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pdfBureau of Health Workforce
SDMS PCO Provider Management User Guide
Shortage Designation Management
System (SDMS)
PCO Provider Management User Guide
April 2020
The information collected via the Shortage Designation Management System is used to determine which areas,
populations, and facilities have qualifying as Health Professional Shortage Areas for the distribution of NHSC
resources. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. The OMB control number for this
information collection is 0906-0029 and it is valid until 5/31/2020. This information collection is required to
obtain or retain a benefit (Section 332 and Section 330(b)(3) of the Public Health Service (PHS) Act). Public
reporting burden for this collection of information is estimated to average xx hours per response, including the
time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room
14N136B, Rockville, Maryland, 20857 or [email protected].
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TABLE OF CONTENTS
Shortage Designation Management System (SDMS) Overview ............................................................................ 4
Content of this User Guide ................................................................................................................................. 4
1. Accessing the SDMS Portal ............................................................................................................................. 5
1.1 PCO Portal Landing Page (Overview) .................................................................................................................. 7
1.1.2 Account Settings ........................................................................................................................................... 8
1.2 Forgot Password .................................................................................................................................................. 9
1.3 Create Account .................................................................................................................................................... 9
2. Shortage Designation Management System (SDMS) Main Page..................................................................... 10
3. Provider Management................................................................................................................................... 11
3.1 Provider Search.................................................................................................................................................. 13
3.1.1 Customizing The Provider Search Results Grid View .................................................................................. 17
3.1.2 Downloading Provider Search Grid Results ................................................................................................ 18
3.1.3 Editing Provider Records in the Search Results Grid View.......................................................................... 18
3.2 Provider Information ......................................................................................................................................... 21
3.2.1 NPI Address ................................................................................................................................................. 23
3.2.2 Adding and Editing Provider Physical Locations ......................................................................................... 23
3.2.3 Provider Taxonomies .................................................................................................................................. 24
3.2.4 Provider Change History ............................................................................................................................. 25
3.2.5 Comments................................................................................................................................................... 26
3.3 Provider Locations ............................................................................................................................................. 28
3.3.1 Location Status ........................................................................................................................................... 30
3.3.2 Ineligible Reasons ....................................................................................................................................... 31
3.3.3 Location Address ........................................................................................................................................ 33
3.3.4 Location Geocoded Address ....................................................................................................................... 35
3.3.5 Employment Status..................................................................................................................................... 37
3.3.6 Program Status ........................................................................................................................................... 38
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3.3.7 Clinical Information..................................................................................................................................... 38
3.3.8 FTE Calculations .......................................................................................................................................... 39
3.3.9 Clinician Data Attestation ........................................................................................................................... 39
3.4 Import Tool ........................................................................................................................................................ 40
3.4.1 Downloading Provider Export File .............................................................................................................. 40
3.4.2 Export File Introduction .............................................................................................................................. 41
3.4.3 Editing Provider Locations Using the Export File ........................................................................................ 44
3.4.4 Upload Completed File ............................................................................................................................... 46
3.4.5 System and Business Rules ......................................................................................................................... 51
3.4.6 Import Tool Examples and Best Practices ................................................................................................... 54
Appendix A – Changes to Last Updated By Data ................................................................................................. 58
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SHORTAGE DESIGNATION MANAGEMENT SYSTEM (SDMS) OVERVIEW
Goal: The Shortage Designation Management System is used to manage, create, and update designations, and to
manage and update provider records in support of designations. The foundation of the Shortage Designation
Management System comes from nationally sourced data and the policies and procedures of the Division of Policy
and Shortage Designation (DPSD).
PCOs are able to complete the following:
•
•
•
•
•
•
•
•
Search for existing designations
View information about existing designations
Create and submit new designations
Update existing designations
Copy designations
Review and update POC-submitted designations
Create and manage inquiries
Create and update provider location records
Roles: The shortage designation role is required to be part of the PCO user account in order to have access to the
Shortage Designation Management System for Designations for their state. Please refer to the Create Account
Section to gain the role and permission to perform the Designation Management functions.
CONTENT OF THIS USER GUIDE
This user guide covers provider management functionality and business rules. For further information on
designation and user management related functionality and business rules, refer to the Designation Management
User Guide and User Management User Guide on your SDMS Portal Home Page.
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1. ACCESSING THE SDMS PORTAL
Go to the BHW portal homepage and select the “A State Primary Care Office Member” option. The homepage can
be accessed via the HRSA Program Portal.
Figure 1: BHW Portal Homepage
Once directed to the login page, the user should enter their login email and password to login. If the user has three
failed login attempts, the account will be locked. To create an account or recover a lost password, see Section 1.2
Forgot Password and Section 1.3 Create Account.
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Figure 2: BHW Login Page
After successfully logging in, select “Link to Shortage Designation Main Page” link on the PCO Portal Landing Page.
Figure 3: PCO Portal Landing Page
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1.1 PCO PORTAL LANDING PAGE (OVERVIEW)
The purpose of the PCO Portal Landing page is to give the PCO access to both the NHSC Site Applications and
Recertifications and the Shortage Designation Program.
Figure 4: BMISS PCO Portal Landing Page
Feature
Description
1. NHSC Site Applications and
Recertifications
This section contains a number of tools for the site administrator as well as
support contact information and a summary of all open requests. If the site
administrator has either submitted an application for a site or is a POC at a
site which has an application pending, those applications will appear there.
2. Program Portal
Clicking on the Program Portal logo will take the user to the Portal.
3. Account Settings
The account setting will allow the PCO to manage and update security
information as well as email and password information.
4. My Messages
The PCO can view their messages within the Portal here.
5. Roles
The PCO can view the roles associated with the user account.
6. Log Out
The PCO can log out of the PCO Portal here.
7. Shortage Designation
Program
This section contains information about the Shortage Designation Provider
Management. It allows PCOs to manage, review, and update the provider
information as part of the designation application process.
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Feature
Description
8. Shortage Designation
Reports
User Notes:
• Only PCO with the Shortage Designation Program role will have
access to this.
• The PCO will see only their designated state.
•
There are now four reports available:
• ASAPS Archive Designations Report
• ASAPS Archive Report for Providers by Designation
• NPI Provider Data Report: The report is an exportable file of all the
provider information associated with the PCO state.
• Designation Data and Health Data Export: Is an exportable file for
all associated information broken down by designation for all
designations in the PCO state.
See the Designation Management User Guide for additional information
on ASAPS Archive Reports.
1.1.2 ACCOUNT SETTINGS
The Account Settings page can be used to update security information as well as email and password information.
Figure 5: Change PCO Account Settings
Feature
Description
1. Change Email Address
Allows the user to change the email address which they log-in with.
2. Change Password
PCO can change their password in this section.
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Feature
Description
3. Change Security
Information
PCO can change the security information through these steps.
1.2 FORGOT PASSWORD
When a password is forgotten or needs to be reset, please select the Forgot Password link.
INSTRUCTIONS
1.
2.
3.
4.
Select the Forgot Password link. This will open another window that will request the user’s email address
Enter the email address associated with the account
Enter the answer to the security question
Select Submit
A reset password email will be sent after submission of the correct security question answer. It will contain a link
that must be used to rest the password. After changing the password, the user can return to the portal login page
and enter the account email and new password.
USER NOTES:
•
•
The security question and answer are entered during the create account process. If this is unknown, the
Forgot Password process cannot proceed, and the user will need to contact the BHW Customer Call
Center at 1-800-221-9393.
Passwords must have a minimum length of eight characters; shall not contain slang, jargon, or personal
information; shall not contain all or part of the username; and must contain: at least one English uppercase character (A-Z), at least one English lower-case character (a-z), at least one numerical digit (0-9), and
at least one special character (e.g. @, !, $, %). A character may not be repeated more than once in
succession.
1.3 CREATE ACCOUNT
The Create Account process begins on the Portal Login page. Primary Care Offices must only use the create
accounts for PCOs.
USER NOTES
•
•
PCO Accounts created prior to September 27th, 2014 must follow the create account process.
The email address to be used as the username, the state, and the role must be communicated from the
PCO to the Project Officer or Customer Call Center prior to creating the account otherwise the account
will not be activated.
•
The account will be activated after 24 hours. An account activation email may be sent prior to this 24
hours but the account will only be activated after the 24 hour period has passed.
