What Happens If CMD Can’t Match a Provider by Facility?

Issue

What should I do if the facility isn’t listed, doesn’t have a reference number, or no matching providers can be found by reference number in CollaborateMD?

Environment

Kipu EMR, CollaborateMD, Roles: Account Setup & Providers, Facility Permission, Features: Claims, Claim Info

Resolution

If CMD can’t find a provider by facility reference, it will try a few other steps to find the best match:

1. Check for an Older Provider ID (UPIN)

   • If the ID is a 6-character UPIN (an older provider ID type), CMD looks for a provider with that UPIN.

   • If there are multiple matches, CMD narrows them down by name.

2. Try Matching by NPI Again

   • CMD re-checks the claim for an NPI.

   • If multiple providers share the same NPI, CMD narrows them down by first and last name, and then by middle initial if needed.

3. Check for a Scheduler Resource ID

   • If the ID comes from the appointment system and belongs to a provider in CMD, CMD uses that provider.

4. Name Matching

   • If no ID match works, CMD tries to match by name only:

     • At least a last name is needed.

     • If a first name is available, CMD uses both.

     • If there are multiple matches, CMD uses the middle initial to narrow them down.

5. If Nothing Works

   • If CMD still can’t identify a provider, it will return an error stating that no match could be found.
     

Additional Information

• Find or edit a Facility
• Find or edit a Provider