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pdfBureau of Health Workforce
SDMS Provider Management User Guide
Shortage Designation Management
System (SDMS)
Provider Management User Guide
Associated Resources:
Facility Form User Guide
PCO Portal User Guide
Mapping Tool User Guide
November 2015
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SDMS Provider Management User Guide
TABLE OF CONTENTS
1. Search Providers ................................................................................................................................................ 3
2. Provider Search Results ..................................................................................................................................... 5
Customize Grid Columns............................................................................................................................................7
Edit in the Grid View ..................................................................................................................................................8
3. Provider Information ....................................................................................................................................... 10
4. provider history ............................................................................................................................................... 12
5. NPI Primary Address ........................................................................................................................................ 13
Edit Direct Tour Hours and Reason Code ................................................................................................................14
FTE Calculations .......................................................................................................................................................15
Clinical Information .................................................................................................................................................18
6. Add New Address............................................................................................................................................. 20
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1. SEARCH PROVIDERS
The purpose of the Provider Management functionality is to give the PCO the ability to search for a provider and
update eligible information.
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Figure 1 - Provider Management Landing Page
1. NPI
Enter the 10-digit numerical National Provider Identifier in this field.
2. Last Name
Enter any text in this field, only exact matches will be returned.
3. First Name
Enter any text in this field, only exact matches will be returned.
4. Discipline
Select one of the 3 disciplines:
• PC: Primary Care
• MH: Mental Health
• DH: Dental Health
5. Specialty
Select one of 10 disciplines. Note that once a discipline is selected, only the specialties that fall
under that disciple will be available for selection.
PC: Primary Care
• FP: Family Practice
• IM: Internal Medicine
• OBG: Obstetrics and Gynecology
• PD: Pediatrics
DH: Dental Health
• GDT: Dentist
MH: Mental Health
• PSY: Psychiatrist
• CPSY: Clinical Social Psychologist
• CSW: Clinical Social Worker
• PNS: Psychiatric Nurse Specialist
• MFT: Marriage and Family Therapist
6. County FIP
Select any of the County FIPs provided in the dropdown; conditional to the state selected.
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7. County Name
Select any of counties available for that state; conditional to the state selected.
8. MCD
Enter any 10-digit numerical value in this text, only exact matches will be returned.
9. Census Tract
Enter any 11-digit numerical value in this text, only exact matches will be returned.
10. License
Number
Enter any numerical value in this text, only exact matches will be returned.
11. Recent NPI
Update
Select one of the 2 options:
• True
• False
12. Status
Select one of the 4 options:
• Included
• Omitted, PCO
• Omitted, Ineligible Taxonomy
• Omitted, NPI Deactivated
13. State
Select any one of the 50 state or 6 territories.
14. Successfully
Geocoded
Select one of the 2 options:
• Yes
• No
15. Clear
Click on this button to clear all the search criteria.
16. Search
Click this button to run the search, after at least one criteria has been entered into a field.
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BUSINESS RULES
•
•
•
•
At least one search criteria is required to run the search.
Each search criteria will run only exact matches.
Ex. A misspelled name will render no results. (See Figure 2)
Fields are not case-sensitive.
Only one option may be selected in the discipline and specialty dropdown menus.
Figure 2 - Error: Enter Search Criteria
For “Recent NPI Update””
• If a provider record is updated by NPI file then “NPI update” = true
• When you click on record in search results then “NPI update” = false
• The flag of “NPI Update” in search results stays as ‘true’ until a PCO clicks on the detail of the record
• Viewing a provider detail record is not saved or tagged to the PCO user
For State:
• The default state is set to state associated the username of the PCO
• You can elect to search on any other state
• If you select [Clear] all values will default to original choices and state will default to that of the PCO
2. PROVIDER SEARCH RESULTS
After correctly entering search criteria and clicking on the search button, the results of the search criteria will
display.
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Figure 3 - Provider Search Grid
1. Columns
Allows the user to customize the columns that are part of the search grid, see
“Search Result Column Display” section for more detail.
2. Viewing 1 – 20 of # Results
Displays the total number of results returned.
3.
Click to move to the next page.
4.
Adjust the number of records viewed per page by clicking on the dropdown and
selecting 10, 20, 50, or 100. The search results page is defaulted to 20 records per
page.
USER NOTES
•
•
Click on the NPI to navigate to provider profile.
Data may only be saved successfully by pressing ENTER on the keyboard after editing each provider’s
information.
BUSINESS RULES
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•
•
•
•
Total Hours will be defaulted to 40 hours and can be identified by a visual indicator .
