Provider network

Every care request names the provider organization that will deliver it. The provider register holds each one with a code, a contact person, an address, an active marker and an eligibility note that states what may be referred to it, such as “adult dermatology teleconsults, English and Spanish” or “pediatric follow-ups only”. Coordinators read the note before choosing a provider; reviewers read it before authorizing.

Tenant organizations own care requests, provider relationships and team members. A health system with several regions, or a care network serving several clinics, keeps each as its own organization with its own time zone and currency. Team members link a signed-in user to one organization with a role name, and are active or inactive.

• Eligibility in writing. Each provider’s note states the specialties, ages and languages agreed.
• Organization scope. Team members work only on their own organization’s requests and providers.
• Active markers. Inactive providers and team members stay on record for past work but are not used for new work.

Agree provider codes and keep them aligned with your contracting records. Write eligibility notes in plain terms. Decide who adds and deactivates providers; the Provider Network Manager owns this in the standard setup. Agree the role names for team members and who holds clinical review authority in each organization.

A care network adds a new pediatric telehealth group. The Provider Network Manager records it with code PED-TH, the medical director as contact and the note “pediatric follow-ups ages 2 to 17, weekdays”. A coordinator receives a request for a 15-year-old’s follow-up and chooses PED-TH. A request for a 19-year-old goes to an adult provider instead.

Six months later the group stops weekend coverage and later leaves the network. The manager updates the note, then marks the group inactive. Past requests and their evidence remain readable, and no new requests name it.

Rehearse this during setup with two providers whose eligibility differs. Route a request that fits one and not the other, then deactivate a provider and check that it no longer appears for new requests while its past work stays readable.

• Provider Directory — Active providers with contact, address and eligibility note.
• Membership Register — Active team members with role name, time zone and organization.
• Organization Register — Active tenant organizations with time zone and currency.

• Request to clinical authorization: Choose an eligible provider for each request.

Review roles and permissions before inviting staff.