Organization to Individual Provider Affiliations
Revised: February 18, 2021
Online videos are available to take you through the steps of requesting an organization to individual affiliation or an organization to direct support worker (DSW) affiliation at the following links.
Overview
Use this page to manage your organizations affiliations to individual providers and direct support workers.
Use the Existing Organization to Individual Affiliation Search section to search for and manage your existing affiliations.
Initiate new affiliation requests by clicking the Create a New Organization to Individual Affiliation button.
Manage Existing Organization to Individual Provider Affiliations
If you have affiliation information for individual providers that has already been entered into your enrollment record, you can update that information by searching for that affiliation. Start by initiating a search for the affiliation you wish to update.
Existing Organization to Individual Affiliation Search
In the Existing Organization to Individual Affiliation Search section, complete one or more fields to search for your existing affiliations. You can also leave all search fields blank and click Search to see a list of all of your organization’s individual affiliations. Searching for all individual affiliations may take longer than one minute or cause MPSE to time out if your organization has a large amount of affiliations. If the search time causes MPSE to time out, just log back in to continue your search.
The following is a list of fields in which you can enter information to search for individual affiliations.
Organization Enrollment Record
To manage the affiliations of a specific enrollment record, use the Organization Enrollment Record drop-down list to select an enrollment record from within your portfolio.
Organization Location NPI/UMPI
Type the National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) of your organization enrollment record in the Organization Location NPI/UMPI field to manage the affiliations to that NPI or UMPI.
Individual Provider NPI/UMPI
Type the NPI or UMPI of an individual provider or direct support worker to manage their affiliations to your organization.
Provider Name
Type the name of an individual provider or direct support worker in one or all of the following fields:
First
Type the first name of an individual or direct support worker.
Middle
Type the middle name of an individual or direct support worker.
Last
Type the last name of an individual or direct support worker.
Search
After you have entered your desired search criteria, click Search. Your search results will display in the following section, Existing Organization to Individual Affiliation Search Results.
Existing Organization to Individual Affiliation Search Results
In the Existing Organization to Individual Affiliation Search Results section, the results of your search criteria that you entered will display. If the system does not find any search results, this section will not have any information to display.
This section displays results only for individual affiliation requests that have been completed. If you have submitted a request to affiliate to an individual or direct support worker and the request is still pending or in review, that affiliation will not appear in your existing affiliations.
The Request Actions that display for each affiliation are determined by your user role and the login ID you used to access MPSE. If you have a role of enrollment record provider enroller or affiliations provider enroller, you will only see the View/Edit option on the individual or direct support worker’s that are affiliated to the NPI that is tied to your login ID.
View
Click View to go to the End an Existing Organization to Individual Affiliation page or the End an Existing Organization to Direct Support Worker Affiliation. If your user role does not allow you to edit the affiliations that are listed, then only the View option will appear.
View/Edit
Click View/Edit to go to the End an Existing Organization to Individual Affiliation page or the End an Existing Organization to Direct Support Worker Affiliation. On these pages, you can view or edit the information listed.
Manage Individual Provider Portfolio
Click Manage Individual Provider Portfolio in the Request Actions column to go to the Manage Affiliated Individual’s Portfolio page. This page allows you to update the information to an individual provider’s record.
Return to Portfolio
Click Return to Portfolio to go back to your organization’s portfolio page.
Create a New Organization to Individual Affiliation
Click Create a New Organization to Individual Affiliation to go to the Search for an MHCP-Enrolled Individual Provider page. On this page, you can search to see if a provider is enrolled with Minnesota Health Care Programs (MHCP).
End an Existing Organization to Individual Affiliation
Use this page to end an existing organization to individual provider affiliation. Enter an end date and click Submit Request.
Organization and Individual Profile/Portfolio Information
The Organization and Individual Profile/Portfolio Information section displays portfolio information for the organization whose affiliations are being accessed and the specific individual being managed in the current request. You will only be able to view the fields displayed in this section. You will not have the option to edit.
Organization Profile/Portfolio
The Organization Profile/Portfolio field displays the practice name and enrollment record ID of the enrollment record the listed individual provider is affiliated with.
