Uniform health care ID card to be issued Feb. 1
PAYERID likely to become national standard
The new Health Care Identification Standard designed to support electronic data interchange transactions by providing unique, accurate information in a standard form on patient identification cards has been sent to the American National Standards Institute (ANSI) in New York City for final editing and is expected to be issued around Feb. 1. That’s the word from Peter T. Barry, chairman of ANSI’s National Committee for Information Technology Standards for a Uniform Health Care Identification Standard, who says the new standard represents the industry working together for a common purpose. Barry offers these details on the new health care ID card:
1. Required identifiers on the card. The card is an ID card, not a portable database. The standard neither specifies nor excludes demographic, history, encounter, prescription, or other data on the card. It requires these identifier fields, each of which is on a separate line on the front of the card:
• card issuer number (telling what payer or other organization issues the card);
• ID (the ID number of the insured person);
• name (the name of the insured person).
If the payer requires another identifier, such as group number, policy, certificate, etc., then that identifier must be on the card as well.
2. PAYERID is the card issuer number. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that a national health plan identifier standard be adopted. The most likely candidate is the PAYERID being developed by the Health Care Financing Administration (HCFA). HCFA is expected to publish a Notice of Proposed Rule Making on PAYERID in the next month or so. There will be a 60-day comment period, some analysis, and a final rule adopting PAYERID. HIPAA’s deadline is Feb. 28, 1998.
The PAYERID is a nationally assigned, unique nine-digit identifier for health plans (as defined in HIPAA) such as health insurance companies, HMOs, certain ERISA Group Health Plans, Medi-care, Medicaid, CHAMPUS, and other plans.
PAYERID fits within the international standards for card issuer numbers and has been approved by the ANSI USA Registration Committee as the card issuer number for identification cards used in health applications in the United States. (A familiar example of a card issuer number is the bank identification number, which is the first six digits of a charge card number.) A health card needs a number like this to identify the payer.
3. Four technologies can be used. The standard card provides four optional machine-readable technologies. If any of the technologies is used, a magnetic stripe must be used. They are:
a. magnetic stripe;
b. contactless integrated circuit (smart card chip without electrical contacts);
c. integrated circuit with contacts (smart card chip with electrical contacts);
d. optical memory card (technology of a CD).
The ID information uses about 50 characters of the magnetic stripe. Smart card chips can store 8K or more. Optical memory can store up to four million characters. The standard is written so more than 99% of the higher-capability technologies is available for other applications.
4. Embossing and portrait may be included. The card also provides standards for embossing data characters and putting a picture of the insured on the front of the card. This is optional.
5. The look of the card. If no machine-readable technology is used, the card can be printed on cardboard or another medium. This is intended to help payers switch to the card. If one or more technologies is used, a magnetic stripe is required. Adding a magnetic stripe invokes international standards for plastic cards, so the card must look much like a bank credit card.
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