If the Tour Hours have been updated, the visual indicator will not be displayed.
Sort the search result by ascending or descending order by clicking on any the column header.
Information from NPI database is read-only.
CUSTOMIZE GRID COLUMNS
Add, remove, or order the columns on the Search Results grid by clicking on the columns icon.
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1
2
4
3
8
6
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Figure 4 - Column Preferences
1. # of Columns
Find a total count of columns to display on the results grid.
2. Remove All
Remove all columns displayed in the search.
3. Search Field
Type any column header to filter the display of list on the right hand side list.
4. Add All
Select this link to add all the columns to be displayed on the results search grid.
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5.
This icon behaves the same way as the cancel button and removes the pop-up without saving
the changes.
6.
Select the save button to save any changes made for the column preferences. The system
will display the changes in the search result grid and the pop-up will disappear from screen.
Select the cancel button to discard any changes, and the pop-up will disappear from screen.
7.
Select and sort criteria.
8.
USER NOTES
•
•
•
•
Click on the
to remove a column or click on the
to add the column for display.
The search result grid can display up to 34 column headers.
The first five: NPI, Discipline, Specialty, First Name, and Last Name column headers will remain frozen in
order.
Direct Tour Hours can only be changed to 0 and saved if the Reason Code column is added to the search
grid view, so that the reason code can be specified.
EDIT IN THE GRID VIEW
The purpose of this functionality is to enable PCOs to quickly update multiple records at once and save. After
reviewing the search results on the grid, make edits directly within the grid and save without having to go into the
details of the provider record.
INSTRUCTIONS
1.
2.
3.
Double click on the row of the provider to edit.
Make edits to the fields that are editable.
Press Enter on the keyboard to save changes after editing each row of provider information. There will be
no save confirmation message.
Note that all data from NPI is read-only.
1
2
Figure 5 - Edit Hours in Search Grid
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1.
All the fields that are read-only will be displayed in gray in edit mode. The data for these
fields is provided by the NPI.
2.
All editable fields will have a white background or a dropdown menu with a “Yes” or a “No”
option.
BUSINESS RULES
•
•
•
•
•
All read-only fields will be displayed in gray while in edit mode.
All % fields are dependent on the answers to the “Yes” or “No” dropdown answers of the applicable
question.
The maximum % is 100.
When Hours are changed to 0, a warning message will be displayed. The warning message reads: “You
must provide a Reason Code when setting Direct Tour Hours to 0.” (See Figure 6)
The
column may only be saved if the discipline of the provider record is a DT: Dental
discipline. If a PCO enters in a numerical value into this field for any other disciplines, the system will
display an error message. (See Figure 5)
Figure 7 - Reason Code Error
Figure 6 - Dental Auxiliaries Error
USER NOTES
•
•
You user must hit “Enter” on the keyboard to save while editing in the search grid.
Use the scroll bar on the bottom of the search result grid to navigate horizontally across the search results
to a column.
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3. PROVIDER INFORMATION
Click on the NPI in the search grid to be brought to the provider overview page, which displays the provider’s basic
information and taxonomy details.
Figure 8 - Provider Overview
1. Last Name, First Name
The name of the provider in view is displayed here.
2. Last Updated
This is the last date the provider record has been updated. If the record has not
been updated, it will display the date on which the record was created. The format
for display is: MM/DD/YYYY HH:MM (24-hour time)
3. Provider Taxonomies
This section lists the provider’s Taxonomy information. If a provider has multiple
taxonomies, the bolded row represents the primary taxonomy.
4. Back to Search Results
Click on this button to return to the search results page with the last successful
search results. If changes were made without saving the provider information, the
changes will be lost and the system will display the last successful search results
page.
5. Save Provider Information
Click on this button to save any provider details fields that were updated.
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USER NOTES
•
•
•
•
•
All read-only data cannot be updated through the system and can only be updated through the NPI
Primary File or delta file.
Last updated time and date will be captured after the user clicks “Save Provider Information.”
The “NPI Primary Address” is the primary location of practice that the provider has submitted to NPI.
A warning message will appear on the right side of the screen when there are unsaved changes entered
on the page. (See Figure 8)
After clicking
at the bottom of the page, a status message will appear at the top of
the new page to verify that the information saved successfully. (See Figure 10)
Figure 9 - Unsaved Changes
Figure 10 - Provider Details Saved Successfully
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4. PROVIDER HISTORY
Clicking on the [Overview] tab will show the Provider History function. Any history records (if they exist) will be
available as a drop-down. The time/date stamp and user id for each revision made by NPI updates or PCO updates
will be captured as a unique history record. The default view is for ‘Current’.