Individual Profile/Portfolio
The Individual Profile/Portfolio field displays the name of the affiliated individual provider.
Affiliation Information
The Affiliation Information section displays the start and end date of the affiliation.
Start Date
The Start Date field displays the start date of the affiliation.
End Date
Enter the end date of the affiliation in the End Date field.
Cancel
Click Cancel to return to the Manage Existing Organization to Individual Provider Affiliations page.
Submit Request
Click Submit Request to submit your request to end this affiliation.
End an Existing Organization to Direct Support Worker Affiliation
Organization and Direct Support Worker Profile/Portfolio Information
The Organization and Direct Support Worker Profile/Portfolio Information section displays portfolio information for the organization whose affiliations are being accessed and the direct support worker (DSW) being managed in the current request. You will only be able to view the fields displayed in this section. You will not have the option to edit.
Organization Profile/Portfolio
The Organization Profile/Portfolio field displays the practice name and enrollment record ID of the enrollment record the listed direct support worker is affiliated with.
Direct Support Worker Profile/Portfolio
The Direct Support Worker Profile/Portfolio field displays the name of the affiliated DSW.
Affiliation Information
The Affiliation Information section displays the details of the organization to DSW affiliation.
Affiliation Request Type
The Affiliation Request Type field displays if this affiliation was a new hire or a rehire.
Employee Hire Date
The Employee Hire Date displays the date the organization hired the DSW.
Start Date
The Start Date field displays the start date of the affiliation.
End Date
Enter the end date of the affiliation in the End Date field.
DSW Organization Enrollment Record
The DSW Organization Enrollment Record field displays the enrollment record the DSW is affiliated to.
Cancel
Click Cancel to return to the Manage Existing Organization to Individual Provider Affiliations page.
Submit Request
Click Submit Request to submit your request to end this affiliation.
Search for an MHCP-Enrolled Individual Provider
On this page, you can search for an individual provider that you would like to affiliate with your organization. Click Search once you have entered your search information. Search results will appear if that individual is enrolled with MHCP. If your search does not yield any results, click Create a New Individual Profile Request to initiate the enrollment of that individual with MCHP.
Enrolled MHCP Provider Search
In the Enrolled MHCP Provider Search section, provide information about the individual provider or DSW you are requesting to affiliate to. If the individual provider is enrolled, you can request the affiliation. If the provider you wish to affiliate to does not appear in this search, you can request to enroll the provider with MHCP.
NPI/UMPI
Type the individual provider or DSW’s NPI or UMPI in the NPI/UMPI box.
Social Security Number
Type the individual provider’s full Social Security number in the Social Security Number box.
Date of Birth
Enter the individual provider’s date of birth in the format of MM/DD/YYYY in the Date of Birth box.
Search
Click Search after you have entered your search criteria.
Enrolled MHCP Provider Search Results
The Enrolled MHCP Provider Search Results section displays the results of the search criteria you entered in the Enrolled MHCP Provider Search section.
If the search finds no results, the following message will display: “No enrollment records were found that match the search information.” Click Create a New Individual Profile Request to initiate the enrollment of that individual.
The User Actions that display in the User Actions column are determined by the enrollment record type of the individual provider, the provider’s self-managed indicator, and their enrollment status.
Add Affiliation
Click Add Affiliation to go to the Manage New Organization to Individual Provider Affiliation page.
The Add Affiliation option will only appear if the provider is not a direct support worker and their enrollment status is active.
To affiliate to a direct support worker, you must click Manage Individual Provider Portfolio in the User Actions column. This will take you to the Manage Affiliated Individual’s Portfolio page. From the direct support worker’s Manage Affiliated Individual’s Portfolio page, you can create a request to affiliate to that direct support worker that includes all the required information for an organization to direct support worker affiliation, such as a background study.
If an individual provider is not active, you must submit a new profile request to reinstate that individual. To do this, you will click Manage Individual Provider Portfolio in the User Actions column. This will take you to the Manage Affiliated Individual’s Portfolio page. You can then click Create a New Request and update their enrollment information as needed, including uploading a new provider agreement.
