Clarification of external provider-reference file

[olderthandirt5]

One of our partners has said that our provider-reference file is invalid because it contains multiple groups. From everything I have read and heard on the webinars, the point of the external provider-reference file is to have multiple groups. Am I way off base?

I have attached our file which has been validated by the CMS JSON Validator tool. Thanks again for that!!
2_MRF_provider-reference.txt

[shaselton-usds]

@olderthandirt5 That file contains invalid JSON. Try copying and pasting the contents into an online validator to show that the file contains multiple root nodes which isn't valid.

A valid provider reference file will have a single provider_groups array containing all of the possible provider/ein combinations for that network.

[olderthandirt5]

I have fixed the JSON file and it has been validated by the Validator tool:
1validation.txt
provider-reference_1_cms.txt

This is the question I have now:
We have one partner with 287 different provider groups in a single network. In addition to the Table of Contents and the In Network files, do we need to include 287 different provider-reference files? Or is there a way to combine those 287 different provider groups into a single file with different id numbers?

[olderthandirt5]

@shaselton-usds Any direction on the question above?

We have one partner with 287 different provider groups in a single network. In addition to the Table of Contents and the In Network files, do we need to include 287 different provider-reference files? Or is there a way to combine those 287 different provider groups into a single file with different id numbers?

[shaselton-usds]

If the 287 different provider groups are in a single network, include them in the same file -- it would be 287 objects in the provider_groups array. This is assuming that the negotiations of the groups are the same across the entire network.

The external provider group references aren't included in the table of contents; they are included in the actual in-network files.

[olderthandirt5]

For demonstration purposes, I created a file with only 3 provider groups and ran it through the validator tool. This is how we will generate the provider-reference files and will reference them in the in-network file.
The validation output:

PS C:\cms\price-transparency-guide-validator> cms-mrf-validator validate c:\cms\data\April\2_MRF_provider-reference.json v1.0.0 -t provider-reference
Input JSON is valid.

PS C:\cms\price-transparency-guide-validator> cms-mrf-validator validate c:\cms\data\April\2_MRF_provider-reference.json v1.0.0 -t provider-reference -o c:\cms\414_2_MRF.txt

The validation output file:
414_2_MRF.txt

The provider-reference file (Converted to text file):
2_MRF_provider-reference.txt

I appreciate your help. I will post this file to the "Show and Tell" section later, in case anyone else gets confused. I know I am seeing JSON in my sleep these days.

[olderthandirt5]

@shaselton-usds
The attached provider-reference file passes the JSON Validator tool, formats correctly in Notepad++, but running it through an online validation tool results in a condensed version with the provider group #1 only showing the last npi/tin combination

Result of the online JSON validator at DuckDuckGo:
{ "provider_groups": [ { "id": 1, "npi": [ 1306950175, 1821191966, 1174591911, 1023308780 ], "tin": { "type": "ein", "value": "470781933" } }, { "id": 2, "npi": [ 1720332489 ], "tin": { "type": "ein", "value": "611352417" } }, { "id": 3, "npi": [ 1245296664, 1578768339, 1770685604, 1790994960 ], "tin": { "type": "ein", "value": "426004813" } } ] }
2_MRF_provider-reference0503.txt

Can a provider group have multiple npi/tin combinations?

Thanks again for all your work.

[skochin]

@olderthandirt5 The schema allows for one or more objects under the "provider_groups" array, however, each object can only have one "npi" and "tin" property, so I beleive that is why you're seeing the validator only recognize one "npi" and "tin". Also, there is no defined "id" property in this schema. To my understanding, the provider-reference schema can only represent one grouping of providers (with "grouping" being any combination of providers and/or groups that share the same rates and therefore can be referred to by one provider_references value in the in-network-rates file).

To include multiple npi/tin combos within one grouping, you would strucuture it as:
{
"provider_groups": [
{
"npi": [
1111111111,
2222222222
],
"tin": {
"type": "ein",
"value": "123456789"
}
},
{
"npi": [
3333333333
],
"tin": {
"type": "ein",
"value": "987654321"
}
}
]
}