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Figure 6: Creating a PCO Account
Feature
Description
1. Create My Account
The six fields displayed are required to create an account. The user can
select the information icon to get more information about password
requirements or additional information about the field.
2. Cancel
User Notes:
• The email used will serve as email username for portal login.
• The Security Question and Answer must be easily remembered in
order to be used as part of the Forgot Password process.
•
The PCO can click on this button and be taken to the Portal page.
3. Register
After entering all the required fields, the PCO can click on the “Register”
button to register their account.
4. Login
PCO can login to the account after 24 hours.
2. SHORTAGE DESIGNATION MANAGEMENT SYSTEM (SDMS) MAIN PAGE
The purpose of the Shortage Designation Main Page is for the PCO to view important updates, access helpful
resources and access the Designations portal, Providers portal, User Management portal, and Inquiries and Report
functionalities. The user can access this page by selecting “Link to the Shortage Designation Main Page” on the
main portal homepage.
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Figure 7: PCO Shortage Designation Main Page
Feature
Description
1. Navigation Panel
The user may navigate to other sections of the PCO Portal using this toolbar.
Several of these menu items have sub-menus when clicked.
2. News and Alerts
This section will provide the user with new information and updates
pertaining to Shortage Designation Management.
3. My Profile
This section will list the name and email address of the logged-in user.
4. Helpful Resources
This section will provide the user with resources on the policies and
procedures of SDMS.
From the Shortage Designation Main Page Navigation Panel, PCOs can access:
•
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SDMS Mapping tool (via the Designations Portal) to create and update designations
Designations Portal (Search for and View Designations, Manage Tasks in My Activities)
Auto-HPSA Designations Portal (via the Designations Portal) to view and rescore Auto-HPSAs
Tools
Provider Management Portal (Search for Providers, Upload an Import File, Download State Provider Data)
User Management Portal (Manage Auto-HPSA Points of Contact, Manage Stakeholder Notifications)
An overview of the provider management portal is provided in the subsequent section.
3. PROVIDER MANAGEMENT
The purpose of the Provider Management Portal is to give the PCO the ability to search for a provider and update
eligible information. The portal currently provides PCOs two convenient ways to update provider data: using the
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web application or by importing data using the import tool. This user guide details how to search for providers and
make updates to provider records using the two methods mentioned above.
Figure 8 illustrates the Provider Management Dashboard, which serves as the landing page for the Provider
Management Portal. From this page, users can navigate to the “Search,” “Upload,” or “Download” pages.
Figure 8: Provider Management Dashboard (Landing Page)
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3.1 PROVIDER SEARCH
The user can navigate to the Provider Search Page (see Figure 9) by clicking on the “Search” button on the Provider
Management Dashboard. The default search screen allows users to search basic provider information.
Users can conduct a more advanced search by clicking on “Advanced Search” which expands the search box and
enables additional search fields. Figure 10 provides a visual of all the fields available for search.
Figure 9: Provider Search Page - Basic Search Screen
Figure 10: Provider Search Page - Advanced Search Screen
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BASIC SEARCH
Feature
1. NPI
Description
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. State
Select any one of the 50 states or 6 territories.
User Notes:
•
ADVANCED SEARCH
If a state is not selected as part of the search criteria, SDMS will
search providers across all states. PCOs can view providers across all
states, but can only edit providers within their designated states
(the state associated with the PCO’s user account).
Feature
5. Discipline
Description
Select one or more of the three disciplines:
• PC: Primary Care
• MH: Mental Health
• DH: Dental Health
6. Specialty
Select one or more of the ten specialties. This field can only be completed
once a discipline has been selected. Once a discipline is selected, only the
specialties that fall under that discipline will be available for selection. Note
that if multiple disciplines were selected, all specialties that apply will be
available as dropdown menu options.
PC: Primary Care
• FP: Family Practice
• IM: Internal Medicine
• OBG: Obstetrics and Gynecology
• PD: Pediatrics
MH: Mental Health
• PSY: Psychiatrist
• CPSY: Clinical Social Psychologist
• CSW: Clinical Social Worker
• PNS: Psychiatric Nurse Specialist
• MFT: Marriage and Family Therapist
DH: Dental Health
• GDT: Dentist
•
Select one of the two statuses:
• Eligible
• Ineligible
7. Status
8. Ineligible Reason
Select one or more of the eight ineligible reasons. Note that this field will
not be visible if an “Eligible” status is selected.
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Feature
Description
• CMS Deactivated
• PCO Omitted
• Not Geocoded
• Is Federal Provider
• Is NHSC Provider
• J1 Visa Waiver Holder
• No Discipline/Specialty
• New, Not Reviewed
9. County Name
Select one or multiple counties available for that state. Only the county
names that fall under the selected state will be available for selection. Note
that when a “County Name” is selected, the system will populate the
“County FIP” dropdown with its corresponding value.
10. County FIP
Select one or multiple County FIPs available for that state. Only the County
FIPs that fall under the selected state will be available for selection. Note
that when one or more County FIP(s) is selected, SDMS will populate the
“County Name” dropdown with its corresponding value.
11. CSD
Enter any 10-digit numerical value in this field; only exact matches will be
returned.
12. Census Tract
Enter any 11-digit numerical value in this field; only exact matches will be
returned.
13. NPI Change Type
Select one of the four options:
• New Provider
• CMS Deactivated
• Taxonomy Change
• NPI Address Change
14. NPI Change Date
Select one or multiple dates available. Note that dates will be populated
based on the “NPI Change Type” selected.
15. License
Enter any numerical value in this field; only exact matches will be returned.
16. Last Updated By
Select one or multiple usernames available. Note that if a state is selected,
only those users who updated records in that state will be listed.
17. Needs Review
Select one of the two options:
• Yes
• No
18. Clinician Data Reviewed
Select one of the two options:
• Yes
• No
After entering all relevant search criteria, click “Search” to initiate the search. The search results will display in the
“Provider Search Results” grid. Figure 11 provides an example grid of search results.
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Figure 11: Provider Search Results Grid
Feature
1. Customize Columns
2.
/
3.
/
Description
Allows the user to customize the columns that are part of the search grid;
see Section 3.1.1 Customizing The Provider Search Results Grid View for
more detail.
Click to move to the previous/next page.
Click to move to the first/last page.
4.
Allows the user to adjust the number of records viewed per page by clicking
on the dropdown and selecting 10, 20, 50, or 100. The search results page
defaults to 10 records per page.
5. 1 - 10 of # Items
Displays the total number of results returned and the subset of results being
displayed.
BUSINESS RULES
•
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At least one search criteria is required to run the search. The system will return an error message if no
search criteria is entered.
Each search criteria will run only exact matches.
o Ex. A misspelled name will render no results.
Fields are not case-sensitive.
Only one option may be selected on these dropdowns:
o State
o Status
o NPI Change Type
Multiple options may be selected on these dropdowns:
o Discipline
o Specialty
o Ineligible Reason
o County Name
o County FIP
o NPI Change Date
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•
•
•
o Last Updated By
The default state is set to a null value. Search will search across all states.
You can elect to search on any state.
If you click the “Clear” button, state will reset to a null value.
USER NOTES
•
•
•
Click on the NPI to navigate to provider profile.
Sort the search result by ascending or descending order by clicking on any column header.
Information from NPI database is read-only.
3.1.1 CUSTOMIZING THE PROVIDER SEARCH RESULTS GRID VIEW
On the Provider Management Search Results grid, users can add, remove, or reorder columns by clicking on the
“Customize Columns” button. The following “Visible Columns” pop-up will display:
Figure 12: Customize the Column Layout in Search Results Grid
INSTRUCTIONS
To add, remove, or reorder columns on the search results grid:
1. Check (to add) or uncheck (to remove) column options.
a. The columns that display in the default search results grid will be checked. Uncheck these
columns to remove them from the layout of the search results grid.
b. Additional columns can be added to the layout of the search results grid by checking the
checkbox.
c. Click and drag the checked columns in the desired order to be displayed.
d. Click Select All to select all the search grid columns.
e. Click Deselect All to deselect all the search grid columns.
2. Click the “Close” button to save changes and return to the updated search results grid layout.
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USER NOTES
•
•
•
•
The search result grid can display up to 38 column headers.
