NPI information to a provider file, identifies
    taxonomy values and delivers an amended file on a frequency chosen by the
    client. In addition, NPI Match attaches the correct NPIs to legacy provider
    files for accurate claim matching and adjudication. Enclarity has found
    that the company is able to match 95 percent of Type 1 NPI data and 80
    percent of Type 2 NPI data, assuring payers the most up-to-date information

NPI information is also available via Enclarity ProviderLookup, the company's real-time, web-based solution that dramatically reduces the time spent searching for information about a specific provider. For more information about ProviderLookup visit

Enclarity's Core Technology

Enclarity has compiled its Master Provider Referential Database of more 140 million records using a unique blend of thousands of sources, advanced analytics and healthcare industry expertise. Using the AcuSync™ process, Enclarity is able to match a payer's provider file to the Master Provider Referential Database to efficiently and reliably deliver the most correct, current and comprehensive information available.

NPI Match and ProviderPoint are available today. To inquire about service or learn more, visit or call (949) 330-6383.

About Enclarity

Enclarity® solves healthcare's provider information problem. The company delivers correct, current and comprehensive provider information solutions by blending thousands of data sources, advanced analytics and healthcare expertise. As a result, its clients improve results in many areas, including claims processing, provider directories and network analysis. Named one of the Top 100 private technology companies in North America by Red Herring magazine and awarded the Global Healthcare Information Technology Excellence Award by Frost & Sullivan, Enclarity is headquartered in Aliso Viejo, Calif. Enclarity's investment partners include Bain Capital Ventures and Ignition Partners. For more information, visit

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