Individual to Organization
Revised: June 6, 2024
Manage Individual to Organization Provider Affiliations
Overview
Use this page to create a new affiliation or make changes to an existing affiliation between this enrollment record and the enrollment record of an MHCP-enrolled organization. You can only edit the information on this page if you are in an MPSE Request.
Affiliations refer to a partnership between an organization and individual provider. Affiliations are required when a claim submitted to Minnesota Health Care Programs (MHCP) needs both a pay-to provider and a rendering provider. You can find more information about the affiliation requirements for each provider type on the Eligible Providers list of the MHCP provider manual.
Portfolio/Profile Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Portfolio/Profile Information on the Recurring Items page of the Minnesota Provider Screening and Enrollment (MPSE) User Manual.
Enrollment Record Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.
Modified Individual to Organization Provider Affiliations
The Modified Individual to Organization Provider Affiliation section displays information on your current affiliation request. If you do not have a current request, this section will not appear.
View/Edit
Click View/Edit to go to the Manage Individual to Organization Provider Affiliation page. From this page, you can view and edit your affiliation information.
Delete
Click Delete to delete an organization to individual affiliation that was added during this request. The Delete option does not appear for affiliations that were previously approved by MHCP.
All Individual to Organization Provider Affiliations
The All Individual to Organization Provider Affiliations section shows information related to existing individual to organization affiliations for this enrollment record. If there are no individual to organization affiliations, this section will not have any information to display.
View/Edit
Click View/Edit to go to the Manage Individual to Organization Provider Affiliation page. From this page, you can view and edit your affiliation information. The View/Edit option only appears when you are in an MPSE Request.
View
Click View to go to the Manage Individual to Organization Provider Affiliation page. From this page, you can view your affiliation information. You will not be able to make any changes while in view mode.
Create New Affiliation
To add a new individual to organization affiliation, click Create New Affiliation to go to the Individual to Organization Provider Affiliation Search page.
Continue
Click Continue to go to the next page.
Individual to Organization Provider Affiliation Search
Overview
Use this page to search for an organization to affiliate this enrollment record to.
Portfolio/Profile Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Portfolio/Profile Information on the Recurring Items page of the MPSE User Manual.
Enrollment Record Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.
Search Information
In the Search Information section, provide the National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) of the organization you are requesting to affiliate with an individual provider.
NPI/UMPI
Type the NPI or UMPI of the organization you would like to affiliate with in the NPI/UMPI field. You must click Search after entering the NPI or UMPI to get your search results.
Search Results
The Search Results section displays the results of the search criteria you entered in the Search Information.
If the NPI or UMPI entered in the NPI/UMPI field produces no results, the following message will display: “No enrollment records were found that are eligible for the affiliation type you are requesting.”
Select
Click Select to go to the Manage Individual to Organization Provider Affiliation page. From this page, you can enter your affiliation information to affiliate with this organization.
The Select option appears in the User Actions column of the Search Results section if the search produces results and the enrollment record can have an affiliation applied to it. If the User Actions column is not visible to you, use the horizontal scroll bar at the bottom of the Search Results section to display additional columns.
Search
Click Search to begin your search of the criteria entered in the Search Information section. You must enter a valid NPI or UMPI number into the NPI/UMPI field for the Search button to work.
Cancel
Click Cancel to go back to the previous page.
Manage Individual to Organization Provider Affiliation
Overview
Use this page to manage your existing affiliation or to add a new affiliation with an organization’s enrollment record.
Portfolio/Profile Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Portfolio/Profile Information on the Recurring Items page of the MPSE User Manual.
Enrollment Record Information
This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.
Provider Information
The Provider Information section displays details of the organization selected for affiliation. This section is informational only and you cannot make any changes to the organization’s information that is displayed.
Affiliation Information
In the Affiliation Information section, provide information for your affiliation request.
Start Date
Enter the start date of your affiliation with this organization in the format of MM/DD/YYYY in the Start Date field.
End Date
Enter the date this enrollment record’s affiliation with the organization’s enrollment record has ended in the format of MM/DD/YYYY in the End Date field.
Only enter an End Date when you are requesting to end this affiliation.
Continue
Click Continue to save your changes and go to the next page.
Cancel
Click Cancel to go back to the previous page.
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