Provider Maintenance

Use Provider Maintenance to maintain information about the providers in the practice.  This maintenance contains demographic and billing information for each provider including billing numbers that will be used for both electronic and paper billing to insurance carriers.  Some statistical information is maintained including the provider's month-to-date and year-to-date financial summary of services, payments and adjustments, and last year's accounts receivable.  In addition, Provider Set Maintenance found on the Additional menu can be used to maintain additional information an insurance carrier may require for receiving claims from a provider who performs services at multiple locations or within multiple departments.  And, Provider Miscellaneous Information Maintenance also found on the Additional menu, is used to maintain the provider's first, last and middle name that is used for billing.

Tips:  

• You can set INSight to bill claims by providers or by groups.  During your installation NDS will work with you to determine how your claims will be billed.  Your INSight Claims Parameter which controls whether you perform billing by groups or by providers is set accordingly.  For more information, contact NDS Support 800-649-7754.

• For more information about working with data in fields, see Data Entry Guidelines.

Directions:

To see directions for...

• Opening Provider Maintenance, click More.

   

  1.  Click File Maintenance from the Menu Bar.

  2.  Click Standard Maintenance.

  3.  Click Providers.
  
  Or, use the keyboard shortcut:  [ALT] [m] [t] [v].

   

  Provider Maintenance Window Example:

  

• Creating a new Provider, click More.

   

  Provider Maintenance Prompts Tip: To see more information about a field, click the hyperlink for that field name.
  Provider Code	Enter the code assigned to this Provider. (up to 4 characters) Tip:  If you are building a new Provider, displays near the Provider Code.  Default entries display and the first field is highlighted to let you know you can begin entering information.
  	To update the new or changed information click Save or press [ENTER]. Keyboard shortcut:  [ALT + s]
  	CAUTION: To avoid losing data, you must save new or changed Providers.
  	You can use Search to view all of the existing Providers.  From the Search list you can select a Provider to change or delete. Keyboard shortcut: [ALT + r]
  	To display an existing Provider, enter the Provider Code and click Retrieve or press [ENTER]. Keyboard shortcut: [ALT + t]
  Provider Name	Enter the name of the Provider.  The Provider Name displays whenever the Provider Code is entered during daily processing. (up to 20 characters)
  Discontinued	To indicate that the Provider code is active, leave the default No. To indicate that the Provider code is no longer used or discontinued, select Yes.  Discontinued means that it cannot be used for new charges, but the Provider code isn't deleted because it may still be used on patient and ticket history as well as current patient tickets. Note:  By default the Provider Search window does not display discontinued procedures.  To include discontinued providers, select the Search window option View Discontinued Items, then the discontinued Provider code will display in the search list.
  Prof. Name	Enter the full Name and title of the Provider here.  The Provider's Professional Name will print on claim forms. (up to 30 characters)
  SSN	Enter the Provider's Social Security Number. (11 characters, include dashes) Tip:  This field is required if the practice doesn't have a Federal Identification Number.
  Address	Enter the Provider's Address. (up to 25 characters)
  City	Enter the City Name, Town Name or a valid City Code to display the associated City, State and Zip Code where this Provider is located. (up to 15 characters)
  State	The US Postal Service State Code displays if you entered a City Code above.  Press [Tab] to accept or enter the state abbreviation where this provider is located. (2 characters)
  Zip	The Zip Code displays if you entered a City Code above.  Press [Tab] to accept or enter another Zip Code. (up to 10 characters)
  Phone	Enter the Provider's Phone Number. (10 characters, include dashes and area code)
  Group Number	Enter a valid Group Number assigned to this Provider. (2.0 numeric)
  Federal ID #	Enter the Provider's Federal Identification Number. (up to 10 characters)
  Note:  Because you can tailor the labels of the nine Form Type fields, the field labels in your software may not match the field names listed.
  Form Type 1 Provider Code	Enter the specific Provider Code to print for this Form Type.  This usually is the Provider's state license number or PIN #.  The Provider print Code will print on the appropriate claim form.  (up to 15 characters) Tip: To quickly enter the same Provider Print Code for each successive Form Type (if applicable) use the copy and paste commands. Keyboard shortcuts:  [CTRL + c] = copy and [CTRL + v] = paste
  Form Types 2 - 9 Provider Code	Enter the specific Provider Code to print for each Form Type that you have.  This usually is the Provider's state license number or PIN #.  The Provider print Code will print on the appropriate claim form.  (up to 15 characters)
  Notes:  The fields below are generally used for viewing only.  They are updated by the system and under normal situations you do not need to edit them.   For a printed copy of these figures, print the Provider Analysis Report.
  Services MTD	Displays the dollar amount of services rendered by this provider so far this period. (7.2 numeric)
  Services YTD	Displays the dollar amount of services rendered by this provider so far this year. (9.2 numeric)
  Payments MTD	Displays the dollar amount of payments received for services rendered by this provider so far this period. (7.2 numeric)
  Payments YTD	Displays the dollar amount of payments received for services rendered by this provider so far this year. (9.2)
  Adj/Ref MTD	Displays the dollar amount of adjustments and refunds received for services rendered by this provider so far this period. (7.2 numeric)
  Adj/Ref YTD	Displays the dollar amount of adjustments and refunds received for services rendered by this provider so far this year. (9.2 numeric)
  Cases MTD	Displays the number of cases this provider has seen so far this period. (7.0 numeric)
  Cases YTD	Displays the number of cases this provider has seen so far this year. (7.0 numeric)
  Note: The following fields are for viewing only.
  Totals MTD	Displays the A/R dollar amount for services rendered by this provider so far this period. (7.2 numeric)
  Totals YTD	Displays the A/R dollar amount for services rendered by the provider so far this year. (9.2 numeric)
  Last Year End A/R	Displays the A/R amount for services rendered by the provider last year. (9.2 numeric)
  Current A/R	Displays the current A/R dollar amount for services rendered by the provider this year. (11.2 numeric)

• Editing an existing Provider, click More.

   CAUTION!  If you forget to click Save, you may lose your changes.

  1.  To display the record to be changed, enter the Provider code and click Retrieve or press [ENTER].
  Keyboard shortcut:  [ALT + t]
  Tip:  If you do not know the Provider code, you can click Search to see a list of providers.

  2.  To position the pointer to the information that you want to change, press [TAB] or click the field using the mouse.

  3.  Enter the data changes.

  4.  To complete the edit process, click Save or press [ENTER].
  Keyboard shortcut:  [ALT + s]

• Deleting a Provider, click More.

  1.  To display the record to be deleted, enter the Provider code and click Retrieve or press [ENTER].
  Keyboard shortcut:  [ALT + t]
  Tip:  If you do not know the Provider code, you can click Search to see a list of Providers.

  2.  Click File from the Menu Bar, and then click Delete.
  Keyboard shortcut:  [ALT] [f] [d]

  3.  At the Delete Records prompt, click the Proceed button to delete the record
  or, click the Cancel button to escape from the delete routine.
  
  Example:
  
  
  
  Note: After you click Proceed, you will see the following message on the Status Bar.
  
   

   

• Maintaining a Provider Set record, click More.