Providers with Credentialing Report
The Providers with Credentialing report includes information from the Providers master file in File Maintenance. Information on the report pulls from the Modify Provider Information window for providers with one or more entries on the Credentialing tab. The report includes the following information:
| Column | Description | Data Populates From |
|---|---|---|
| Name | Provider Name | Demographics tab > Last Name, First Name and Middle Name fields. |
| Display As | Display As Name | Demographics tab > Display As field. |
| Hid | Delete Indicator | Hide check box. Displays Y or blank. |
| Addr 1 | Address 1 | Demographics tab > Street 1 field. |
| Addr 2 | Address 2 | Demographics tab > Street 2 field. |
| City | City | Demographics tab > City field. |
| State | State | Demographics tab > State field. |
| Zip | Zip Code | Demographics tab > Zip field. |
| County | County | Demographics tab > County field. |
| Country | Country | Demographics tab > Country field. |
| Hm Phone | Home Phone | Demographics tab > Phone field. |
| Mobile Phone | Mobile Phone | Demographics tab > Mobile Phone field. |
| Fax | Fax Number | Demographics tab > Fax field. |
| Email Addr | Email Address | Demographics tab > E-Mail Address field. |
| Rend | Rendering Provider Indicator | Practice tab > Rendering provider at this practice check box. Displays Y or blank. |
| Referring | Referring Indicator | Provider Types tab > Referring check box. Displays Y or blank. |
| Prim Care Phys | Primary Care Physician Indicator | Provider Types tab > Primary Care Phys check box. Displays Y or blank. |
| Admitting | Admitting indicator | Provider Types tab > Admitting check box. Displays Y or blank. |
| Fst Consult | First Consulting Indicator | Provider Types tab > First Consulting check box. Displays Y or blank. |
| Sec Consult | Sec Consulting Indicator | Provider Types tab > Second Consulting check box. Displays Y or blank. |
| Supervisor | Supervising Provider | Practice tab > Supervising provider at this practice check box. Displays Y or blank. |
| Pat Prov UD 1 - 12 | Patient Provider User Defined 1 - 12 Fields
| Provider Types tab > Practice Level Provider Types check boxes. Displays Y or blank. |
| NPI | NPI | System tab > National Provider ID field. |
| Credent Type | Credentialing Type | Credentialing tab > Credentialing Type field. |
| Eff Dt | Credentialing Effective Date | Credentialing tab > Effective Date field. |
| Exp Dt | Credentialing Expiration Date | Credentialing tab > Expiration Date field. |
| Credent Num | Credentialing Number | Credentialing tab > Number field. |
| Credent Notes | Credentialing Notes | Credentialing tab > Notes field. |
| Credent Hid | Credentialing Delete Indicator
| Credentialing tab > Hide check box. Displays Y or blank. |
| Prim Cred Ind | Primary Credential Indicator
| Credentialing tab > Primary Credentials Displays Y or blank. |
| Prim Cred Eff Dt | Primary Credential Effective Date | Credentialing tab > Primary Credentials > Effective Date field. |
| Prim Cred Exp Dt | Primary Credential Expiration Date | Credentialing tab > Primary Credentials > Expiration Date field. |
| Prim Cred Hid | Primary Credential Delete Indicator | Credentialing tab > Primary Credentials > Hide Primary Credential check box. Displays Y or blank. |
| Ordering | Ordering Provider | Provider Types tab > Ordering check box. Displays Y or blank. |
Filter 2
Use columns to filter data on the report. Column filter options include the following:
- Between
- Equals
- Not Equals
- Greater Than
- Less Than
- Like
Sorting
Use columns to sort and group data on the report. Column sorting options include the following:
- Ascending
- Descending
- Group By
- Page Break
Totals
Use columns to sub-total and total data on the report. Column total options include the following:
- Sum
- Average
- Count
- Totals