Provider

The Edit Provider window is where provider information is entered.

To open, in the Main Menu, click Lists, Providers. Click Add or double click an existing provider to edit.

The window is divided into three tabs: General, Supplemental IDs, and Web Sched. A description of all options on this window is below.

General Tab

Note: If viewing information for a provider that has been removed due to a merge (deleted), all fields are viewable only, not editable.

Provider ID: A system generated unique identifier that is useful for third party reporting.

Abbreviation: A short abbreviation that will identify the provider in various lists throughout the program. There is a 255 letter limit. May be changed at any time.

SSN or TIN: Enter the number used for billing purposes. Most offices will enter their TIN.

State License Number: The Providers state license number.

DEA Number: The DEA Number associated to the provider. Only required when sending prescriptions.

State Rx ID: The provider's state assigned Rx ID. Only required when sending prescriptions.

For providers with multiple DEA numbers or Provider IDs (e.g. a DEA number for clinics in different states), click Edit to enter numbers per clinic. Click in a cell to enter the number where required.

Medicaid ID: Only required when billing to Medicaid.

National Provider ID: (aka NPI). On an Electronic Rx (eRx), you must use an individual provider NPI, not the organizational NPI. If you have a separate Facility NPI, you can create a separate provider profile for the facility. Enter the facility name as the Last Name, and check the 'Not a Person' box. To set the facility as the default practice or clinic billing provider (and thus use the facility NPI), select the facility as the default insurance billing provider in Practice or Clinic Setup.

EHR Key: (Version 14.2 and earlier). Only visible when EHR is turned on. Click [...] to enter the EHR Annual Provider Keys provided by technical support. This key is required to access EHR Measure Calculation reports, and is used for CPOE and Electronic Prescription measures.

Term Date: The date when the provider will no longer be active. After the term date has ended, the provider will be unable to schedule or complete appointments, create prescriptions, or send new claims.

Appointment Color: The background color on the schedule for the provider's appointments, time bar, and operatory. Click the box to select the color. Hint: Lighter colors help black text show more clearly.

Highlight Outline Color: The color of the outline that surrounds appointment information for this provider. The outline only shows when the appointment is selected.

EHR Meaningful Use: EHR only. Determines which measures show in reports and on the dashboard when this provider is the primary provider. There are four options:

Claim Billing Prov Override: Optional. Select a non-person entity (set up as a non-person provider) that will be set as the default billing provider on claims when this provider is the treating provider. The claim billing provider will override the Default Insurance Billing Provider set in Clinic or Practice setup. Example: Set the practice or a treatment category for a billing override.

Hourly Production Goal: Set an hourly production goal for the provider ($0.00). This value will be used to calculate the daily production goal for all scheduled providers that shows in the Appointments Module. See Production Totals.

Fee Schedule: The provider's default fee schedule (e.g. the UCR fee schedule).

Specialty: The provider's specialty. Customize options in Definitions: Provider Specialties.

Scheduling Note: When the user clicks on an operatory header in the appointment schedule on a day the provider is scheduled, text entered here will display in the operatory header dropdown next to the provider's scheduled time.

Custom ID: A user-editable unique identifier that is useful for third party reporting.

Taxonomy Code Override: If you enter a Taxonomy Code it will override the specialty.

Anesthesia Provider Groups (optional): Assign the provider to an anesthesia group. If assigned, this provider will populate the corresponding dropdowns in the Anesthesia record.

Secondary Provider: Mark the provider as a hygienist.

Signature on File: Indicate whether or not the provider has a signature on file. May affect what shows on the ADA 2012 Claim Form for treating provider signature.

Not a Person: Check this box to mark the provider as an entity or organization instead of a person. Then enter business ID numbers instead of personal ID numbers. Useful when offices want to use practice or facility as the provider on claims.

Hidden: Remove this provider as a selection option in various areas of the program (e.g. for providers who are no longer with the practice). Their schedule will be deleted and an X will show in the Hidden column of the Providers List. The provider will still be a selection option in standard reports. Hidden providers cannot access eRx. This will not affect scheduled appointments.

Note: Providers associated with an Appointment View cannot be marked hidden. See Appointment View Setup to remove them first.

Hidden on Reports: Remove this provider as a selection option in Standard Reports. An X will show in the Hide on Reports column of the Providers List.

Use Electronic Prescriptions (eRx): Enable Electronic Prescriptions for this provider. There are per provider fees. Once enabled, a provider must still complete identity proofing before use. Contact support for assistance. Unchecking this box will disable eRx for this provider.

Allow Legacy eRx Option: Enable if provider is still using Legacy eRx. Useful for offices transitioning between the legacy option to DoseSpot.

Supplemental IDs Tab

Supplemental Provider Identifiers: Store provider IDs assigned by insurance companies, especially Blue Cross/Blue Shield. When you bill an insurance company using this payor ID, the assigned ID will show on the claim.

Click Add to create a new supplemental ID.

Payor (Electronic) ID: The payor ID of the carrier. This is case sensitive and must match the Electronic Payer ID list exactly.

Type: Type of supplemental ID. Informational only.

Assigned ID Number: The supplemental ID number assigned.

Click OK to save.

Click Delete to remove a number.

Web Sched Tab

Enter a provider description and photo that will show in the Web Sched Recall and Web Sched New Patient interface when patients are allowed to select their provider.

Description: Enter the provider description.

Picture: Click [...] to select a picture file on your computer. Click None to clear a picture selection.

Note: To allow patients to select a provider, see Setting up Web Sched Recall, Setting up Web Sched New Patient


Clinics Tab

Provider clinic associations set in this tab will determine which providers show in the provider selectors for those clinics.

When set to All, the provider will be available to be selected for any clinic. If specific clinics are associated to the provider, the provider can only be selected at those clinics.

Providers can also be set to show or not show if they are associated to a clinic-restricted user in security setup. Even if the provider is associated to a clinic in the provider setup window, the provider's user must also have access to that clinic for any other user to select that provider, even if the other user is not restricted. For restricting users to specific clinics please see: User Edit.