• Need to verify provider information for member
• Too many screens in Facets
• Don't know where to look for what

2. Provider Information

• Provider is Dr. Kathy Jones in Huntington Beach, CA
• Dr. Jones has 3 offices:
  • Main office on Beach Blvd - has staff, performs billing, in directory
  • Home office on Ellis Ave - no staff, no billing, but different tax ID
  • Orange County Physicians Group in Newport Beach - group practice
• Dr. Jones is affiliated with 2 facilities:
  • Huntington Beach Hospital is where she admits her patients
  • Southern California Labs is where she sends her lab tests

3. Facets Structure

• Information specific to the provider (Dr. Jones) is stored in the Common Practitioner application.
  • A provider can only have 1 Common Practitioner record.
  • Includes: Date of birth, SSN, medical school, license #
• Information specific to the provider's office (Main office, home office) are stored in the Practitioner application.
  • A separate record is created for each office. Dr. Jones would have 2 Practitioner records, one for the main office and one for the home office.
  • Each record includes:address, address type, tax ID, network effective date, directory
• Information specific to the group is stored in the Group application.
  • Group records include the name, address, tax id and effective date of the group and also link to the Common Practitioner records for each provider in the group.
• Information specific to the hospital is stored in the Faciliy application.
  • Facilities include hospitals, medical centers, or any other facility that bills with a HCFA form.
  • Includes: address, effective date
• Information specific to the lab is stored in the Ancillary application.
  • Ancillaries include labs, surgical centers, imaging centers, outpatient treatment centers, or any other facility that billw with a UB-92 form.
  • Includes: address, effective date

4. Review

• Summarize relationships between provider information and Facets.