INSTRUCTIONS
1.
2.
3.
Select the drop-down next to “Revisions” and click the [View Revision] button.
View the changes by selecting the tabs for the record.
Selecting any history records other than “Current” will enable the Field differ from the Current
information legend. Use the blue highlighting to compare the history record to the Current record.
1. Revisions
The time/date stamp and user id for any history records
2. View Revision
To activate and view any previous revision of history records.
3. Field differs from the
Current Information
A legend that appears when you select any history revisions.
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5. NPI PRIMARY ADDRESS
The NPI Primary Address is the default address used for determining FTE Calculations and cannot be edited by the
user. There are four groupings on the NPI Primary Address:
• Address (Read-Only & Editable)
• Geocoded Address (Read-Only & Editable)
• FTE Calculations (Read-Only)
• Clinical Information (Editable)
Figure 11 - NPI Primary Address
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1. Address
This is the address provided by the provider in the NPI file as the primary location
of practice.
2. # of Dental Auxiliaries
This field is only available for providers with a discipline of “DT: Dental.” All other
disciplines will not see this field.
3. Direct Tour Hours
The “Direct Tour Hours” will be defaulted to 40 hours, and Geographic HPSA will
be 1.00 in the FTE Calculations. PCO can enter whole number integers from 0-168
hours.
4. Reason Code
This field is only enabled if the “Direct Tour Hours” is changed to 0.
5. Is address a Correctional
Facility?
This field has a dropdown with the following options:
• Yes
• No
USER NOTES
•
SDMS does not calculate primary care FTEs when only office hours are known. It is the responsibility of
the user to enter the correct tour hours (adjusted or otherwise) into SDMS. See Section IV of the Manual
for Policies and Procedures for more detail.
EDIT DIRECT TOUR HOURS AND REASON CODE
Revise the “Direct Tour Hours” in the “Address” section. If the “Direct Tour Hours” are reduced to 0, the user must
select a reason code from the dropdown list.
Figure 12 - Reason Code
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Reason codes include:
• Deceased
• Duplicate entry
• Incorrect profession
• Inpatient facility only
• License suspended by state/in disciplinary status by state
• Locum Tenens/PRN
• Non-Fed not licensed in state
• Not in clinical practices
• Not Public Access Facility
• Open-ended long term leave
• Relocated
• Retired
• Specialist/Subspecialist
• Urgent Care Clinic
• Only reporting psychiatrists (option available only for the Mental Health discipline)
• Only reporting CMH (option available only for the Mental Health discipline)
GEOCODED ADDRESS
This section illustrates additional geographical information returned by the geocoding service, using the primary
address of practice found in the NPI file. All information under this grouping is read-only, except for the latitude
and longitude fields.
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Figure 13 – Geocoded Address
1. Address Successfully
Geocoded
This indicates if the system has successfully geocoded the provided address or not.
2. Latitude and Longitude
These fields are prepopulated by the system if it found a Latitude and Longitude
for the provided address. Users associated to the provider can override the given
latitude and longitude by entering new values.
3. Match Level
This field indicates. If the user modifies the latitude and/or longitude the new
match level would be 0 – User Override.
4. Address Map
The map pinpoints the physical location of the provided address.
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USER NOTES
•
•
•
•
If the NPI Primary Address could not be geocoded, the following message will be displayed as part of the
“Geocoded Address” section: “Address Successfully Geocoded: No” The address will need to be updated
in the NPI Primary file or updated by the user in order to collect an accurate address.
If the primary address was unsuccessfully or incorrectly geocoded by the system, users have the option to
manually geocode the address by dropping a pin on the provider’s location on the map or entering the
latitude and/or longitude. Please note that PCOs will only be able to edit addresses for providers
associated to their State.
If the provider cannot be geocoded then it will not show up on the map and therefore not be counted in
the area the PCO is trying to create the RSA.
Reference the Index section below for a detailed description of the steps to handling geocoding
exceptions.
FTE CALCULATIONS
This section shows the FTE calculations for the “NPI Primary Address” location. The calculations are dynamic, with
values updating after each save of edits that impact FTE calculations. All the values displayed are read-only.
Figure 14 - FTE Calculations
BUSINESS RULES
•
•
•
•
For any Low-Income calculation, enter in either or both of the following:
1. “Yes” to Medicaid with a value great than 0 for Medicaid claims or %.
Note that if both Medicaid claims and % have values greater than 0, the system will look at the
Medicaid claims value.
2. “Yes” to Sliding Fee Scale with a value greater than 0.
