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Custom Providers

Manage custom provider data overrides and configurations.

Overview

The Custom Providers feature allows you to maintain a list of provider records that override or supplement the standard CMS data (IPSF/OPSF). This is useful for correcting data errors, adding missing providers, or maintaining internal-only provider configurations. Custom records are 'seeded' from an existing IPSF or OPSF record, and then can be edited to override specific fields.

Managing Providers

Navigate to Customizations → Custom Providers to view the list of all custom providers.

Searching and Filtering

Use the search bar and filters to find specific records: - Search: Enter a Provider ID or Label. - Contract: Filter by specific contract (e.g., Hospital A, Clinic B). - Status: Toggle "Include Inactive" to see historical or deactivated versions.

Creating a Custom Provider

  1. Click the Create Custom Provider button.
  2. Fill in the required fields:
    • Provider ID: The unique CMS certification number (CCN).
    • Contract: The contract this provider belongs to.
    • Effective Date: When this configuration becomes active.
    • Label: A friendly name for the provider.
  3. Choose a based IPSF or OPSF record to add custom overrides to. Utilize the Field Override Editor to search for and override specific provider fields.
    • Alternatively you can manually edit Raw JSON override view on the bottom of the modal to directly edit the provider data. Be careful when doing so as improperly formatted data can corrupt your record.
  4. Click Create to save.

Editing and Versioning

Custom providers are versioned. When you edit a provider, you are effectively creating a new version of that record.

  1. Click on a provider row to open the details view.
  2. Click Edit to modify the current version.
  3. Make your changes and click Save.

[!NOTE] The Effective Date cannot be changed for an existing version. To change the effective date, you must create a new record or a new version with the desired date.

Version History

The details view shows the full history of the provider. You can: - View: See the details of past versions. - Diff: Compare two versions to see exactly what changed. - Activate: Roll back to a previous version by making it the active one.

Audit Logs

All changes to custom providers are audited. The history view shows: - Who made the change. - When the change occurred. - What changed (via the Diff view).