Network and Provider Detail Screen





 

Parameter Name

Function
Network Name The operator may enter the name of the Network here.
ID The operator may enter the Network ID here. Maximum Size: 5 characters.
Network Active If the network is currently active, the box should be selected.
Network Address This is the address of the network.
Blank Drop-Down Menu Clicking here will change the network image displayed above to the image you have selected.
City Here the operator may enter the City of the Network.
State Here the operator may enter which State the Network is in.
Zip Here the operator may enter the Zip code of the Network.
Telephone Here the operator may enter the primary phone number of the Network.
Fax Here the operator may enter the primary fax number of the Network (if any).
Toll-Free Here the operator may enter the primary Toll-Free number of the Network (if any).
General Notes Here the operator may enter any relevant notes. The maximum size is 200 characters.
Claims Repricing Key Contact Name Here the operator may enter the name of the Key Contact person for Claims Repricing.
Claims Repricing Telephone Here the operator may enter the phone number of the Key Contact person for Claims Repricing.
Claims Repricing Fax Here the operator may enter the fax number of the Key Contact person for Claims Repricing.
Claims Repricing Toll-Free Here the operator may enter the Toll-Free number of the Key Contact person for Claims Repricing.
Claim Repricing Notes Here the operator may enter any notes relevant to Claims repricing. The maximum size is 200 characters.
Provider Relations Key Contact Name Here the operator may enter the name of the Key Contact person for Provider Relations.
Provider Relations Telephone Here the operator may enter the phone number of the Key Contact person for Provider Relations.
Provider Relations Fax Here the operator may enter the fax number of the Key Contact person for Provider Relations.
Provider Relations Toll-Free Here the operator may enter the Toll-Free number of the Key Contact person for Provider Relations.
Provider Relations Notes Here the operator may enter any notes relevant to Provider Relations. The maximum size is 200 characters.


 

Button Name

Function
Delete Clicking here will delete the selected network.
New Network Clicking here creates a new network, and clears all text entry fields so the information pertaining to that network may be entered.
Save Changes Clicking here will save all changes to an existing network and save all text entered for a new network.


 

Parameter Name

Function
Institution or Group Name The operator may enter the Institution or Group Name here.
Provider or Department Name The operator may enter the provider or department name here.
Tax ID The operator may enter the Tax ID of the provider here. Many providers can have the same Tax ID but are usually mutually associated by Institution. If the source option is changed to SSN, then this field actually contains the SSN and not the Tax ID number.
Suffix The operator may enter the identification Suffix of the provider here. Though many providers can have the same Tax ID, the Suffix combined with Tax ID and source creates a unique identifier for each provider.
Source This displays TIN (Tax Identification Number) or SSN, depending on which number is used in the Tax ID field for unique provider identification in the Claims Manager system.
Class Here the operator may select the class of provider entry that this is. Options include F- Facility, P- Provider, V- Vendor.
Type Here the operator may select the abbreviation of the type of provider that the selected provider entry is listing.
Spec 1 The operator may select the abbreviation for the primary specialty of the provider.
Spec 2 The operator may select the abbreviation for the secondary specialty of the provider.
Spec 3 The operator may select the abbreviation for the tertiary specialty of the provider.
Address 1-3 Street The operator may enter number and name of the street of the office address of the provider here.
Address 1-3 City The operator may enter the name of the city of the office address of the provider here.
Address 1-3 County The operator may enter the name of the county of the office address of the provider here.
Address 1-3 State The operator may select the state of the office address of the provider here.
Address 1-3 Zip The operator may enter the zip of the office address of the provider here.
Address 1-3 Phone The operator may enter the phone number of the office of the provider here.
Network Information This lists network history, including which networks the provider has been associated with, their start and end dates etc. If the provider is not associated with any network, the network ID is listed as XXX.


 

Button Name

Function
New Clicking here will create a new provider, and clear all of the text entry fields to allow the operator to enter the necessary information.
Save Clicking here will save all modifications to an existing provider's information, or will save all information entered for a new provider.
Delete(1) Clicking here will delete the currently displayed provider.
Suffix This button may only be clicked when a new provider is being entered. Clicking here will create a unique Suffix for the Tax ID of the provider, for use with the new provider.
*Status and Notes Clicking here pops open a window where miscellaneous notes may be created and edited.
Add Clicking here will pop open a window so that the operator can associate the provider with a certain network.
Edit Clicking here will pop open a window allowing the operator to modify information regarding the association of a provider with networks.
Delete(2) Clicking here will delete the selected provider/network association.


 

Tab Name

Function
Network List Clicking here will show the Network List panel on top of the Network Detail panel.
Network Detail This shows that the Network Detail panel is open.
Provider List Clicking here will show the Provider List panel on top of the Provider Detail panel.
Provider Detail This shows that the Provider Detail panel is open.
Orphan Providers Clicking here will show the Orphan Providers panel on top of the Provider List panel.


 

Button Name

Function
RPT This opens the Eligibility Reports window.
LTR This opens the Letters window.
ADM This opens the Administration Tools window.
ELG This opens the Enrollment screen.
CLM This opens the Claims Entry screen.
NWK This shows that the Networks and Providers screen is open.
EVT This opens the Event Tracking screen.
PLN This opens the Plans and Options screen.
GRP This opens the Groups, Locations, and Units screen.


  This button closes the Claims Manager program.