Click and drag column headers in the Search Results Grid or in the “Customize Columns” pop-up menu to
change the column order.
Use the scroll bar on the bottom of the search result grid to navigate horizontally across the search results
to a column.
The search result grid can be downloaded by clicking on the Download button.
3.1.2 DOWNLOADING PROVIDER SEARCH GRID RESULTS
On the Provider Management Search Results grid, users can add or remove columns and download those results
by clicking on the “Download” button.
INSTRUCTIONS
To download provider search results grid:
1. Select your state.
2. Apply filters to the Advanced Search fields.
3. Select “Customize Columns” to add or remove columns for the search grid results
4. Click “Download” and a pop-up message will appear notifying you that the required columns to upload
the file back through the import tool will be included in your search grid results download.
5. Click “Download” to see the file.
Figure 13: Download Search Results Grid
BUSINESS RULES
•
•
The state the PCO works in must be selected in order for the “Download” button to be enabled.
The required 24 columns will be included in the Search Grid Results download regardless if they were
chosen as part of the search grid.
3.1.3 EDITING PROVIDER RECORDS IN THE SEARCH RESULTS GRID VIEW
The purpose of this functionality is to enable PCOs to quickly update multiple records and save. After reviewing
the search results on the grid, make edits directly within the grid, and save without having to navigate to the
provider record.
INSTRUCTIONS
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To edit provider data directly in the search results grid:
1. Double click on the cell you want to edit. Be sure you are on the row of the correct provider record.
2. Make edits to the fields that are editable.
3. Press “Enter” on the keyboard to save changes after editing each row of provider information or click out
of the row. There will be no save confirmation message.
USER NOTES
•
•
If you click into a cell in another row or click outside of the row you are editing, the system will still save
your changes. If you want to cancel any changes you’ve made, you must change the data back.
All data from NPI is read-only.
Figure 14: Editing Fields in the Search Results Grid
Depending on the field, the edit format will vary:
Feature
1.
Description
All the fields that are read-only will highlight when you double click on the
cell, but will not switch to an editable format.
Applies to:
• NPI, Last Name, First Name, County FIP, County Name, CSD, Census
Tract, Last Updated Statuses, Activation Date, NPI Deactivation, NPI
Reactivation, NPI New, NPI Address Change, NPI Taxonomy Change,
Dental Auxiliaries, Address, City, State, Zip, NHSC Provider
2.
All the fields that enable typing directly within the cell will highlight when
you double click on the cell, and will switch to an editable format.
Applies to:
• Phone Number, Fax Number
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Feature
2.
Description
Fields with pre-defined data to select from will be in the format of a
dropdown menu. Double-click in the cell to display the dropdown, then
select the desired option from the dropdown menu.
Applies to:
• Discipline, Specialty, Reason Code
Fields with numerical data will have an up/down arrow option to scroll to
the desired numerical value. You can also type the number directly into the
cell as long as it is a valid value.
3.
Applies to:
• Hours, Medicaid Patient?, Annual Medicaid Claims?, Homeless %,
Migrant or Farmworker %, Native American %, Sliding Fee Scale %,
Migrant Seasonal Worker %
To edit the field, double click into the cell and a checkbox will appear. A
checked checkbox indicates a value of “Yes” and a blank checkbox indicates
a value of “No”. Check the box to change the field to yes. Uncheck the box
to change the field to no.
4.
Applies to:
• Serves at Correctional Facility, Serves at State/County Mental
Hospital, PCO Omitted, Intern or Resident, JV Visa Waiver Program,
Federal Provider
BUSINESS RULES
•
•
•
All read-only fields will not allow you to edit the data in that field.
The maximum % is 100.
The “Dental Auxiliaries” column can only be edited if the discipline of the provider record is a DT: Dental
discipline.
USER NOTES
•
Hours can only be changed to 0 and saved if the Reason Code column is added to the search grid view,
and a reason code is specified. If a reason code is not specified, the entire row will turn red, indicating
that the edit cannot be saved due to an error.
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3.2 PROVIDER INFORMATION
From the Provider Management Search Results grid click on the hyperlinked NPI number of a provider to navigate
to that provider’s profile page.
Figure 15: Provider Overview Page of the Provider Record
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Feature
1. Last Name, First Name, NPI
Description
The name and NPI of the provider is displayed here.
2. < BACK: Search Results
Click this button to return to your current search results. If changes to the
provider information are not saved before selecting this button, the changes
will be lost. Users will not receive a warning message about unsaved data.
3. NEXT: Location 1 of # >
Click this button to navigate to the edit view of the first/next physical
location for the provider. The location page for each address can also be
accessed by clicking on the hyperlinked address in the Locations” module.
4. Last Updated by …
This is the last date the provider record has been updated by either a user or
by the system (e.g., NPI delta file import). The format for display is:
MM/DD/YYYY HH:MM AM/PM (12-hour time).
5. Revisions
Click on this dropdown to view previous versions of the provider’s location.
6. Provider Information &
Location Addresses
This section lists the provider’s basic information, NPI address, and physical
location(s). Provider Information and NPI address are data from the NPI and
are therefore read-only. From this section, users can add an NPI address to
a physical location and can add or edit physical locations.
7.
Click on a hyperlinked address in the “Locations” module to view additional
details and edit details for that provider location.
8.
Change the filter on the Locations list to show all addresses, only eligible
addresses, or only ineligible addresses.
9.
Click on this button to navigate to the “Edit Location” page to add a new
physical location to the provider record.
10.
Click on this button to quickly create a physical location record from the NPI
address. When this button is clicked, the “Edit Location” page will open with
the location address fields already populated with the NPI address.
11. Provider Taxonomies
This section lists the provider’s taxonomy information. A provider may have
one or multiple taxonomies listed. The primary taxonomy is identified by a
in the “Primary” column.
12. Provider Change History
This section lists changes to the provider record from the NPI file. It does
not include changes made by system users.
13. Comments
This section allows users to post comments to a provider record. Any user
can post a comment, regardless of the state associated with the provider
record.
14. NPI Non-Primary Provider
Information
This section will display a providers secondary NPI Address from CMS. No
changes or actions can be made on this address.
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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 makes an update through the search grid,
location page, or import tool. For more information on when last updated time and date are changed, see
Appendix A – Changes to Last Updated By Data.
When viewing previous versions, all information will be read-only.
3.2.1 NPI ADDRESS
The NPI Address is obtained from the NPI Primary and Delta Files and cannot be edited by the user.
•
•
When a new provider is added to SDMS, the NPI address is the default address used to determine FTE
calculations and is copied over as the provider’s location address.
Changes to the NPI address of an existing provider record will not affect location addresses and will be
reflected only in the NPI address displayed on the Provider Profile page (see Figure 16).
ADDING THE NPI ADDRESS AS A PHYSICAL LOCATION ADDRESS
If the NPI address needs to be added as a physical location
address, users can quickly add the NPI address by clicking
the “Copy Address” button.
The Add/Edit Location page will open and the NPI address
will pre-populate to the address fields. For complete
instructions on adding or editing physical location addresses
to a provider record, see Section 3.2.2 Adding and Editing
Provider Physical Locations.
Figure 16: Read-Only NPI Address on Provider Profile Page
USER NOTES
•
The “NPI Address” is the only address imported from the NPI Delta File. Other location addresses for a
provider can only be added to the provider record by a user.
3.2.2 ADDING AND EDITING PROVIDER PHYSICAL LOCATIONS
From the Provider Profile page, users can access the Locations module to add new locations and edit existing
locations. Each provider location will have its own page so users can only view the details of one provider location
at a time.
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Figure 17: Locations List and Access to View/Edit Location Page
Feature
1. Add New Location
Description
To add a new location, select the “Add New” button in Figure 17 to navigate
to a blank Location page.
2. View or Edit Details of an
Existing Location
To view or edit the details of an existing location, click on the hyperlinked
location address to view/edit in the Locations list.
See Section 3.3 Provider Locations for more details.
USER NOTES
•
A user can choose to filter the Locations module to view all locations, only eligible locations, or only
ineligible locations by selecting a filter option from the “View Status” dropdown menu.
3.2.3 PROVIDER TAXONOMIES
The taxonomy information in this section is NPI data and is read-only (see Figure 18). The taxonomy information
reflects provider-reported data on their practice location(s) and specialization(s).
