Provider Directory Search and Match



Provider Directory Search and Match is an optional feature in the Orders Component. When it's configured for your portal, with the Provider Directory Search and Match feature you can select a Refer-To provider from a directory of specialists based on name or based on scored attributes such as network affiliation, patient insurance plan, and distance from patient.

The Provider Directory Search and Match feature is available when you meet the following conditions:

  • The order is a Referral order.
  • The Use Provider Directory option is selected in the form's Order Form Settings.
  • System settings establishing connectivity with the directory are configured.

Provider Directory Search and Match Help

Access Provider Directory

Complete the following steps to access the Provider Directory:

  1. Select the referral order's Requested Service tab.
  2. Locate the Refer To element in the order form's Providers section.
  3. Select the ellipsis (...) next to the Refer To element to open the Provider Directory search feature.

Search for a Recommended Provider

Note: Searching for a recommended provider is available only when your Provider Directory is configured with provider scoring algorithms.

Users can search for a recommended provider using the following search attributes:

  • Network affiliation
  • Plan
  • Specialty
  • Language
  • Gender
  • Distance
  • ZIP Code

Complete the following steps to search for a recommended provider:

  1. Access Provider Directory.
  2. Select the Recommended Providers tab.
  3. From the Network menu, select a network affiliation. Note: The network list by default displays the ordering provider's network affiliations if the ordering provider is available in the directory. Enter text to select another available network.
  4. Enter text to select an optional Insurance Plan from the Plan menu.
  5. Enter text to select a Specialty from the Specialty menu.
  6. Enter text to select an optional language from the Language menu.
  7. Enter text to select an optional gender from the Gender menu.
  8. Enter text to select an optional distance from the Distance menu. Note: By default, the distance is set to five miles. You can select 2 miles, 5 miles, 10 miles, and 20 miles.
  9. Enter a ZIP Code so the system can apply the distance search. Note: By default, the ZIP Code the system uses matches the patient's ZIP Code, if that information is available. You can enter a different ZIP Code.

Search for a Provider by Name/NPI

Search for a provider by Name/NPI when you already know who you will refer a patient to. Users can use the following attributes to search for a known provider:

  • Last Name
  • First Name
  • NPI
  • Specialty
  • City State

Complete the following steps to search by provider Name/NPI:

  1. Access Provider Directory.
  2. Select the By Name/NPI tab.
  3. Enter a partial or complete last name in the optional Last Name search element. Note: You must enter at least three characters to perform a partial name search.
  4. Enter a partial or complete first name in the optional First Name search element. Note: You must enter at least three characters to perform a partial name search.
  5. Enter a full NPI in the optional NPI search element.
  6. Enter the complete name of a city in the optional City search element.
  7. Select a state from the optional State menu.

View Provider Attributes

All Providers

All providers that a search displays contain the following information:

  • Provider Name
  • Provider NPI
  • Provider Specialty
  • Location Name
  • Location Address Details
  • Provider Telecoms (Phone, Email, Fax) if telecoms are available
  • A View Locations option if additional locations are available

Recommended Providers

Providers displayed in a recommended provider search are scored based on a scoring algorithm. Complete the following steps to view details about a Recommended Provider:

Score Details

Position the pointer over the provider's score to display the components that make up that score. Note: A score of 0, which has blank score details, indicates that a value entered into the search was not configured in the algorithm. The provider may match one or more of the search values, but those may not be scored.

Network

Position the pointer over the network icon to display whether a provider is in or out of the specified network. The following color codes are used:

  • Green: The provider is in the specified network.
  • Yellow: The provider has no network affiliations in the provider directory, so the search cannot score them based on this criterion.
  • Red: The provider is not in the specified network.

Distance

Position the pointer over the distance icon to display the estimated distance based on the ZIP Code provided to the search. The following color codes are used:

  • Green: The provider is five miles or less from the ZIP Code.
  • Yellow: The provider is between 5 and 10 miles from the ZIP Code.
  • Red: The provider is more than 10 miles from the ZIP Code.

Insurance Plans

Position the pointer over the insurance icon to display the insurance plans that the provider accepts. The following color codes are used:

  • Green: The provider accepts the insurance plan specified in the search.
  • Yellow: No insurance plan was specified in the search.
  • Red: The provider does not accept the insurance plan specified in the search.

Select a Refer-To Provider

Complete the following steps to select a provider from the Provider Directory:

  1. If the provider has additional locations, select View Locations.
  2. Select Select next to the provider or location you want to select.
  3. If you are prompted to include a reason for selecting a provider with a low score, select one of the following reasons:
    • Provider Directed
    • Patient Directed
    • Insurance Issue
  4. The provider name is displayed in Last Name, First Name format in the referral order's Refer-To Provider element.
  5. The selected provider's information is displayed in the referral order's Refer-To heading.

Remove a Refer-To Provider

Complete the following steps to remove a Refer-To provider from the referral order and perform a new search:

  1. Locate the Refer To element in the order form's Providers section.
  2. Select the X next to the Refer-To provider's name to remove them and search for another provider.

Note: Whether you can edit the order depends on the order's status.

See Also:

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