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2 Default Provider Object Model, Matching Configuration, and Code Lists

This chapter provides information about Organization and Individual Provider Index primary objects (OrgProvider and IndProvider). It also presents a listing of the organizational and individual Provider Index matching configurations, and pre-populated code lists.

This chapter includes the following sections:

• Understanding Provider Index Primary Objects and Sub-Objects

• Organizational and Individual Provider Index Matching Configuration

• Understanding What is Included in the Pre-populated Code Lists

Understanding Provider Index Primary Objects and Sub-Objects

This section provides tables that describe the provider index primary object and sub-objects and field values. The Provider Index data models are based on the following standards: US National Provider Identifier (NPI), Australia Provider Index standard, and the IHE Healthcare Provider Directory, along with the best practices of OHMPI. The below tables illustrate the Data Model for the Organizational Provider Index and the Individual Provider Index.

Note:

In the following tables, the primary object attributes are in normal font and sub-objects are in bold-italic font, and sub-object attributes are in italic font.

Abbreviation List of Names Used in the Following Tables

• BusNames: Business name

• Cert: Certificates

• DOB: Date of Birth

• DOD: Date of Death

• EIN: Employer Identification Number

• ESURI: electronic service uniform resource identifier. e.g. web service URL

• ITIN: Individual Taxpayer Identification Number

• MREmail: Medical Record Delivery E-mail

• MStatus: Marital Status

• SSN: social security number

• Telecomm: telecommunication

Table 2-1 Organizational Provider Data Model - OrgProvider

Attributes of Primary Objects or Sub-Objects	Attributes of Sub-Objects	Required or OptionalFoot 1	Data Type	Field Size
ProviderStatus	-	R	String	15
MREmailFoot 2	-	O	String	250
EINFoot 3	-	O	String	16
Names	-	-	-	-
-	NameType	R	String	15
-	Name	R	String	200
-	Name_Std	O	String	200
-	Name_Phon	O	String	200
-	Name_OrgType	O	String	40
-	Name_AssocType	O	String	40
-	Name_Industry	O	String	40
-	Name_Sector	O	String	40
-	Name_Alias	O	String	200
-	-	-	-	-
Locations	-	R	-	-
-	LocationType	R	String	15
-	AddressLine1	R	String	40
-	AddressLine1_HouseNo	O	String	10
-	AddressLine1_StDir	O	String	5
-	AddressLine1_StName	O	String	40
-	AddressLine1_StPhon	O	String	8
-	AddressLine1_StType	O	String	5
-	AddressLine1_Building	O	String	5
-	AddressLine1_Apart	O	String	5
-	AddressLine1_Structure	O	String	5
-	AddressLine1_Locality	O	String	5
-	AddressLine1_County	O	String	45
-	AddressLine2	O	String	40
-	City	R	String	30
-	StateCode	O	String	2
-	PostalCode	O	String	8
-	PostalCodeExt	O	String	4
-	Country	O	String	2
-	LocPhone	O	String	20
-	LocFax	O	String	20
-	-	-	-	-
Contacts	-	O	-	-
-	ContactType	R	String	15
-	ContactName	R	String	200
-	ContactPhone	O	String	20
-	ContactEmail	O	String	250
-	-	-	-	-
Languages	-	O	-	-
-	Language	R	String	2
-	-	-	-	-
Credential	-	O	-	-
-	CredType	R	String	15
-	CredName	O	String	250
-	CredNumber	O	String	20
-	CredDesc	O	String	250
-	CredIssueDate	O	Date	12
-	CredRenewDate	O	Date	12
-	CredState	O	String	2
-	CredCountry	O	String	2
-	CredStatus	O	String	15
-	-	-	-	-
Identifier	-	O	-	-
-	ID	O	String	20
-	IDIssuer	O	String	200
-	IDType	R	String	15
-	IDGeoArea	O	String	15
-	IDStatus	R	String	15
-	IDRenewDate	0	Date	12
-	-	-	-	-
Cert	-	O	-	-
-	Certificate	O	blob	NA
-	-	-	-	-
Specialty	-	O	-	-
-	Splty	R	String	10
-	SpltyLic	O	String	200
-	LicIssueState	O	String	2
-	-	-	-	-
ESURIs	-	O	-	-
-	ESURI	R	String	250
-	-	-	-	-
Telecomm	-	O	-	-
-	TelType	R	String	15
-	TelNumber	O	String	20
-	TelNumberExt	O	String	6

^Footnote 1 In the Required or Optional column "R" represents required and "O" represents optional.

^Footnote 2 This is the medical records delivery email address.

^Footnote 3 This is the employer identification number.