When a new provider is imported into the SDMS system, the system will search for a primary and valid taxonomy.
a.
b.
If there is an identified primary taxonomy and it is valid, the system will populate the “Discipline” and
“Specialty” fields (on the Provider Location page) with the corresponding “Discipline” and “Specialty.”
If there is no primary taxonomy or the identified primary taxonomy is invalid, the “Discipline” and
“Specialty” fields (on the Provider Location page) will be left blank, resulting in an “Ineligible” Status and
“Ineligible Reason” of “No Discipline/Specialty”.
NPI Delta File updates to taxonomy information will not result in an update to the “Discipline” and “Specialty”
fields.
The SDMS Provider Portal allows PCOs to override the NPI-determined “Discipline” and “Specialty” by entering a
new discipline or specialty that may or may not match the taxonomy code and taxonomy type. The system will use
the discipline/specialty information in its calculations, not the taxonomy information.
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Figure 18: Provider Taxonomies
Taxonomy
1. Primary
Description
This field displays NPI data and is populated by the NPI Primary and Delta
Import Files. This is a read-only field. A provider may have one or more
taxonomies, but only one primary taxonomy. The primary taxonomy is
identified by a . If there is no primary taxonomy identified, the
“Discipline” and “Specialty” fields will not be populated by the system,
resulting in an “Ineligible” status.
2. Taxonomy Code
This field displays NPI data from the NPI Primary and Delta Import Files. This
is a read-only field. Taxonomy codes are assigned by CMS based on the
specific CMS-defined specialty of practice for the provider.
3. Taxonomy Type
This field displays NPI data from the NPI Primary and Delta Import Files. This
is a read-only field. “Taxonomy Type” is determined by the “Taxonomy
Code.”
4. License Number
This field displays NPI data from the NPI Primary and Delta Import Files. This
is a read-only field. A provider must have at least one license number for
each state in which they practice, and may have more than one license
number per state if they have more than one specialization.
5. Taxonomy State
This field displays NPI data from the NPI Primary and Delta Import Files. This
is a read-only field. “Taxonomy State” indicates the state in which the
provider is providing services for that taxonomy type/code.
BUSINESS RULES
•
•
A primary taxonomy is required in order for the system to populate the “Discipline” and “Specialty” fields.
A valid taxonomy is required in order for the system to populate the “Discipline” and “Specialty” fields.
USER NOTES
•
•
•
•
Users may manually enter or update a valid discipline/specialty for providers in their designated state.
Users may have more up-to-date information on providers than CMS. Therefore it is possible that the
data fields that are completed by PCOs may not always match the NPI read-only data. PCO-entered data
will never be overridden by NPI Delta File updates.
A provider may have two different taxonomy codes with the same taxonomy type if they have two
specializations.
A provider may have two of the same taxonomy code with two different license numbers and states if
they are providing the same service in two different geographic locations.
3.2.4 PROVIDER CHANGE HISTORY
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On the Provider Profile page, users can see a change history log of important NPI changes to the provider. NPI
changes are imported to SDMS weekly in the NPI Delta Import File.
The change history log captures four NPI change types:
•
•
•
•
New Providers
NPI Taxonomy Changes
NPI Address Changes
NPI Provider Deactivations
The change log does not capture changes made by users.
Figure 19: Provider Change History Log
Feature
1. Date/Time
Description
This field identifies the date and time that the provider record was updated
by NPI.
2. Change
This field identifies the type of change being recorded. It will be one of the
four change types listed above.
3. From
This field shows the original data before the NPI update. The purpose of this
field is to aid users in determining what changes have been made.
4. To
This field shows the new data after the NPI update. Users can compare this
data to the data in the “From” column to determine what changes have
been made.
USER NOTES
•
•
The change history log is read-only.
Sort the search result by ascending or descending order by clicking on any column header.
3.2.5 COMMENTS
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On the profile page, users can add comments to a provider record to communicate important information with
other users. Comments will display with the name of the commenter, the date and time the comment was added,
and the comment text. Comments cannot be deleted once the “Add Comment” button has been clicked, and all
system users who can access the provider’s record can see the comments. There is no way to limit the audience
when entering a comment.
Figure 20: Adding Comments to a Provider Record
Feature
1. Name
Description
This field displays the name of the user who added the comment.
2. Date
This field displays the date and time that the comment was added.
3. Comment
This field shows the published comment. This is a read-only field.
4. Add Comment
Users can type their comments in the text box and then click “Add
Comment” to publish their comment. Once a comment has been published,
it cannot be edited or deleted.
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3.3 PROVIDER LOCATIONS
On the Provider Location page, users can add new locations, activate and deactivate locations, and view all details
related to a provider location.
Figure 21: Provider Location Report
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Feature
Description
1. Last Name, First Name, NPI
The name and NPI of the provider is displayed here.
2. Address
The address of the provider location being viewed is displayed
here.
3. < BACK: NPI Info & Taxonomies
Click this button to return to the previous screen – the Provider
Overview page.
4. Last Updated by
This is the last date the provider record has been updated by
either a user or by the system (e.g., NPI delta file import). The
format for display is: MM/DD/YYYY HH:MM AM/PM (12-hour
time).
5. Location Status
This section displays whether or not the location is eligible,
provides the reason(s) a location is ineligible, and allows PCOs to
omit or include locations. See Section 3.3.1 Location Status for
more information.
6. SDMS Activation Date
If active, the date the location was activated will be displayed here.
7. Location Address
This section displays the physical address of the provider location,
the type of location, the phone and fax of the provider location,
and the type and number of hours of service provided. See Section
3.3.3 Location Address for more information.
8. Location Geocoded Address
This section illustrates additional geographical information
returned by the geocoding service. All information under this
grouping is read-only, except for the latitude and longitude fields.
See Section 3.3.4 Location Geocoded Address for more information.
9. Employment Status
This section displays additional details about the provider’s
employment status specific to the location being viewed.
10. Program Status
This section displays the provider’s BMISS Program status. If the
provider is not enrolled in a BMISS program this section will not
appear.
11. Clinical Information
This section lists the fields pertaining to clinical information
specific for the provider location being viewed.
12. FTE Calculations
This section shows the FTE calculations for the provider location
being viewed. The calculations are dynamic, with values updating
after each save of edits in other sections that impact FTE
calculations. All the values displayed are read-only.
13. Needs Review Status
This section indicates whether the clinician data associated with
the provider location needs to be reviewed
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14. Clinician Data Attestation
This section shows whether the clinician data has been reviewed
and attested to and allows the user to update the status.
15. Save
The user must click “Save” to save the updated information. If the
user leaves the page without saving, they will not be prompted to
save and the information will be lost.
BUSINESS RULES
•
When a new provider is imported into the system, the SDMS activation date will be null until the PCO
modifies the location and saves.
USER NOTES
•
•
When a user creates a new location, the system will pre-populate certain fields (such as “Discipline” and
“Specialty”) based on valid NPI data in the provider record, but the user can update these fields before
saving the new location.
When a user updates any of the information in the provider location page and saves those changes, the
“Needs Review” status will not change.
3.3.1 LOCATION STATUS
Provider locations can be eligible or ineligible.
•
•
If a provider location is eligible for a given provider, that provider location will be counted or otherwise
used in the designation application process and/or HPSA update for that state.
If a provider location is ineligible for a given provider, that provider location will not be counted or
otherwise used in the designation process and/or HPSA update for that state.
Figure 22: Eligible Status Display
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3.3.2 INELIGIBLE REASONS
If a provider location is ineligible, it must have one or more ineligible reasons. If a location is ineligible, the
“Ineligible Reason(s)” field will display one of the reasons described in the table below
Reason
Description
CMS Deactivated
CMS deactivated the provider. This ineligible reason can only be removed by
a change in the NPI Delta file.
PCO Omitted
The PCO selected the “PCO Omitted” checkbox and entered a reason code.
This ineligible reason can be removed by unchecking the “PCO Omitted”
checkbox. If the provider has other ineligible reasons listed, they will remain
ineligible.
Not Geocoded
The system received a geocoded match level of 4 or higher. This ineligible
reason can be removed by prompting the system to attempt to geocoded
the address again, or by manually geocoding the address. See Section 3.3.4
Location Geocoded Address for instructions on how to resolve geocoding
issues.
