VACCN OPERATIONS DATABASE QRG
If the MAID never existed or is active on one or more professional O type records and isn't loaded would you load the location or close it?
Yes, you would load the location
For a Group TIN what are the ORG types for a professional contract on the F4 report?
ORG types are 033,039 and 050
If a tracer ID that is non-UHN is previously loaded what changes need to be made?
No updates will need to be made to the tracer.
Should the solo practitioners license be loaded to all suffixes?
No, only to the base
When loading an O record how do you find the contract effective date used?
TIN will be loaded with the earliest date across all Providers from the tool or NDB
When loading a no MAID found where do you get the NPI number from?
NPI is used from the lowest professional suffix loaded into PIMS
For a Solo practitioner what tables are the earliest effective date in NDB to be loaded on?
Tables T43 and T44
Where do you go to locate the providers specialty for IPAs of 555?
The I-S-Z screen in NDB and F5 hang off screen
If a place of service address is not correct per USPS what should you do?
Close the request (close no action) per USPS address is invalid.
If a group with an IPA if 137, 138, 139 or 990 has multiple specialties how would you load them?
Each specialty would be loaded individually on the T50 and T15, you can load up to 3 specialties
For work items with an IPA 139 with a No A01 Id description when loading the group where is the MAID found that is loaded to the tracer?
The MAID is found on the A02 work item
If the F4Y Line is prior to 5/1/19, what date should be loaded onto the Contractual tables?
06/26/2019
When searching for group practitioner in PIMS do you search by the practitioners name or NPI # first?
Practitioners Name
What provider type is loaded when loading an Area of Expertise?
The provider type of the primary specialty
If a group practitioner is already loaded in PIMS with an effective date prior to the earliest effective date in this case what action should be taken with the dates on the demo screens?
Dates are not required to be updated
For work items with an IPA 138 with a No A01 Id description, if the F4 report shows it to be a Fac/Anc location only can there is a matching address with a CG suffix and it be affiliated?
Yes it can be affiliated to the CG suffix
If a provider has dual F4Y Lines for the same TIN and the market numbers are the same and the IPA’s are different what do you do?
Place work item into clarification
For what IPA do you use the OHPH tool as the Source of Truth?
IPAs 137, 138, 139 and 990
For IPAs of 555, on the F5 hang off screen of NDB we load all specialties with “CONTR ORG: UBH” except when?
When there is a cancel date listed with the specialty
What information can be used to search within the OHPH tool?
TIN, NPI, Practitioners First Name, Practitioners Last Name, and State
For work items with an IPA 672 with a No A01 Id description, if the F4 report shows it to be a Professional or Shared TIN can the location be loaded?
In this situation No it can’t be loaded and must be put into clarification
For an A02 provider if there is a Gap in coverage what tables does it need to be shown on?
T44 and T55
If the primary degree is listed as NON what degree do you load?
You would load the secondary degree
If a license was previously loaded by PGBA and matches the license information from the NDB data section of your request what is the only other validation that would need to be made?
The only update that would be needed is if the cancel date was any date other than 12/23/26
When loading the license for an OHPH provider where does the license number come from?
The license number will come from the OHPH tool. Load the license for the state on the request.