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Provider - Individual/Facility option

Question:

For the Provider file, are both the individual and facility required? If we can choose, and choose the option facility, are we required to list individuals tied to one location?

Answer:

A provider can be either an individual or a facility, not both.



Question:

Can groups be submitted on the file as a “facility” since there is no other way to submit organizations. As an example, Urgent Care centers are not known by the name of the practitioners affiliated to the locations but by the group name.

Answer:

Groups may be submitted as facilities. Starting 8/15/16, they may be submitted as a GROUP.



Question:

Can pharmacies be submitted on the file as a “facility” since there is no other way to submit organizations?  Should a pharmacy be a facility or an individual?

Answer:

Pharmacies may be submitted as facilities.

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