Associating A Record to A Provider

Owned by Dylan Nigh
May 09, 2023
7 min read

Once providers have been created in MacPractice, begin associating providers to patients and other records within the database. Choosing provider associations carefully will ensure the most accurate reports and information in MacPractice. If the office has multiple providers, it be be necessary to have multiple providers associated to a patient for different reasons. For example, the primary care physician may need to be credited to receive payment for all the patient's charges, even if the patient saw a different provider on a given day.

Patient Provider:

The patient provider is the provider assigned to the patient on the Patient screen. This provider should be the patient's primary care physician or the provider the patient sees most often. The patient provider will be used by default for most new records created for that patient, such as new charges, appointments, prescriptions, and forms. However, this can always be changed on the fly in the event the patient sees another provider. Many reports will also be filtered by the patient provider.

  • Pulls into the new charge window and becomes the charge provider for all new procedures and charges entered for a patient as long as there is no provider set in the fee schedule. Please note that if a change is made to the provider in the charge window and subsequent charges are added, MacPractice will continue using the new provider.

  • Can be set as the default payment provider. This is a preference in Ledger > Payments > General.

  • Can be set as the provider shown on claims for all claims created for a specific charge provider, as set in that charge provider's User reference.

  • Will pull into new appointments as the default appointment provider if there is no resource provider.

  • Will pull into new prescriptions and medications as the default provider in the Rx and Optical abilities.

  • Will be printed on any optical prescriptions, unless the optical provider is set to None.

  • Will pull into new patient EMR forms by default.

  • Filters the following Insurance reports: Patients By Insurance and Appointment Type, Patients By Insurance Carrier, Patients With Multiple Coverages, Patients With No Insurance, Patients with Remaining Coverage, and Prior Authorization Report.

  • Filters the following Management reports: Archived Patients, Deleted Patients, Duplicate Patients, Last Visit Report, and Printed Encounter Forms.

  • Filters the following Marketing reports: Follow-Up Report, Patients, Patients By Age, Patients By Birthday, Patients By Emails, Patients By Problem List and Medication, Patients By Status, Patients By Zip Code, Patients with No Transactions, and Treatment Plans.

  • Filters the Referrals reports: Referred Patient By and Referred Patient To.

Account Provider:

The account provider differs from the patient provider in that it is used for the account as a whole. The account provider allows filtering certain reports and managers that are account-based and not patient based. Generally speaking, the account provider should be the provider who collects funds for services for this patient, however some preferences can alter this setting. See below for more detail.

  • Can be set as the default payment provider. This is a preference in Ledger > Payments > General.

  • Can filter the statement list in the Statements Manager to show only accounts with a specific account provider.

  • If using a statement that details provider information per item, the account provider will be shown next to finance charges, statement sent descriptions, and reversed payments.

  • If the preference "Print Provider on First Line" is enabled in Statements preferences, the account provider will be printed in the address line on the statement. The name printed will be pulled from the Name Printed in Box 33 HCFA field in MacPractice MD, DC, or 20/20 or the Name Printed in Box 53 of Insurance field in MacPractice DDS.

  • If the prescription or optical provider is set to None, the account provider will be printed on medical and optical prescriptions instead.

  • Filters the following Accounting/Financial reports: Accounts by Financial Status, Reversed Payment, and Statements Sent by Providers.

  • Filters the Posted Date Day Sheet and Procedure Date Day Sheet reports for finance charges.

  • Filters the Management report Accounts by Monthly Statement Options.

  • Filters the following Marketing reports: Account Primary, Patients, Discounts, and Persons By Employer.

Charge Provider:

The charge provider is one of the most important provider ties in MacPractice. The charge provider is the provider who performed services for the patient and will be listed on claims and statements as such, unless a different Provider Shown on Claim is set in the provider's User reference. The charge provider is credited for all charge production in the Production Analysis reports, and is also the provider who is credited on the Earned Receipts report for money applied to those procedures. When entering new charges, the charge provider will pull from the fee schedule if one is associated to the fee. If the fee schedule provider is set to None, the charge provider will pull from the patient provider.

  • Will be the provider printed on the patient's claim, unless a different provider is set in the Provider Shown on Claim section of the provider's User reference.

  • If using a statement that details provider information per item, the charge provider will be shown next to charges, write-offs, and insurance claims.

  • Pulls from the fee schedule provider, then the patient provider if the code does not have a provider set in the fee schedule. Note that if additional charges are added, it will retain the provider from the first charge.

