Provider Information

Manage the provider information record for a contracting provider.

• Data entered in this form is for information only.
• This is a user-defined form that can be modeled through RADplus Utilities.

Prerequisite:

• The provider must have been entered into myAvatar MSO through the Applying Contracting Provider form.

1. Go to: Avatar MSO > Provider Management > Provider Information.
2. In the Select Provider screen, search for and select the provider name.
3. In the 'Liab.' fields, enter insurance company information as appropriate.
4. In the Filed a Professional Liab. Claim in the Last 3 Years field, select Yes if a claimed was filed.
5. In the Number of Pending Claims field, enter the number of pending claims.
6. In the Number of Prior Claims in Past 3 Years field, enter the number of prior claims.
7. In the Total Dollars Paid in the Last 3 Years field, enter the dollar amount.
8. In the Is Explanation Attached field, select Yes if the explanation is attached..
9. In the Have You Ever had a Malpractice Settlement field, select Yes if the provider was involved in a malpractice settlement.
10. In the Explanation of Malpractice Settlement field, enter information associated with a malpractice settlement.
11. When finished, click Submit.