The Providers table holds the therapist-specific information that will appear on claims. When a claim is generated, Fusion Enterprise will look for information to be included in the claim. It starts with the clinic the visit was scheduled in then the therapist who treated the patient. If the only information needed on your claim can be pulled from the therapist level, you would really not need any additional sub levels. Without the additional sub-levels, the claim will stop at the therapist.
If there are additional levels, the Clinic Controller will proceed to each level looking for the most specific information that matches up to the visit based on Carrier Type, Carrier Group, and finally, actual Carrier. Because it will look for the most specific information it can find, even if you have a forward at the Carrier Group level if an individual carrier is listed and it is the one attached to the claim Fusion Enterprise will pull from that final level.
NOTE: The more information you can add when entering Providers information and any new credentials, the better Fusion Enterprise will be able to match in billing
The Provider Tree will show specific information for each individual therapist. The Provider Tree will contain the following information:
- Carrier Type (Commercial, Government, Worker's Comp)
- Carrier Group (Aetna, BCBS, etc)
- Individual Carrier (patient-specific plan)
Here is an example of how it will look in Fusion Enterprise (the numbers correspond to the list above):
NOTE: Be sure to look for the + to click on to see more information in your Providers Tree.