Providers

The Providers window lists clinicians who have been added to Communicare as providers at your health service.

A provider is anyone who provides health care for a patient (such as, a doctor, health worker, nurse, and so on) who may or may not be a billing entity. Specifically, a service provider is defined by Medicare.

Table 1. Provider fields
Field Description
Logon User Name The username used to associate a user with this provider at logon time. If a provider has a Logon User Name assigned, the following security restrictions apply:
  • When the user logs on to Communicare, this provider is automatically selected as the default provider and cannot be changed
  • Progress Notes for this provider can only be written if the provider logs on to Communicare with this Logon User Name
  • Providers without a Logon User Name cannot make electronic claims
  • If a provider has an HPI-I, it will only be usable in Communicare if the provider is also logged into Communicare with their selected Logon User Name
Provider personal details
  • Title - the provider's title
  • Forenames - the given of the provider
  • Surname - the family name of the provider
  • Sex - the sex of the provider
  • Indigenous Status - the provider's indigenous status
  • Date of Birth - the provider's date of birth
Provider professional details
  • Qualifications - the qualifications of the provider
  • Registration Number - the AHPRA registration number of the provider. To find a provider's AHPRA registration number, visit the AHPRA website.
  • Speciality - the specialty or occupation of the provider. A provider is associated with a single speciality. If a provider's speciality type is changed then all retrospective progress notes reflect this change. For example, if a nurse writes notes as an Enrolled Nurse and then becomes a Registered Nurse, the old notes will indicate that they are now a Registered Nurse.
  • Prescriber Number - the provider's prescriber number. Without a prescriber number, the provider can't print prescriptions or prescribe medications unless they belong to a user group which has formulary rights.
  • HPI-I Number - the current Healthcare Provider Identifier - Individual number assigned to the provider. The box may have a different background colour depending on the provider's status. For more information, see HI Service.
    • You may not be able to enter HPI-I Numbers if the HI Service module is switched off. See HI Service for more detail on availability, as well as the rules that govern when an HPI-I Number search or validation is triggered.
    • To validate a number with Medicare, click HI Validation buttonValidate. The last checked date is updated, and a new status or number may be assigned.
    • To display a history of HPI-I Number's assigned to the provider, click HI History buttonHistory. For more information see Viewing Healthcare Identifier History.
  • Student - set to identify a provider as a student practitioner. Students are identified in progress notes in the clinical record together with their speciality if available.
  • Transport Driver - set to identify that the provider is also a driver of transport.
  • Cultural Awareness Training Given - select whether cultural awareness training has been given to the provider or not
Show Medicare Claim Tab Set to always show the Medicare Claim tab when this provider closes a clinical record for a service.
Allow online appointment bookings Set if the provider allows appointments to be booked online.
Enable and disable providers

To enable a provider, in the Enable Date field, enter a date from which the provider will be active in Communicare.

When the provider leaves your health service, to disable a provider, in the Disable Date field, enter a date from which the provider cannot access Communicare.
Notes Enter any relevant notes about the provider.
Verbal Order

To enable Verbal Order options, the Medications Management module must be enabled.

Configure individual providers to require verbal orders when creating medication orders for particular medications, according to their scope of practice, for particular Schedule classifications and at particular encounter places. A Verbal Order is required if:

  • A provider attempts to create a medication order for a medication that is not included in their Scope of Practice
  • A provider attempts to create a medication order for a medication that is part of a restricted Schedule classification (S1, S2, S3, S4, S5, S6, S7, S8, S9, Unscheduled)
  • A provider attempts to create a medication order at a selected encounter place
Specify medications for which a provider can create a medication order using either Schedules, Scope of Practice or both. Set the following:
  • To enable a provider to create medication orders for medications listed in their Scope of Practice without needing a Verbal Order, set Use Scope of Practice.
  • S1, S2, S3, S4, S5, S6, S7, S8, S9, Un-Scheduled - set one or more options to require that any medication order created for medications included in the selected Schedule requires a Verbal Order. For example, if a nurse needs to be able to prescribe S1, S2 and S3 medications without a Verbal Order, deselect S1, S2 and S3 and set S4-S9.
  • To require a Verbal Order only for particular encounter places, select the required Encounter Place.
    Tip:

    If you deselect an encounter place, the provider does not require a Verbal Order at that encounter place.

    If you want a provider to always require a verbal order at all encounter places,for Encounter Places, set Select All.
Ix Claimant
Provider numbers for Medicare Online Claiming can be associated with providers by encounter place.
Example Provider number by encounter place

This allows a provider to claim on different provider numbers based on the place they are providing services from. Claims cannot be submitted against this provider number at the relevant encounter place before the effective date.

For the current encounter place, provide the following information:

  • Provider Number - an eight character identifier by which a provider is referenced, typically six numbers followed by two letters, for example, 123456AB.
    Tip: If your provider number contains fewer than six numbers, it is considered invalid and the following error is displayed: Invalid provider number. Prefix shorter provider numbers with zeroes to make them six numbers long, for example, 012345AB.
  • Effective Date - the date at which the specified provider number became effective for the current provider. The effective date must not be in the future.
    Note: Providers should ensure that their details are finalised with Medicare before the effective date is reached.
  • Ix Claimant - set to allow the current provider to request investigations for the encounter place. An investigation request can only be requested by, or on behalf of a provider who has Ix Claimant set for an encounter place. If this field is not enabled, the provider will only be able to request an investigation on behalf of another provider if Allow Investigation Request on behalf of another claiming provider is set in Organisation maintenance.
Electronic Claims When a provider provides a service, only that provider can submit their claims, with the following exceptions:
  • Payee Provider - the delegated doctor whose provider number is attached to the health service bank account where the Electronic Claims deposits are made.
    Note: If the provider being edited is the payee provider, this field should be left blank.
  • Delegated User - another user authorised to submit claims on behalf of this provider. This user must be a Communicare Logon User and can be anyone with Billing system rights in Communicare.

All Communicare System Administrators can also resubmit a bulk bill in case of transmission failures.

If a personal token must be used to sign all claims made by this provider, also set Sign the Claims using the PKI Token.