Individual Name Standard v2.1

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This UHIN Standard is intended to provide guidance for entering names into any Utah provider, payer or sponsor systems for patients, enrollees, as well as all other people associated with these records.   The Utah health care community should standardize the collection of an individual’s name at every point of care and enrollment.  Because name is used in all sponsor, payer, clinical, financial, and provider areas, it is important for the entry to be standardized.  Matching of electronic and paper records between payer and provider, as well as between payers is simplified when standard naming conventions are used.

Implementation

  1. Any time a name is recorded, the person collecting the name is to ask for and use the full legal name. Though no “standard definition” of full legal name is proposed, the intent is to encourage the individual or responsible party to provide a standard name for the person being identified.
  2. First/Individual name, Middle name, and Last/Family name:
    • Hyphens will be allowed when part of the legal name. (Smith-McKite).  Some payers may strip the hyphen and report back the name without it.
    • Apostrophes will be allowed when part of the legal name. (O’Garah)
    • Spaces are allowed. (if “Mary Jane” is the person’s legal first name, it should be entered as “Mary Jane”.  If Mary is the legal first name and Jane is the legal middle name, then the first name is entered as “Mary” and the middle name is entered as “Jane”.).
    • Last/Family name is required.
    • First/Individual name is required.
    • Middle name is optional.
  1. When the person has only one name legally.

Both last and first names are required fields for HIPAA transactions when identifying a person.  Collect the name as follows:

  • Last/Family Name is entered as the single legal name.
  • First name is “NoFirst”. This is not case sensitive.
  • Middle name is blank.
  1. When the name is unknown.

When the patient’s name is not known enter the name as follows:

  • Last/Family Name is “NotKnown”. This is not case sensitive.
  • First name is “NoFirst”. This is not case sensitive.
  • Middle name is blank.

          Transactions with NoFirst and NotKnown as names may not be accepted by the receiver.

  1. Baby name
  • Until the family provides the name of the baby, providers should use the following format:

 

Examples:

Please note that not every variation is represented.

Last Name

(mother’s last name)

First Name

Before birth (pre-admit)

Smith         

Unknown

Before birth (multiple)

Smith

UnknownA

Smith

UnknownB

After birth (single)

Smith

Baby

After birth (multiple)

Smith

BabyA

Smith

BabyB

  1. Suffix – a suffix is considered to be anything that comes after the Last/Family Name (John Jones ‘the Third’ (John Jones III) is entered as First/Individual name = “John”, Last/Family name = “Jones”, Suffix name = “III”
    • Collect suffix if applicable and available.
    • Standard name rules as defined above apply to suffix.
  1. There will be those times when the person giving the information does not want to use their full legal name. To assist in discussing this with the individual, the following may help:
    • Give a simple explanation of how this record is used across various systems (between payers and providers or within provider systems) for correct identification.
    • Often, clinical information will be linked to a number assigned in order to present a comprehensive view of all their clinical data and locating the right record each time with the individual’s name is critical.
    • Using their full legal name will minimize duplication of records, as well as minimize rejections from the payer.
    • Often data sent to one payer is then transmitted to a secondary payer. Using a standard name format simplifies the identification of the individual from payer to payer.
    • NOTE: We are not attempting to dictate what name is used – only how the information is stored in the system for standard retrieval.
  1. Case: This Standard does not limit the case in which the name is transmitted electronically.  Many submitters transmit in uppercase only, but this Standard does not limit the name to only uppercase letters.

 

IMPLEMENTATION

  1. Recommend that payers begin enrolling new members using their full legal name. This Standard does not require payers to re-enroll all members to obtain legal name, but the goal is to eventually have all members enrolled under their full legal name. Payers will individually determine how to achieve this goal within a reasonable time frame.
  2. Recommend that providers begin registering new patients and subscribers using their full legal name. This Standard does not require providers to re-enroll all patients or subscriber to obtain legal name, but the goal is to eventually have all patients and subscribers listed under their full legal name. Providers will individually determine how to achieve this goal within a reasonable time frame.

 

History

 

Original

A* 1 V2.1

A* 2

A* 3

A* 4

A* 5

A* 6

ORIGINATION DATE

07/11/02

1/2016

 

 

 

 

 

BOARD APPROVAL DATE

06/12/03

5/4/2016

 

 

 

 

 

EFFECTIVE DATE

07/12/03

6/4/2016

 

 

 

 

 

 

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