  • Filters the following Accounting/Financial reports: Accounts Receivable, Earned Receipts, Positive Adjustments, and Sales Tax.

  • Filters the Day Month Year report for everything but gross payments.

  • Filters the Gross Receipts report for applied payments only.

  • Filters the Posted Date Day Sheet and the Procedure Date Day Sheet reports for production, taxes, positive adjustments, and insurance write-offs.

  • Filters the following Insurance reports: All Outstanding Claims, Insurance Collection Report, Insurance Write-Off, Outstanding Claims by Company, Receipts, Receipts By Plan Type, and Receipts By Procedure.

  • Filters the Marketing report, Patients By Procedure and Diagnosis.

  • Filters all Predetermination reports; such as, All Outstanding Predetermination, Outstanding Predetermination by Company, Predetermination Received, Predetermination Write-Off, and Unscheduled Treatments Report.

  • Filters all Production Analysis reports; such as, Production By Category, Production By Diagnosis, Production By Financial Status, Production By Month, Production By Posted Date, Production By Procedure, Production By Provider, and Production By Type.

  • Filters the following Referrals reports: Patient Charges By Referral, Referral Production, and Referrals by Type.

Payment Provider:

The payment provider affects receipts and deposit reports in MacPractice. The payment provider is not credited with earning the money applied to charges as this is based on the charge provider. The payment provider is credited for earning any unapplied amounts. The payment provider will be printed on statements as the recipient provider for payment and will be displayed in such reports as the Day Sheets and Deposit Slip.

  • If using a statement that details provider information per item, the payment provider will be shown next to payments, and refunds.

  • Filters the Day Month Year report for gross and unapplied payments.

  • Filters the Gross Receipts report for unapplied payments only.

  • Filters the following Accounting/Financial reports: Negative Adjustments, Refunds, and Unapplied (Credit) Balance.

  • Filters the Posted Date Day Sheet and the Procedure Date Day Sheet reports for payments, negative adjustments, deposits, refunds, and unapplied amounts.

Fee Schedule Provider:

Providers can be associated to fees in the fee schedule, however this should only be done if that particular procedure will only be performed by the selected provider. If set, the fee schedule provider will pull into the charge window and become the charge provider any time the fee is used instead of the patient provider.

Provider Adjustments:

Provider adjustments can be associated to any provider in the payment window. Provider adjustments are a preference that must be enabled in the Preferences window under Ledger > Payment > Insurance Payment. The Provider Adjustment report filters based on the provider associated to payments.

Appointment Provider:

The appointment provider is only associated to the patient's appointment. Ideally the appointment provider should be the same provider the patient will be seeing that day, and will likely be the same as the patient provider and charge provider. The appointment provider may affect the appointment display, if the display is set to display provider information. The appointment provider can also be displayed in Scheduling reports, and the printed schedule. By default, new appointments created will use the patient provider, if one is not set the resource provider will be used instead. If there is a discrepancy between the patient provider and the resource provider, MacPractice will alert the user to check the appointment provider.

Resource Provider:

The resource provider should only be set if all appointments created in that resource should be associated to that provider. The resource provider only affects the appointment provider for newly created appointments. If there is a discrepancy between the resource provider and the patient provider, MacPractice will prompt the user to check the provider.

Prescription Provider:

The prescription provider is the provider associated to the patient's prescription or medication record. The prescription provider should be the provider who prescribed the medication to the patient, and will print as the provider on any prescription forms. If the prescription provider is a required field and if set to 'None' it will not be able to create a prescription. By default, the prescription provider will pull from the Patient tab provider menu, however this can be changed on the fly. The prescription provider also filters the Marketing report Patients by Medication.

EMR/EDR Form Provider:

The EMR/EDR form provider is associated to patient forms in the patient forms palette. The EMR/EDR form provider should be the provider who evaluated the patient's condition. By default this provider will pull from the patient provider, however this can be overridden on the fly. The EMR form provider allows setting privileges per user group to view and edit a specific provider's forms in the View and Edit by Provider user group EMR privilege.

Optical Provider:

The optical provider is the provider associated to the patient's optical prescription in the Optical ability. The optical provider should be the provider who performed the optical exam. The optical provider will pull from the patient provider by default, however this can be changed on the fly if needed. The optical provider will not be printed on any optical prescriptions, as the patient provider is used instead.