Table 2-2 Individual Provider Index Data Model - Primary Object = IndProvider

Attributes of Primary Objects or Sub-Objects	Attributes of Sub-Objects	Required or OptionalFoot 1	Data Type	Field Size
ProviderStatus	-	R	String	15
MREmailFoot 2	-	O	String	250
ITINFoot 3	-	O	String	16
Gender	-	R	String	1
SSN	-	O	String	16
DOB	-	R	Date	12
DOD	-	O	Date	12
BirthState	-	O	String	2
BirthCountry	-	O	String	2
Citizenship	-	O	String	2
MStatus	-	O	String	1
Names	-	R	-	-
-	Title	O	String	15
-	Prefix	O	String	15
-	FirstName	R	String	40
-	FirstName_Std	O	String	40
-	FirstName_Phon	O	String	8
-	MidName	O	String	30
-	LastName	R	String	40
	LastName_Std	O	String	40
-	LastName_Phon	O	String	8
-	Suffix	O	String	15
-	NameType	R	String	15
-	-	-	-	-
BusNames	-	O	-	-
-	BusNm	R	String	250
-	-	-	-	-
Locations	-	R	-	-
-	LocationType	R	String	15
-	AddressLine1	R	String	40
-	AddressLine1_HouseNo	O	String	10
-	AddressLine1_StDir	O	String	5
-	AddressLine1_StName	O	String	40
-	AddressLine1_StPhon	O	String	8
-	AddressLine1_StType	O	String	5
-	AddressLine1_Building	O	String	5
-	AddressLine1_Apart	O	String	5
-	AddressLine1_Structure	O	String	5
-	AddressLine1_Locality	O	String	5
-	AddressLine1_County	O	String	45
-	AddressLine2	O	String	40
-	City	R	String	30
-	StateCode	O	String	2
-	PostalCode	O	String	8
-	PostalCodeExt	O	String	4
-	Country	O	String	2
-	LocPhone	O	String	20
-	LocFax	O	String	20
-	-	-	-	-
Contacts	-	O	-	-
-	ContactType	R	String	15
-	ContactName	O	String	200
-	ContactPhone	O	String	20
-	ContactEmail	O	String	250
-	-	-	-	-
Languages	-	O	-	-
	Language	R	String	2
-	-	-	-	-
Credential	-	O	-	-
-	CredType	R	String	15
-	CredName	O	String	250
-	CredNumber	O	String	20
-	CredDesc	O	String	250
-	CredIssueDate	O	Date	12
-	CredRenewDate	O	Date	12
-	CredStatus	O	String	15
-	CredState	O	String	2
-	CredCountry	O	String	2
-	-	-	-	-
Identifier	-	O	-	-
-	ID	O	String	20
-	IDIssuer	O	String	200
-	IDType	R	String	15
-	IDGeoArea	O	String	2
-	IDStatus	O	String	15
-	IDRenewDate	O	Date	12
-	-	-	-	-
Cert	-	O	-	-
-	Certificate	R	blob	NA
-	-	-	-	-
Specialty	-	O	-	-
-	Splty	R	String	10
-	SpltyLicense	O	String	200
-	LicIssueState	O	String	2
-	-	-	-	-
ESURIs	-	O	-	-
-	ESURI	R	String	250
-	-	-	-	-
Telecomm	-	O	-	-
-	TelType	R	String	15
-	TelNumber	R	String	20
-	TelNumberExt	O	String	6

^Footnote 1 In the Required or Optional column ”R” represents required and ”O” represents optional.

^Footnote 2 This is the medical records delivery email address.

^Footnote 3 This is the individual taxpayer identification number.

Organizational and Individual Provider Index Matching Configuration

This section provides a listing of the default fields that are available for organizational and individual matching configuration, and are included with the Provider Index templates.

Listing of Organizational Provider Index Matching Configuration

You can find detail configuration in the Provider Index project configuration files: mefa.xml, master.xml, matchConfigFile.cfg.

• Standardization Fields

  OrgProvider.Names[*].Name

  OrgProvider.Locations[*].AddressLine1

• Phoneticize Fields

  OrgProvider.Names[*].Name_Std

  OrgProvider.Locations[*].AddressLine1_StName

• Matching Fields

  Enterprise.SystemSBR.OrgProvider.Names[*].Name_Std

  Enterprise.SystemSBR.OrgProvider.EIN

  Enterprise.SystemSBR.OrgProvider.Locations[*].AddressLine1_HouseNo

  Enterprise.SystemSBR.OrgProvider.Locations[*].AddressLine1_StDir

  Enterprise.SystemSBR.OrgProvider.Locations[*].AddressLine1_StType

  Enterprise.SystemSBR.OrgProvider.Locations[*].AddressLine1_StName

  Enterprise.SystemSBR.OrgProvider.ESURIs[*].ESURI

• Matching Scores

  -	Agreement Score	Disagreement Score
  Name_Std	15	-12
  EIN	20	-20
  AddressLine1_HouseNo	11	-3
  AddressLine1_StDir	6	-1
  AddressLine1_StType	6	-1
  AddressLine1_StName	11	-9
  ESURI	15	-1
  -	-	-
  DuplicateThreshold: 16	-	-
  MatchThreshold: 53	-	-

  
  

Listing of Individual Provider Index Matching Configuration

You can find detail configuration in the Provider Index project configuration files: mefa.xml, master.xml, matchConfigFile.cfg.

• Standardization Fields

  IndProvider.Names[*].FirstName

  IndProvider.Names[*].LastName

• IndProvider.Locations[*].AddressLine1

• Phoneticize Fields

  IndProvider.Names[*].FirstName_Std

  IndProvider.Names[*].LastName_Std

  IndProvider.Locations[*].AddressLine1_StName

• Matching Fields

  Enterprise.SystemSBR.IndProvider.Names[*].FirstName_Std

  Enterprise.SystemSBR.IndProvider.Names[*].LastName_Std

  Enterprise.SystemSBR.IndProvider.SSN

  Enterprise.SystemSBR.IndProvider.DOB

  Enterprise.SystemSBR.IndProvider.Gender

• Matching Scores

  -	Agreement Score	Disagreement Score
  FirstName_Std	10	-4
  LastName_Std	10	-4
  Gender	1	-20
  SSN	15	-10
  DOB	10	-15
  -	-	-
  DuplicateThreshold: 10	-	-
  MatchThreshold: 30	-	-

  
  

Understanding What is Included in the Pre-populated Code Lists

Code lists are pre-populated for your convenience. The code lists (below) are found in the codelist.sql file. Feel free to customize the codelist.sql file.

• The "state" is populated with two-letter United States state code.

• The "country" is populated with two-letter country code.

• The "language" is populated with two-letter language code.