Is Federal Provider
The PCO indicated that the provider is a federal provider. This ineligible
reason can be removed by indicating that the provider is not a federal
provider in the “Employment Status” section on the Provider Location page.
Is NHSC Employee
The PCO is an Active NHSC provider. This ineligible reason can only be
removed by a change in the participant’s status in BMISS.
No Discipline/Specialty
The provider’s primary taxonomy does not map to a valid discipline/specialty
combination in SDMS. This ineligible reason can be removed by adding a
valid discipline and specialty.
New, Not Reviewed
The provider was imported into SDMS but has not been reviewed and/or
updated by the PCO. This ineligible reason can be removed by visiting the
new provider record and clicking “Save” with or without making any edits to
the provider record.
3.3.2A OMITTING A PROVIDER LOCATION
A PCO may omit a provider location at any time by selecting the “PCO Omitted” option and selecting a “PCO
Omitted Reason.”
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Figure 23: Ineligible Status Display
PCO Omitted Reasons include:
• Deceased
• Duplicate entry
• Faculty
• 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
• Not a service delivery site
• Open-ended long term leave
• Relocated
• Retired
• Specialist/Subspecialist
• Urgent Care Clinic
INSTRUCTIONS
To omit a Provider location:
1. Check the checkbox next to “PCO Omitted”
2. Select a “PCO Omitted Reason” from the dropdown menu. This field is required before the system can
successfully omit a provider location. If a reason is not selected when you save your changes, you will
receive an error message (see Figure 24).
3. Click the “Save” button at the bottom of the page to save your changes.
Figure 24: Error Message Received when User Tries to Omit Provider Location without Selecting a Reason
BUSINESS RULES
•
•
The address being omitted must be within the PCO’s state.
The user must provide a reason code when omitting an address.
USER NOTES
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If the user selects a reason code without checking “PCO Omitted”, the system will not save the change
and will return an error message.
•
PCO OMISSION USER CODE DEFINITIONS
Number
1.
2.
3.
4.
5.
6.
7.
Reason Code
Deceased
Duplicate Entry
Faculty
Incorrect taxonomy
Inpatient Facility Only
License Suspended by State/In Disciplinary Status
by State
Locum Tenens/As Necessary
8.
Non-Fed Not Licensed in State
9.
10.
Not in Clinical Practices
Not Public Access Facility
11.
Not a Service Delivery Site
12.
Open-Ended Long Term Leave
13.
14.
15.
Relocated
Retired
Specialist/Subspecialist
16.
Urgent Care Clinic
Definition
Provider is deceased
Duplicate of an existing location
Location is an academic or research location
Provider is listed with an incorrect taxonomy
Facility has no outpatient services
Provider is not practicing due to a suspended
license
Provider is standing in for the permanent full
time provider at this site
Provider not working at federal facility and
also not licensed in state
Provider not currently in clinical practice
Facility does not offer care to the general
public
Medical care cannot be accessed at this
location (Possible home address or an
administrative location)
Provider is on an extended leave from
practice
Location omitted because provider moved
Provider has retired
Provider has an eligible taxonomy but
practices an ineligible subspecialty
Location is an urgent care clinic and does not
provide full scope of Primary, Mental, or
Dental care
3.3.3 LOCATION ADDRESS
The location address section of the Provider Location page displays the physical address associated with the
location and details around the provider services associated with the location.
Figure 25: Location Address Section for a Dental Health Discipline
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Feature
Description
1. Address
For a new provider, the initial location address is the address provided by
the provider in the NPI file as the primary location of practice. For an
existing provider, users can add additional physical location addresses,
phone numbers, and fax numbers.
2. Copy Address
This button will generate a duplicate location record for the location being
viewed. The address of a location cannot be updated once saved, so in the
case of a typo or other user error, the user should deactivate the existing
location, create a copy, and update the fields as needed before saving.
3. Discipline
Select the discipline associated with the provider’s services at the selected
location. The three discipline options are “Primary Care,” “Mental Health,”
and “Dental Health.” This selection will determine what additional fields are
displayed in the “Location Address” module.
User Notes:
•
•
The “Dental Auxiliaries” field will only appear if the “Dental Health”
discipline is selected.
The “Serves State/County Mental Hospital” field will only appear if
the “Mental Health” discipline is selected
4. Specialty
Select a corresponding specialty after selecting a discipline. A specialty
cannot be selected if a discipline has not been identified.
5. Direct Tour Hours
The “Direct Tour Hours” will be defaulted to 40 hours, and Geographic HPSA
will be 1 in the FTE Calculations. PCO can enter whole number integers from
0-168 hours. “Direct Tour Hours” cannot be 0 for an eligible provider. The
system will produce an error message as shown in Figure 26.
6. Dental Auxiliaries
This field is only available for providers with a discipline of “DT” (Dental
Health). This field will not display for all other disciplines.
7. Serves a Correctional
Facility?
This field has a dropdown with the following options:
• Yes
• No
8. Serves State/County
Mental Hospital
This field is only available for providers with a discipline of “MH” (Mental
Health). This field will not display for all other disciplines.
Figure 26: Error Message when Direct Tour Hours are Incorrectly Set to 0 Hours
INSTRUCTIONS
To add a new location address:
1. Input the “Address,” “City,” and “Zip Code” of the new location.
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2.
3.
Update tour hours as necessary and provide a reason code.
Click “Save” to save your changes after completing relevant fields in the other sections on the location
page (e.g., Employment Status).
BUSINESS RULES
•
•
•
•
“Address Line 1,” “City,” “State,” and “Zip Code” are required to add a new address.
The user may enter “Direct Tour Hours” greater than 40 and up to 168, but a maximum of 40 hours will be
used by the database in order to calculate FTE.
The system will not count dental auxiliaries when calculating FTEs based on Medicaid claims.
The “Auxiliary Weight” is determined by the “Dentist’s Age” and “Auxiliary Number” entered.
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.
When “Direct Tour Hours” are changed to 0, an error message will be displayed. The error message reads:
“The location must be omitted if the direct tour hours is to be set to 0 hours.” (See Figure 25)
A new location cannot be deleted once it is submitted. To remove the address fully from FTE Calculations,
users can omit the address. See Section 3.3.1 Location Status for instructions on how to omit a location
address.
A PCO may add an address for their designated state to a provider currently listed in another state.
However, a PCO may not add an address for another state to a provider currently listed in their state.
3.3.4 LOCATION GEOCODED ADDRESS
This section illustrates additional geographical information returned by the geocoding service. All information
under this grouping is read-only, except for the latitude and longitude fields.
The system will geocode new addresses automatically. However, if a user wants to override the system-geocoded
location, or if the system fails to successfully geocode the address, users associated to the provider can override
the given latitude and longitude by entering new values or dropping a pin on the map in the correct location.
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Figure 27: Geocoded Address
Feature
1. Address Successfully
Geocoded
Description
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 here by entering new values or
deleting existing values.
3. State, FIPS, County Name,
FIPS
These fields are prepopulated by the system if the address was successfully
geocoded.
4. Census Tract
This field is prepopulated by the system if the address was successfully
geocoded.
5. CSD FIPS
This field is prepopulated by the system if the address was successfully
geocoded.
6. Match Level
This field indicates the confidence level that this address has been
successfully geocoded. If the user modifies the latitude and/or longitude the
new match level would be “0 – User Override.”
7. Address Map
The map pinpoints the physical location of the provided address. Users
associated to the provider can override the given geocoded location here by
dragging and dropping a pin on the correct location on the map.
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BUSINESS RULES
•
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 “Location
Geocoded Address” section of the location to find more information on its status.
USER NOTES
•
•
Users can delete the “Latitude” and “Longitude” values and save without inputting new values to trigger
the system to attempt to geocode the address again.
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.
3.3.4A STEPS TO RESOLVE GEOCODING EXCEPTIONS
INSTRUCTIONS
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” button.
a) If its match level is 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 is 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 is 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 is 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.
3.3.5 EMPLOYMENT STATUS
This section on the Location page displays additional details about the provider that impact a provider’s eligibility
status and FTE calculations. Users must answer “Yes” or “No” to the following questions:
•
•
•
Is Physician an Intern or Resident?
J1 Visa Waiver Holder?
Federal Provider?
