Provider Directory Definitions

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Provider Definitions

Provider Details

The provider details tab encompasses essential information about a provider, covering personal details, languages, contact information, employment history, practice details, education, and residency. While most of these data fields are self-explanatory, some of the less commonly encountered fields are described below:

Employment Type

Employment type encompasses the various categories of individuals engaged by an organization for employment purposes. The provider directory offers the following options for employment type:

• Employed Full Time

• Employed Part Time

• Employed Per Diem

• Independent Contractor: These providers are directly contracted with Sanitas and are not employed by the organization. They receive a W9 tax form.

• Locum: These providers work for a Locum agency and are temporarily assigned to fulfill the duties of another provider.

• PGY-1 Resident

• PGY-2 Resident

• PGY-3 Resident

Practice Type

The provider directory offers a range of practice type options for different healthcare professionals. These options include:

• Virtual Care: Providers exclusively assigned to a virtual medical center.

• Urgent Care: Providers exclusively focused on delivering urgent care services.

• Specialist: Physicians who have completed additional specialization beyond family medicine, pediatrics, or internal medicine. Examples include podiatry, nephrology, and cardiology.

• Regional Medical Director: Providers serving as regional medical directors for one or more regions.

• Primary Care: Providers dedicated to scheduled primary care visits. Examples include family medicine, internal medicine, and nurse practitioners.

• Preceptor: Providers temporarily assigned through a Locum agency to fulfill the duties of another provider.

• Pediatric Care: Practice type specifically for pediatricians. Not applicable to pediatric nurse practitioners.

• Nutrition Management: Non-providers specializing in nutrition, such as registered dietitians and nutritionists.

• Medical Director: Providers serving as medical directors for one or more facilities.

• Home Health Care: Providers offering in-home care to patients.

• Diagnostic and Imaging: Non-provider professionals or providers offering diagnostic and imaging services.

• Behavioral Health: Non-provider professionals or providers exclusively working in the field of mental health, including clinical social workers, social workers, and professional counselors.

• Administrative: Non-provider professionals or providers primarily serving in administrative roles, including management positions and training-focused assignments.

Patient Age Range

Patient age range determines which patients a provider can see. Here are the valid age ranges for patients that a provider is eligible to see:

• 0-17: This range is for providers who exclusively specialize in pediatric care.

• 6-150: This range is for providers who see patients of all ages, excluding newborns and toddlers.

• 11-150: This range is for providers who see patients of all ages, excluding those under eleven years old.

• 18-150: This range is for providers who see patients of all ages, excluding pediatrics.

• 19-62: This range is for providers who see all adult patients, excluding seniors.

• 63-150: This range is for providers who exclusively focus on senior patients.

• 0-150: This range is for providers who see patients of all ages.

Provider Identifiers

The provider identifiers tab includes industry-standard identifiers associated with a provider. Here you can find various identifiers such as NPI, EMR ID, Medicare License Number, Medicaid License Number, DEA License Number, CAQH Number, and Google My Business Store Code.

NPI

The National Provider Identifier (NPI) is a distinct identification number assigned to healthcare providers. It serves as a standardized identifier for covered healthcare professionals and is governed by the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI consists of a 10-digit numerical format.

EMR ID

Electronic medical records (EMRs) serve as digital counterparts to the physical records maintained at a provider's workplace. The EMR ID represents the distinctive number assigned to each provider for identification purposes.

CAQH Number

To see patients and bill insurance for their services, licensed medical providers are required to have a Council for Affordable Quality Healthcare (CAQH) number. This unique number is specifically assigned to providers for identification purposes.

Google Business Store Code

The Google My Business Store Code serves as a unique identifier assigned by GMB to each business. In the case of providers who have their own individual GMB page, the corresponding code for that page should be entered here.

Provider Services

Companies

Providers are employed by various companies based on their assigned state and facility. The provider directory includes the following company options along with their corresponding states and facilities:

• Sanitas USA: This is a corporate entity and providers are typically not hired through this company.

• Guidewell Sanitas I: Used for Sanitas Medical Centers facilities and providers that are located in Florida.

• Sanitas Dental Management: Management company used for stand-alone Sanitas Dental facilities in Florida.

• Sanitas Dental of South Florida PA: Used for dentists associated to Sanitas Dental facilities located in Florida.