The user may enter Tour Hours greater than 40, but the database will cap to 40 hours in order to calculate
FTE.
For dental FTE, only the Auxiliary Weight is applied to the 40 hour cap before the final FTE is calculated.
The Auxiliary Weight is determined by the Dentist Age and Auxiliary Number entered.
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CLINICAL INFORMATION
This section lists the fields pertaining to clinical information specific for the “NPI Primary Address” location. Note
that percentage values must be entered for each “Yes” response. The user must click “Save Provider Information”
to save the information and update the FTE value. This section will also collect additional provider details regarding
each address the provider is associated to.
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Figure 15 - Clinical Information
BUSINESS RULES
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Please note that the following additional fields under Clinical Information are independent to the current address
being updated:
•
•
•
•
•
Is Physician an intern or Resident?
J1 Visa Waiver Program?
Federal Provider?
NHSC Provider?
Nursing Provider?
6. ADD NEW ADDRESS
The “Add New Address” tab offers the option to input up to 4 additional addresses for the provider. The additional
address will be omitted from FTE Calculations until it is geocoded.
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Figure 16 - Add New Address
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1. Status
This will display the ‘Status’ of the record. The default when adding a new
address is ‘N/A’.
2. State
The state is defaulted to the location of the PCO and is read-only.
3. Address Successfully Geocoded
This will display a Yes / No to signify the address was successfully geocoded.
4. Geocoded Match
This will display the geocoded address of the additional provider location,
once it is geocoded.
INSTRUCTIONS
1.
2.
3.
4.
Input the Address, City and Zip Code of the new location. (See Figure 17)
Provide phone number and fax number if available.
Update tour hours as necessary and provide a reason code.
Provide clinical information for the location if available.
5.
6.
Click
to create the new location. (See Figure 18)
Find the new address confirmation message and new location information under the newly created tab
“Location 1.” (See Figure 19)
Figure 17 - Required Information
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Figure 18 - Add New Address
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Figure 19 - Location 1
Figure 20 - Disabled "Add New Address"
1. Location 1
After clicking “Save Provider Information,” the address will display on a new tab
labeled “Location 1.”
2. Location 2, 3 and 4
Each additional address will display in a new tab labeled “Location 2,” “Location 3,”
and “Location 4.”
BUSINESS RULES
•
•
•
Address Line 1, City, State and Zip Code are required to add a new address.(See Figure 16)
The user may add up to 4 new locations, for a total of 5 locations including the NPI Primary Address. After
the fourth address is submitted, the “Add New Address” tab will no longer be available. (See Figure 19)
The new location will be geocoded immediately after the user selects the “Save Provider Information”
button if the system found a strong enough match to the provided address. Refer to the “Geocoded
Address” section on the “Location #” tab to find more information on its status.
USER NOTES
•
•
A new location cannot be deleted once it is submitted. To remove the address fully from FTE Calculations,
users can either reduce Direct Tour Hours to 0 for that address or deactivate the address. Address
deactivation will be covered in the next section.
If needed, the user may add a provider address located in a different state.
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7. DEACTIVATING AN ADDRESS
Under each address that has been added by the user, the system provides the option to deactivate an address that
may no longer be needed for that provider.
Figure 21: Deactivate Address
1. PCO’s State
State the PCO is responsible for.
2. State
The address being modified is within PCO’s state.
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3. Reason Code
Reason code must be provided when deactivating or zeroing out an address.
4. Deactivate
Address
Select “Deactivate Address” button to deactivate the current address.
BUSINESS RULES
•
•
•
NPI Primary Address cannot be deactivated by the user.
The address being deactivated must be within the PCO’s state.
The user must provide a reason code when deactivating and address.
INDEX
Steps to resolve geocoding exceptions:
1.
2.
3.
4.
5.
6.
Search for locations that have not been geocoded successfully.
Delete the existing latitude and longitude and select the “Save Provider Information” button.
a) If its match level 3 or less, the latitude and longitude are accurate, and the components are also
accurate, then the system has successfully geocoded the address.
b) If its match level 4 or higher, or the latitude and longitude aren’t accurate, or the components
are incorrect, move on to the next steps.
Create a new location
Enter the correct address and save
Check your results:
a) If its match level 3 or less, the latitude and longitude are accurate, and the components are also
accurate, then the system has successfully geocoded the address.
b) If its match level 4 or higher, or the latitude and longitude aren’t accurate, or the components
are incorrect, move on to the next step.
Drag the pin to the correct location and save
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| File Type | application/pdf |
| Author | Morgan Brooke Edmonds |
| File Modified | 2015-12-18 |
| File Created | 2015-11-13 |