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Contracting Provider Program Information Section

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Enter contracting provider program information.

The Program Information table displays all existing records

  • To enter a new record, click Add New Item.
  • To change an existing record, click Edit Selected Item.
  • To remove an existing record, click Delete Selected Item.

Add or Edit a Record

  1. In the Inactive Provider Program field, select whether or not this record should be retained in the system as inactive.
  2. In the Program Name field, enter the program name.
  3. In the Program Type field, select the program type.
  4. Enter program contact information as appropriate.
  5. In the Main Program Address - County field, select the county.
  6. In the Facility ID Code Qualifier field, select the qualifier.

    • When the registry setting Contracting Provider Determination Method is set to a value of '2' the value within this field is compared against 2010B-NM1-08 within the 278 request to determine the contracting provider program. 

    • When the registry setting Contracting Provider Program Identification Loop (Institutional) is set:

      • To a value of '1' the value within this field is compared against 2010AA-NM1-08 within the 837 Institutional to determine the contracting provider program. 

      • To a value of '2' the value within this field is compared against 2310E-NM1-08 within the 837 Institutional to determine the contracting provider program. 

    • When the registry setting Contracting Provider Program Identification Loop (Professional) is set:

      • To a value of '1' the value within this field is compared against 2010AA-NM1-08 within the 837 Professional to determine the contracting provider program. 

      • To a value of '2' the value within this field is compared against 2310C/2420C-NM1-08 within the 837 Professional to determine the contracting provider program.

  7. In the Facility ID Code field, enter the code.

    • When the registry setting Contracting Provider Determination Method is set to a value of '2' the value within this field is compared against 2010B-NM1-09 within the 278 request to determine the contracting provider program. 

    • When the registry setting Contracting Provider Program Identification Loop' is set:

      • To a value of '1' the value within this field is compared against 2010AA-NM1-09 within the 837 Institutional to determine the contracting provider program. 

      • To a value of '2' the value within this field is compared against 2310E-NM1-09 within the 837 Institutional to determine the contracting provider program. 

    • When the registry setting Contracting Provider Program Identification Loop is set:

      • To a value of '1' the value within this field is compared against 2010AA-NM1-09 within the 837 Professional to determine the contracting provider program. 

      • To a value of '2' the value within this field is compared against 2310C/2420C-NM1-09 within the 837 Professional to determine the contracting provider program.

  8. In the Reference Identification Qualifier (835-2100-REF-01) field, select the qualifier.
  9. In the Reference Identification (835-2100-REF-02) field, enter the identifier.
  10. In the Is Program Handicapped Accessible field, select Yes if the program has handicap accessibility.
  11. This field is for information purposes only.
  12. In the Special Accommodations field, select the special accommodations.
  13. In the Accredited by JCAHO field, select Yes if the program is JCAHO accredited.
  14. In the JCAHO Accreditation Expiration Date field, enter the expiration date for JCAHO accreditation.
  15. In the Accredited by CARF field, select whether or not the program is CARF accredited.

    • If Yes, enter the expiration date for CARF accreditation in the CARF Accreditation Expiration Date field.

  16. In the 'Program State Reporting' fields, enter the program's state reporting numbers (if available, and required for state reporting).

  17. In the Other Type of Number 1 field, select the type of other program identification number.

    • Enter the number in the Other Number 1 field.

  18. In the Other Type of Number 2 field, select the second type of other program identification.

    • Enter the number in the Other Number 2 field.

  19. In the Gender field, select the gender for this program.

  20. In the Program Age Group field, select the age group for this program.

  21. In the Languages field, select all languages that apply to this program.

  22. In the Program License Capacity field, enter the license capacity.

  23. In the Program Contracted Beds field, indicate if there are contracted beds for this program.

  24. In the Program Website field, enter the name or address of the website related to this program.

  25. In the 'Program Hours' fields, enter the available program hours for each day of the week.

► Dictionary Values
► SQL Table
  • SYSTEM.provider_program_data 
► Registry Settings