A provider is ineligible if any of the following fields are checked “Yes”:
•
•
•
J1 Visa Waiver Holder
Federal Provider
NHSC Employee
o System will determine if the provider is a NHSC Employee from data sourced from BMISS.
If a PCO checks “Yes” for “Is Physician an Intern or Resident?”, the FTE will be affected as follows:
•
•
•
For Primary Care, the FTE can be no higher than .1
For Mental Health, the FTE can be no higher than .5
For Dental Health, the FTE will be 0
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Figure 28: Employment Status
3.3.6 PROGRAM STATUS
This section on the Location page displays additional details about the BMISS program status of a provider that
could impact a provider’s eligibility status. This section will not appear if a provider has not been enrolled in any
BMISS program. The user will not be able to adjust this information.
•
•
•
•
•
Program Name
Program Status
o A provider is deemed ineligible if they are in an “ACTIVE” status.
Contract Type
Contract Start Date
Contract End Date
Figure 29: Program Status
3.3.7 CLINICAL INFORMATION
This section lists the fields pertaining to clinical information specific to the location being viewed.
•
•
For “Annual Medicaid Claims,” a user may enter any whole number value from 0 – 9999. For primary
care, any value 5000 and above results in a FTE of 1. For mental health and dental health, any value 4000
and above results in a FTE of 1.
For all % fields in this section, a user may enter any whole number value between 0 and 100.
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Figure 30: Clinical Information
BUSINESS RULES
•
For any low-income calculation, enter in either or both of the following:
o An “Annual Medicaid Claims” or “Medicaid Patient %” value greater than 0.
If both “Annual Medicaid Claims” and “Medicaid Patient %” have values greater than 0,
the system will look at the Annual Medicaid Claims value.
o “Yes” to “Sliding Fee Scale” with a value greater than 0.
3.3.8 FTE CALCULATIONS
This section shows the FTE calculations for the location being viewed. The calculations are dynamic, with values
updating after each save of edits that impact FTE calculations. All the values displayed in this section are readonly.
Figure 31: FTE Calculations
3.3.9 CLINICIAN DATA ATTESTATION
This section shows whether the data for the location being viewed needs to reviewed and if the data has been
attested to by a user. The user may indicate if the clinician data for the location being viewed is attested by
checking the “Yes” radio button.
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Figure 32: Clinician Data Review and Attestation
BUSINESS RULES
•
The “Needs Review” status of a provider location will not change in response to updates completed by the
user; it will be changed in response to criteria set by DPSD.
3.4 IMPORT TOOL
The import tool will provide the PCOs the capability to add, update, or omit/include provider location data in bulk
by modifying system-generated excel files. The modified files can then be uploaded through the User Interface
where the system will validate the attempted modification. The system will generate files with the most current
provider data for each state on a nightly basis at 12:00 AM EST.
Figure 33 illustrates the Provider Management Landing page, where users will be able to reach the Search, Upload,
or Download pages by clicking on the respective tile. Clicking on the
Excel file repository where users can download the state’s data.
Figure 33: Provider Management Landing Page
3.4.1 DOWNLOADING PROVIDER EXPORT FILE
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The first step in modifying provider data in bulk is to download the system-generated file. The system will provide
a dropdown displaying only the PCO’s respective state or territory.
Figure 34: Downloading Provider Management File
Feature
1. Select a State
Description
To download the file, click on the “Select a State” dropdown and select the
state that you wish to download a comprehensive list of providers for.
2. Download
When the desired state has been selected, the download button will
download the comprehensive list of providers for the respective state.
The file will be downloaded as a zipped folder that will contain the downloaded state’s provider information.
3.4.2 EXPORT FILE INTRODUCTION
The system-generated provider data file (export file) will have all provider data for that state which includes
eligible and ineligible locations. The file will have a Provider Locations tab and a Metadata tab (see Figure 35). The
Provider Locations tab has provider information for all providers which can be edited to modify provider data
through the Import tool. The Metadata tab has a creation date that informs the system when the file was
generated. If an update is made to a record after the file was generated and an update is being attempted to that
same record through the Export file, the system will reject the file’s attempted update for the given provider. The
Metadata tab also provides the reason code values, discipline and specialty lists.
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Figure 35: Excel Export File tabs
USER NOTES
The Provider Locations and Metadata tab labels should not be relabeled or deleted, as they are needed for the
system to properly recognize the file. Relabeling these tabs will cause the system to reject the file and display an
“Invalid File” error message when the file is uploaded
The Export file will contain the following columns (in order) and be populated with data for each location if the
data exists for those records:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
Action
NPI
First Name
Middle Name
Last Name
Suffix
Phone Number
Fax Number
Discipline
Specialty
Status
Ineligible: CMS Deactivated
Ineligible: PCO Omitted
Ineligible: Not Geocoded
Ineligible: Federal Provider
Ineligible: NHSC Provider
Ineligible: J1 Visa Waiver Holder
Ineligible: No Specialty/Discipline
Ineligible: New, Not Reviewed
Address Line 1
Address Line 2
City
State
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Postal Code
County Name
Latitude
Longitude
Match Level
State FIPS
County FIPS
Census Tract
CSD
Age
Dental Auxiliaries
Direct Tour Hours
Reason Code
Serves at Correctional Facility?
Serves at State/County Mental Hospital?
Annual Medicaid Claims
Medicaid Patient %
Homeless %
Migrant Farmworkers %
Native American %
Sliding Fee %
Migrant Seasonal Farmworker %
Resident/Intern
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47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
J1 Visa Waiver Holder
Federal Provider
NHSC Provider?
Needs Review
Clinician Data Reviewed
Attestation Date
Activation Date
SDMS Last Modified Date
SDMS Last Modified By
NPI Address Change Date
NPI Deactivation Date
NPI Reactivation Date
NPI New Provider Date
NPI Taxonomy Change Date
Taxonomy Code*
Taxonomy Type*
License Number*
License State*
* Taxonomy Code, Taxonomy Type, License Number, and License State will have 15 columns each to accommodate
providers with multiple taxonomies and licenses
Users may delete columns from the spreadsheet that are not required by the system for recognition and
processing. The spreadsheet must always contain the following columns:
•
•
•
•
•
•
•
•
•
•
•
•
Action
NPI
Discipline
Specialty
Address Line 1
City
State
Postal Code
Dental Auxiliaries
Direct Tour Hours
Reason Code
Serves at Correctional Facility?
•
•
•
•
•
•
•
•
•
•
•
•
Serves at State/County Mental Hospital?
Annual Medicaid Claims
Medicaid Patient %
Homeless %
Migrant Farmworker %
Native American %
Sliding Fee %
Migrant Seasonal Farmworker %
Resident/Intern
J1 Visa Waiver Holder
Federal Provider?
NHSC Provider?
Users will have the ability to add additional columns if needed; the system will ignore all but the editable or
identifying columns. Should any of the editable columns be modified or deleted, the system will reject the file and
return an “Invalid File” error message under the Report Detail portion of the upload page and no updates will be
made to provider data.
The first time a file is opened, users may encounter one or both of the following firewall warnings (depending on
the excel version and firewall settings) as illustrated in Figure 36 and Figure 37.
Figure 36: Enabling Editing Capability
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Figure 37: Enabling Macro Capability
To use the Export file, users may need to click the “Enable Editing” and “Enable Content” buttons if prompted by
Excel.
3.4.3 EDITING PROVIDER LOCATIONS USING THE EXPORT FILE
This section outlines how users can add, update, or omit provider locations using the export file.
3.4.3A ACTIVATING THE BUILT-IN MACRO
In order for the system to know the action the user is attempting to make, the user will need to select one of the
options (Add, Update or Omit) in the dropdown under the “Action” column. These options have been built into a
macro in the Export file to facilitate user’s ability to modify the data. The macro can be activated by pressing
(Ctrl + Shift + I) on the keyboard. Activating the macro will populate the Action,
Discipline, Specialty, Dental Auxiliaries, Reason Code, Facility Information, and Employment Status columns’
options. Once the macro is activated, all the necessary dropdowns in the file will be populated with different
options as illustrated in Figure 38 and Figure 39.
Figure 38: Macro Populated Action Column
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Figure 39: Macro Populated Reason Code
USER NOTES
•
The system will only accept values from the provided options for all columns that were prepopulated by
the macro. Entering any other value will cause the record to be rejected and no updates will be made to
that particular record. The system will inform the user why the attempted action was rejected through
the detailed report, which can be viewed through the user interface.