Manage Individual Provider Portfolio
If you wish to affiliate an individual provider to multiple locations in one request or if you are also requesting additional services, such as telemedicine, click the Manage Individual Provider Portfolio option from the User Actions column. This will take you to go to the Manage Affiliated Individual’s Portfolio page.
If an individual provider has indicated on their portfolio that they are self-managed, the option to manage an individual’s portfolio will not appear. The individual provider will have to log in to their own MN–ITS account to update their own information or change their self-managed indicator to “No” to allow an organization to manage their information on their behalf.
Cancel
Click Cancel to return to the Manage Existing Organization to Individual Provider Affiliations page.
Create a New Individual Profile Request
Click Create a New Individual Profile Request to create a new profile request to enroll an individual or direct support worker with Minnesota Health Care Programs (MHCP).
Manage New Organization to Individual Affiliation
Use this page to add a new affiliation to an individual provider who is already enrolled with MHCP.
Manage New Organization to Individual Affiliation Information
In the Manage New Organization to Individual Affiliation section, complete the following fields to request a new affiliation.
Organization Enrollment Record
Select the enrollment record you are requesting to affiliate this individual to from the Organization Enrollment Record drop-down list. Only enrollment records from within your organization’s portfolio will appear in the drop-down list.
Start Date
Enter the effective date of the affiliation in the Start Date box.
End Date
Enter an end date if applicable in the End Date box. If this affiliation does not have an end date, leave this box blank.
Attestation
In the Attestation section, you must attest on behalf of your organization that the information being submitted is correct and the individual you are requesting to affiliate to is aware of the request.
On behalf of this organization, I attest that the affiliation information submitted is current and correct, and that the individual provider selected is aware of this request to affiliate with this organization
Select the check box to complete the attestation.
Cancel
Click Cancel to return to the Search for an MHCP-Enrolled Individual Provider page.
Submit Request
Click Submit Request to submit your affiliation request.
Manage Affiliated Individual’s Portfolio
Use this page to manage an individual provider or direct support worker’s portfolio. You can create requests for new affiliations, to end existing affiliations, or to manage their enrollment information, such as services, credentials, and addresses.
To return to your organizations portfolio, click the Home link on the right side navigation bar.
Organization and Individual Profile/Portfolio Information
The Organization and Individual Profile/Portfolio Information section displays portfolio information for the organization and the individual provider the user selected to be managed. The fields displayed in this section are read only and cannot be changed.
Organization Profile/Portfolio
The Organization Profile/Portfolio field displays the practice name and enrollment record ID of the enrollment record the listed individual is affiliated with.
Individual Profile/Portfolio
The Individual Profile/Portfolio field displays the name of the affiliated individual.
Requests Submitted by Your Organization for this Individual Provider
In the Requests Submitted By your Organization for this Individual provider section, you will see a list of all the requests that have been submitted by your organization for the individual you selected.
Status
The Status column will display the status of any request submitted.
Request Actions
The Request Actions column will display the available options you can take on each request.
View Request
Click View Request to see more details about a specific request. You will be able to view the content for each page within the request, but will not be able to make changes.
View Differences Report
Click View Differences Report to review a report of how your requested changes will change your current profile. The differences report will show you a side-by-side comparison of your current profile and your future profile, which will include your requested changes.
Edit
Click Edit to make changes to your request.
Delete
Click Delete to delete your request.
Assign to Self
Click Assign to Self to assign the request to yourself to make changes to or complete the request.
Revert to Draft
Click Revert to Draft to return the request to draft mode. This allows you to edit your request.
You will have the option to revert your request to a draft after you have submitted your request for approval and before Provider Eligibility and Compliance (PEC) has started their review of your request. The status of your request at this point will be Pending Review. Reverting your request to a draft enables the Edit option on your request. However, once PEC begins the review of your request, and the request status shows, In Review, you will no longer be able to revert that request to a draft to make changes. You would need to start a new request to make additional changes once the request is in Completed status.
Create a New Request
Click Create a New Request to request updates to the information in the individual’s portfolio.
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