The following information must be entered for each appointment location, as applicable for the provider:
Provider: The name of the healthcare professional whose registration details are being entered, which can be selected from the Search Provider
icon.
Location: The specific work site or facility where the provider is offering services, which can be selected from the Search Location
icon.
Each location may require different registration details.
DEA No: The unique identifier issued to the provider by the Drug Enforcement Administration, allowing them to prescribe controlled substances.
State License No & Issuing State: The provider's State License Number can be entered in the text field. The dropdown allows users to select the issuing state for the license. By default, the dropdown and expiration date field are inactive (grayed out) and become active only after a license number is entered. Once a license number is provided, users must select an Issuing State from the dropdown, which displays a list of two-letter state codes. These codes are sourced from the Group Type ST - States in U.S.A. The expiration date can be entered manually or selected using the calendar icon and is displayed in the MM-DD-YYYY format. The tag ENC_AD_REGN_STATE_EXP allows printing the State License Expiry Date on output templates.
eRx Regn No: The provider's registration number for electronic prescriptions, required for sending prescriptions electronically.
EDIN: A unique identifier used for electronic data interchange (EDI), allowing providers to submit claims and receive payments electronically.
Federal Tax Id: The provider's tax identification number, used for billing and financial reporting purposes.
Billing Schedule: The billing plan or schedule applied to the provider for services rendered at this location, relevant for customers using billing services.
The following tags can be used to print the information from this screen in output templates.
- [ENC_AD_LOC_DEA]
- [ENC_AD_LOC_REGN]
- [ENC_AD_LOC_REGN_STATE]
- [ENC_AD_LOC_ERXID]
- [ENC_AD_LOC_FTIN]
- [ENC_AD_LOC_EDIN]
HISTORY: Displays a record of previous changes or updates made to the current data, allowing users to view the modification history.
ERX: Opens the Save eRx Doctor Location popup, which is password-protected, allowing the user to save the prescriber's location in the eRx gateway database and SSAC.
RESET: Clears any unsaved changes on the screen, returning the fields to their last saved state.
DELETE: Permanently removes the current entry or record from the system.
SAVE: Saves any changes or new information entered on the screen, ensuring that data is updated in the system.