The second step in modifying provider data in bulk is to update all the necessary records by selecting one of the
provided action types which are covered in Section 3.4.3B Add New Location, Section 3.4.3C Update Existing
Location, and Section 3.4.3D Omit Existing Location.
3.4.3B ADD NEW LOCATION
The Import tool will allow users to add new locations for existing providers within SDMS by selecting the “Add”
option from the dropdown under the Action column. The user must provide the NPI for the provider that the
location is being added to. The system will accept the following information when the Add action is selected:
•
•
•
•
•
•
•
•
•
•
•
•
•
Discipline
Specialty
Address Line 1
Address Line 2
City
State
Zip
Postal Code
Dental Auxiliaries (If DH provider)
Direct Tour Hours
Facility Information (e.g., Serves at Correctional Facility)
Clinical Information (e.g., Annual Medicaid Claims)
Employment Status (e.g., Resident/Intern)
USER NOTES
•
There can only be one unique address with an “Eligible” status. If a user attempts to add a new location
with the exact same address as an existing location, the system will return an error message.
3.4.3C UPDATE EXISTING LOCATION
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The import tool will give users the ability to modify any provider’s location information in the PCO’s state by
selecting the “Update” option from the dropdown under the Action column. When attempting to update an
existing location’s information, the system will accept changes to information in the following columns:
•
•
•
•
•
•
•
•
•
•
Discipline
Specialty
Address Line 2
Match level*
Dental Auxiliaries (If Dental Health provider)
Direct Tour Hours
Reason Code (Remove reason code to un-omit location)
Facility Information (e.g., Serves at Correctional Facility)
Clinical Information (e.g. Annual Medicaid Claims)
Employment Status (e.g., Resident/Intern)
*Locations with geocoded match levels greater than 3 or no match level can be re-geocoded with the “Update”
action.
USER NOTES
•
The system will only consider records that have an action type selected, if the selected option in the
dropdown is “Select”, the system will ignore that row’s record and move on to the next record without
providing an error message or warning to the user.
3.4.3D OMIT EXISTING LOCATION
The import tool allows users to omit provider locations in the PCO’s state by selecting the “Omit” option from the
dropdown under the Action column and selecting an option under the Reason Code column. A reason code must
be selected or the system will reject the omit attempt.
USER NOTES
•
•
When attempting to Update or Omit records using the Export file, NPI and Address information must
match the system’s records 100% with the following fields:
o NPI
o Address Line 1
o City
o State
o Postal Code (at least the first 5 digits)
Should there be any difference with any of those fields, the system will reject the attempted update/omit
and return an error message.
3.4.4 UPLOAD COMPLETED FILE
The last step to making bulk updates is to upload the modified file by accessing the upload page.
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Figure 40: Accessing Upload Page
Once the user selects the
to upload, press the
button, they will be directed to the upload page (see Figure 41). To select the file
button. This will launch a window for the user to select the file from their computer.
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Figure 41: Uploading a File
1. Upload Notification Bar
A Green notification bar will appear at the top of the portal notifying the
user that the document has been successfully uploaded and will provide
additional instructions to refresh the Upload History. If a file has not
successfully uploaded, this bar will not appear.
2.
This button should be engaged when the user is ready to select a file to be
uploaded. When selected, a pop-up window will appear allowing the user to
browse their computer for the file to be uploaded.
3. File Name and Upload
Status
The percentage directly under the browse button indicates the status of the
file being uploaded to the portal. The name of the selected file will appear
directly below the upload percentage.
4. Upload History
The upload history section will display the bulk upload history for the given
state. It will display the File name, the status of the upload, and a
hyperlinked date and time in the “Created On” column.
5.
When a file has been uploaded, the user should select the refresh button to
have the uploaded file display in the upload history table. Once this is done,
the file should be represented at the top of the table.
Users will not be restricted on the number of files that can be uploaded per user, but each file should contain no
more than 50,000 records. The system will notify users of a successfully upload through a percentage counter
under the
button and the green banner at the top of the page. Depending on the size of the file, the file
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may be reflected immediately under the Upload History section of the page, or the user may need to click the
button after a few minutes to see the file and its status.
3.4.4A EXCEPTIONS REPORT
Once the attempted file is complete, the file will appear in the Upload History section of the page, along with the
status of the file and a hyperlink to the upload report. Clicking on the hyperlink will open the Report Summary
section of the page that summarizes the actions attempted in the file. If a large file is uploaded, the file may
remain in “Processing” until it completely processes the whole file. Users will have the ability to see the progress
the system is making with the file by first clicking on the
the
button and then the hyperlink again. Each time
button is clicked, the system updates the number of accepted and rejected records.
The most recent file will be displayed at the top of the list. Only ten files will be visible per page. If a state has more
than ten files, users will be able to search for them by using the back and forward buttons at the bottom of the
Upload History page.
Once the file has been successfully uploaded, the system will run the file through two validation checks prior to
updating any provider records. The first system check will look at the file as a whole and the second check will
validate each record’s attempted modifications against the business and system rules (See Section 3.4.5 System
and Business Rules).
The uploaded document will fail the first system check if it encounters one of the following issues:
•
•
•
•
•
•
The metadata tab has been deleted or modified.
An unsupported file format has been uploaded.
A file larger than 50 MB has been uploaded.
One of the identifying or editable columns has been deleted.
A row has been added on top of the column headers.
An identical file has been uploaded.
If the system encounters any of the aforementioned criteria, the system will display zero process records in the
Report Summary section and display an invalid file format error message in the Report Detail section of the page
(see Figure 42).
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Figure 42: Exceptions Report - Invalid File
If the uploaded file passed the first system check, individual records will then start going through the validation
process. Figure 43 illustrates an example of the Report Summary page where the file that was uploaded had a
combined total of 654 add, updated, and omit attempts. The system rejected nine out of the 654 attempted
actions because those nine records did not meet the system or business rules.
Figure 43: Exceptions Report - Valid File
All values under the Rejected column of the report summary will have a hyperlink if the value is greater than zero
(except for total, this will always have a hyperlink). Clicking on the hyperlinked number under the “Rejected”
column will direct the user to the Report Detail page which will provide the error messages of the rejected records
as illustrated in Figure 44. The Report Detail section of the page provides the user useful information about the
records that were rejected. It displays the NPI, Row Number in the file, Action type, and the Error Message
describing why the attempted action was rejected.
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Figure 44: Exceptions Report - Report Detail
Users will have the ability to download the generated exceptions report by clicking the “Download Report” button
under the Report Summary section. The downloaded report will be an excel file as illustrated below in Figure 45.
Figure 45: Downloaded Exceptions Report
An individual record will fail the second system check if it violates one of the system or business rules. An uploaded
file can be partially successful and have both accepted and rejected records in one file. Section 3.4.5 System and
Business Rules covers the system and business rules in more detail.
3.4.5 SYSTEM AND BUSINESS RULES
The system will process updates to the Import file according to the rules depicted in the table below, which
describes the editable columns when certain actions are selected.
Action
Column
Business Rule
File Rule
- Add
- Update
- Omit
NPI
NPI must exist in the system’s database.
- Add
- Update
Discipline
Discipline and Specialty must match according to the
following criteria:
Cannot be blank. Must
be a numeric value
containing 10
characters.
Cannot be blank, A value
must be selected from
- Add
- Update
- Omit
Action
An option must be selected if a record requires a
modification. All records with the “Select” option
will be ignored by the system.
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be selected.
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Action
Column
Business Rule
File Rule
- Add
Address Line 1
Address Line 2
Can be added, updated, or removed at any time.
Cannot be blank. Must
contain alphanumeric
characters.
May be blank.
- Add
- Update
- Add
City
Must be within the state of the PCO modifying the
record.
- Add
State
Must be within the state of the PCO modifying the
record.
- Add
Postal Code
Must be within the state of the PCO modifying the
record.
- Add
- Update
Dental
Auxiliaries
May only be selected for DH providers.
- Add
- Update
- Omit
Direct Tour
Hours
Reason Code
Must be a number between 1 and 168.
- Add
- Update
Serves at
Correctional
Facility?
Serves at
State/County
Mental
Hospital?
Annual
Medicaid
Claims
Medicaid
Patient %
Homeless %
Select if provider serves at a Correctional Facility.