• Keralty Hospital: Used for providers and Keralty Hospital facilities located in Florida.

• Sanitas Special Care

• BCBST Sanitas I: Used for Sanitas Medical Centers facilities located in Tennessee.

• Sanitas Medical Center of Tennessee PA: Used for providers in Tennessee as the management company is not allowed to employ providers.

• HCSC Sanitas I: Used for Sanitas Medical Centers located in Texas.

• Sanitas Medical Center of Texas PA: Used for providers in TX as the management company is not allowed to employ providers.

• Sanitas of New Jersey: Used for Sanitas Medical Centers facilities and providers located in New Jersey.

• GWS-CMSI: Used for Connecticut, where Sanitas no longer operates.

Specialties

Specialty refers to the specific field of medicine in which a provider has acquired advanced education and training, making them a specialist in that particular area. The provider directory offers a range of specialty options, including:

• Acute Care Nurse Practitioner

• Adult Gerontology Nurse Practitioner

• Adult Gerontology Nurse Practitioner Autonomous

• Behavioral Health Counselor

• Cardiology

• Clinical Social Worker

• Dermatology

• Emergency Medicine

• Family Medicine

• Family Nurse Practitioner

• Family Nurse Practitioner Board Certified

• Gastroenterology

• General Practice

• General Surgery

• Internal Medicine

• Marriage and Family Therapist

• Mental Health Counselor

• Nephrology

• Obstetrics & Gynecology

• Osteopathic Medicine

• Pediatric Nurse Practitioner

• Pediatric Nurse Practitioner Autonomous

• Pediatrics

• Physician Assistant

• Podiatry

• Psychiatric Nurse Practitioner

• Psychiatric Nurse Practitioner Autonomous

• Pulmonary Medicine

• Radiology

• Registered Dietitian

• Social Worker

• Sports Medicine

Provider Type

Provider type indicates the specific category of healthcare provider responsible for billing. Within the provider directory, you can find a variety of provider type options, including:

• APRN

• CNP

• DO

• DPM

• LCSW

• LPC

• MD

• MS

• NP

• PA

• PC

• DI

• UC

• RD

• RDN

• MHC

• LMCH

• MSW

• MSHC

Online Booking

The online booking toggle switch serves as an indicator of whether a provider has the option for an online booking widget powered by Vim. When this toggle is switched on, the provider's information will be included in the daily files sent to Vim, enabling online booking functionality for that specific provider. You can locate this toggle switch by editing a provider's specialty within the system.

Web Enabled

The web-enabled toggle switch functions as an indicator for determining whether a provider should be showcased on the https://www.mysanitas.com/en/doctors website. When this switch is toggled on, the provider will be featured in the doctor search section of the website. To locate and modify this toggle switch, you can edit the provider's specialty within the system.

Provider Attributes

The provider attributes section encompasses data pertaining to a provider's web properties, including their web page and biography. It also includes visit categories, name attributes, a range of customizable attributes and additional non-industry standard identifiers. While many of these data fields are straightforward, below are descriptions of some of the less frequently encountered fields:

Web Page Link 1

The following URL corresponds to the English version of a provider's web page on mysanitas.com.

Web Page Link - Spanish

The following URL corresponds to the Spanish version of a provider's web page on mysanitas.com.

Panel Size Adult, Panel Size Chronic, Panel Size Pediatric, Panel Size Seniors

The four panel size custom attributes represent the patient type-based measurements of a provider's panel size.

Target Appointments Per Week

This represents the target number of appointments that a provider aims to complete each week.

Schedule Type

The schedule type indicates the specific schedule arrangement of a provider. Here are valid schedule types from the provider directory:

• Admin

• Behavioral Health

• FL High Utilizers

• FL Home Care

• FL Hybrid Commercial and High Utilizer

• FL Hybrid Commercial and Medicare

• FL On Demand Virtual

• FL Standard Commercial

• FL Standard Medicare

• FL Standard Urgent Care

• Nutritionist - Dietician

• PGY-1 Resident

• PGY-2 Resident

• PGY-3 Resident

• Per Diem

• Specialist

• NJ Standard Max

• TN Standard Adult and Senior

• TN Standard Pediatric

• TX Standard All Segments