Provider Master Relationship File Data Elements

 

The Extract Identifier code for this file is PRM.

 

Refer to Appendix B, “Provider Master Relationship Data-Map Process,” for details on how Provider records are added or updated in the Healthx database.

 

Field #

Field Name

Req.

Len

Type

Notes

1

VersionNumber

K

10

AN

Spec Version Number : 3.04

2

OrgPractitionerID

K

100

AN

This is a value that uniquely identifies the provider and is used in the HealthPlan Provider Portal to tie all provider data together. It can be an NPI, UPIN, or any other value that uniquely identifies the provider for your organization.             
Only used for Practitioner records

3

OrgFacilityID

K

100

AN

This is a value that uniquely identifies the provider and is used in the HealthPlan Provider Portal to tie all provider data together. It can be an NPI, UPIN, or any other value that uniquely identifies the provider for your organization.

4

OrgHospitalID

K

100

AN

This is a value that uniquely identifies the provider and is used in the HealthPlan Provider Portal to tie all provider data together. It can be an NPI, UPIN, or any other value that uniquely identifies the provider for your organization.            
Only used for Practitioner records

5

NetworkCode

R

50

AN

Provider Network Code

6

SpecCode

R

50

AN

Specialty Code                                  
Only used for Practitioner records

7

ProviderTypeCode

R

50

AN

Provider Type Code

8

RecordType

K

1

AN

Type of record being sent

P = Practitioner

All others = Facility

9

OrgMedicalGroupID

R

100

AN

This is a value that uniquely identifies the provider and is used in the HealthPlan Provider Portal to tie all provider data together. It can be an NPI, UPIN, or any other value that uniquely identifies the provider for your organization.            
Only used for Practitioner records

Note:  There should be one record for each combination of relationships for each provider. 

For example, if a practitioner works at two facilities, has two hospital affiliations, works in two networks, with one specialty code and one provider type, you would send 8 records for that practitioner.

 

 

 

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