Migrant
Farmworker %
Can be any number ranging from 0 to 100.
- Add
- Update
- Add
- Update
- Add
- Update
- Add
- Update
- Add
- Update
- Add
- Update
Specialty
Primary Care:
o Family Practice
o Internal Medicine
o Obstetrics and Gynecology
o Pediatrics
• Mental Health:
o Psychiatrist
o Clinical Psychologist
o Clinical Social Worker
o Psychiatric Nurse Specialist
o Marriage and Family
• Dental Health:
o Dentist
Must be a valid address containing alphanumeric
characters.
•
A Reason Code must be selected only if omitting a
location.
May only be selected for Mental Health provider. If
the selected value is ‘Yes’, the value for the
Correctional Facility must be ‘No’.
the provided options in
the dropdown.
Cannot be blank. Must
contain alphabetic
characters.
Cannot be blank. Must
be a valid state/territory
abbreviation.
Cannot be blank. Must
be 5 to 9 numeric
characters.
A value must be
selected from the
options provided.
Must be a numeric
value.
A value must be
selected from the
options provided.
Only values form the
provided dropdown can
be selected.
Only values from the
provided dropdown can
be selected.
Can be any number greater than or equal to 0.
Must be a numeric
value.
Can be any number ranging from 0 to 100.
Must be a numeric
value.
Must be a numeric
value.
Must be a numeric
value.
Can be any number ranging from 0 to 100.
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Action
- Add
- Update
- Add
- Update
- Add
- Update
Column
Native
American %
Sliding Fee %
Business Rule
Can be any number ranging from 0 to 100.
Can be any number ranging from 0 to 100.
Migrant
Seasonal
Farmworker %
Resident/Intern
Can be any number ranging from 0 to 100.
- Add
- Update
J1 Visa Waiver
Holder
Select if provider is a J1 Visa Waiver Holder.
- Add
- Update
Federal
Provider?
Select if provider is a Federal Provider.
- Add
- Update
NHSC Provider?
Select if provider is part of NHSC.
- Add
- Update
Select if provider is a Resident or Intern.
USER NOTES
•
File Rule
Must be a numeric
value.
Must be a numeric
value.
Must be a numeric
value.
Only values from the
provided dropdown can
be selected.
Only values from the
provided dropdown can
be selected.
Only values from the
provided dropdown can
be selected.
Only values from the
provided dropdown can
be selected.
Only the fields mentioned in the table above will be considered by the system when files are uploaded, all
others will be ignored if modifications are made to the existing data.
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3.4.6 IMPORT TOOL EXAMPLES AND BEST PRACTICES
This section outlines best practices for using the Import tool.
3.4.6A IMPORT TOOL FAQS
Q. How do I activate the macro or populate the dropdowns?
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
A. Press Ctrl + Shift + I
Can I update an address by using the update action?
A. No, an actual address cannot be modified. If an address needs to be modified, the user will need to
first omit the address that requires address update, and then add a new location with the updated
address.
How can I add a new location?
A. By selecting the Add option under the Action column and adding a new address for the record.
When adding a new location, will updating the address in the file delete the existing location’s
address?
A. No, a new location will be created with the newly provided address.
Can I add additional columns and/or change the order of columns?
A. Yes, the system will only check that all original columns exist in the file. The only restriction is to not
modify original column titles or add new columns with the same title.
Can I modify/add different types of formatting to the file (e.g. data formatting/highlighting
rows/columns)?
A. Yes, the system will ignore any formatting done to the file, but still accept the value.
Can I hide rows?
A. Yes, the system will find any data in the file as long as it has a selected action type.
Can I delete rows?
A. Yes, it is actually encouraged to delete unnecessary rows.
Do I need to upload the whole original file?
A. No, it is actually recommended that only those records that need to be updated be uploaded.
Why do most providers in the Export file have 40 hours?
A. Those are the defaulted hours provided by SDMS to all providers. If 40 hours are not accurate for all
locations, then the user is encouraged to update them to reflect the correct number of hours.
Why am I receiving this error message after uploading a file: “Location has been modified since
the location data was exported”?
A. The attempted update through the export file was rejected because the record was updated AFTER
the file was originally created. The system rejects the attempted update to prevent over-riding
changes accidentally.
Can I update the latitude and longitude through the export file?
A. No, any updates made to the latitude and longitude fields in the export file will be ignored by the
system. Coordinates can be updated on the location page in the web application.
Can I add new providers through the export file?
A. No, the system will only accept changes to provider’s NPIs that are already in SDMS.
3.4.6B BEST PRACTICES
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•
•
•
•
•
Save an original copy and working copy in case something goes wrong with the working copy.
Split uploads by ‘action’ type, if all action types are required, consider uploading all ‘omit’ first, ‘Add’
second, and ‘Update’ last.
Try to keep files to less than 50,000 records.
Consider deleting all unnecessary rows.
Consider deleting unnecessary columns.
3.4.6C MODIFYING PROVIDER DATA EXAMPLES
The following sections will cover three basic scenarios on how to Add, Update, and Omit provider data using the
export file.
ADDING NEW PROVIDER LOCATIONS
To add a new location, users could either type in or copy the row of an existing provider’s location and update all
the necessary fields. The necessary steps to adding a new location are described below:
Step 1)
Step 2)
Step 3)
(Optional) Copy an existing row, then right click and insert the copied row as a new row
Select ‘Add’ from the Action column
Enter new location’s address information with all the required fields:
i. Address Line 1
ii. City
iii. State (Must be within PCO’s state)
iv. Zip Code
v. Direct Tour Hours (Must be greater than zero)
Should one of the required fields be left empty, the system will reject the request to add the new location.
The example below illustrates the process of adding a new location by copying and inserting an existing location.
Figure 46: Adding Provider Locations - Copying Data
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Figure 47: Adding Provider Locations - Inserting Provider Data
Figure 48: Adding Provider Locations - Selecting Add Action
Figure 49: Adding Provider Location - Completed Cell
The Import file will only accept NPIs known to SDMS.
UPDATING EXISTING PROVIDER LOCATIONS
The steps to updating existing locations are described below:
Step 1)
Select ‘Update’ from the Action column
Step 2)
Update all the necessary information
Step 3)
Make sure all business and file rules have been followed which are described in Section 3.4.5
System and Business Rules above
The example below illustrates the process of updating Direct Tour Hours and Correctional Facility.
Figure 50: Updating an Existing Provider - Selecting Update Action
Figure 51: Updating an Existing Facility - Changing Additional Information
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USER NOTES
•
NPI and Address information must match the system’s records or the attempted updates will be rejected.
Should an update be required to an existing address, a new location would need to be added. If the
existing address is no longer valid, the user can make that location ineligible through the web portal.
OMITTING EXISTING PROVIDER LOCATIONS
The steps to omit existing locations are described below:
Step 1)
Select ‘Omit’ from the Action column
Step 2)
Select an option from the ‘Reason Code’ column
The example below illustrates the process of omitting an existing location.
Figure 52: Omitting Provider Location - Selecting Omit Action
Figure 53: Omitting Provider Location - Omit Reason Code
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APPENDIX A – CHANGES TO LAST UPDATED BY DATA
Different updates to provider data and provider locations cause the last updated by data at the top of the provider and location profiles to be changed.
Update
Initiator
Updates Location Last
Modified Date?
Updates Location Last
Modified by?
Updates Profile Last
Updated Date?
Updates Profile Last
Updated by?
New Provider
NPPES - Import
Yes
Yes
Yes
Yes
NPI Address
Taxonomy Change
DoB Update
Deactivate Provider
Reactivate Provider
NHSC Nightly Job
New Location through
Portal
New Location Through
Import Tool
Location Updated Through
Search Page
Location Updated Through
Location Page (includes
geocoding)
Location Updated Through
Import Tool (includes
geocoding)
NPPES - Import
NPPES - Import
NPPES - DoB
NPPES - Import
NPPES - Import
System - NHSC
Yes
No
No
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Update Type
Batch Geocoding Updates
User
User
User
User
User
System Geocode
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| File Type | application/pdf |
| File Title | SDMS PCO Provider Management User Guide |
| Author | Publicis Sapient Government Services |
| File Modified | 2020-04-21 |
| File Created | 2020-03-24 |