Practitioner Link to Performing Provider - PM

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As part of your organization’s configuration, contracted practitioners need to be enrolled in both myAvatar MSO and myAvatar PM to complete inbound claims in MSO and the compilation/submission of outbound claim files from PM. myAvatar can link practitioners enrolled in myAvatar PM Practitioner Enrollment to performing providers registered in myAvatar MSO Performing Provider Registration which allows you to create and maintain contracted provider enrollments within myAvatar. This means you can have a more efficient maintenance workflow:

Create a Practitioner Enrollment once.
Once a practitioner record is created in Practitioner Enrollment a matching and linked Performing Provider Registration will generate automatically.
Update a Practitioner Enrollment record and the corresponding updates will also file in the linked Performing Provider Registration record.

Your organization has the ability to edit an existing Practitioner Enrollment record and create the link to a Performing Provider.
Note: This is not currently supported within the Practitioner Enrollment (Brief) form it is a planned product enhancement.

Creating and linking practitioner records is initiated in Practitioner Enrollment (PM). There are two outcomes. First, for new registrations there is an automated creation of a matching Performing Provider Registration (MSO) record.

Second, when a linked record is updated, the following information will pass from Practitioner Enrollment (PM) to the linked myAvatar MSO Performing Provider Registration (MSO) record:

NameRegistration Start Date
Primary License Type for Claims
Performing Provider Gender
Ethnic Origin
Performing Provider Office Address
Provider ID (NPI)

This is a one-way update. When these fields are updated in Practitioner Enrollment (PM) the update will be made in the linked Performing Provider Registration (MSO) record. If updates are made within Performing Provider Registration (MSO), the changes will only be reflected in that form. To keep these fields in sync, it is recommended to make these changes in Practitioner Enrollment (PM).

Prerequisites

Prior to installing necessary updates for the Practitioner Link to Performing Provider enhancements in a production environment, Netsmart strongly recommends installing the updates and performing thorough testing in a test environment.

The Practitioner Link to Performing Provider functionality was added to myAvatar PM in myAvatar PM 2020 Update 134.

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