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What is a provider?

In Effra, a provider is the clinic, location or practitioner whose details are used when submitting invoices to insurers. Depending on how you are registered with each insurer, you may bill under:
  • a clinic provider number
  • a location-specific provider number
  • an individual practitioner’s provider number

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How many providers do I need to set up?

You need a provider in Effra for each clinic, location or practitioner whose details you use to bill insurers. If you bill an insurer using your clinic provider number, you can add that provider number to your clinic profile. Your clinic profile is automatically created when your Effra account is set up. If an insurer recognises different locations separately, you may also have separate provider profiles for those locations, each with its relevant provider number. If you need to set up this arrangement, please **contact Effra support. ** If you bill an insurer using individual practitioner provider numbers, you should create a separate provider for each practitioner you bill under. For example, you might bill Bupa using a clinic provider number, but bill Aviva using individual practitioner provider numbers. In this case, the Bupa number would sit against the relevant clinic or location profile, while each Aviva-recognised practitioner would need their own provider profile in Effra.

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Viewing your providers

You can view and manage your providers from: Settings → Providers Here you will see all of the clinic, location and practitioner profiles currently set up on your Effra account. Before adding a new practitioner, check this list to make sure they have not already been set up.

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Adding a practitioner

If you bill insurers using an individual practitioner’s provider number, you will need to add that practitioner to Effra.
  1. Go to Settings → Providers.
  2. Click Add provider.
  3. Enter the practitioner’s name.
  4. Add any names (aliases) they may appear under in your practice management system.
  5. Add their professional registration number.
  6. Add their provider number for each insurer they are registered with.
  7. Click Create provider.
You only need to enter provider numbers for insurers that the practitioner is registered with.

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Practice management system aliases

Effra uses the practitioner’s name to match invoices from your practice management system to the correct provider. If a practitioner can appear under a different name in your practice management system, add this as an alias. For example, if the provider is set up in Effra as Alexandra Smith, but appears in your PMS as Alex Smith, add Alex Smith as an alias. If there are multiple variations, enter each one on a separate line. You do not need to create a second provider simply because the same practitioner appears under a different name.

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Professional registration number

Select the practitioner’s professional registration type and enter their registration number. For example:
  • HCPC
  • GMC
  • GOsC
  • GCC
  • BAcC
Effra uses this information when preparing certain insurer submissions, so invoices may move to Action Required if the required registration information is missing.

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If an invoice says the provider is missing

An invoice may move to Action Required if Effra cannot match the practitioner on the invoice to a provider in your account. Check that:
  • the practitioner has a provider profile in Settings → Providers
  • their name or PMS alias matches the practitioner on the invoice
  • their professional registration details are present
  • their provider number for the relevant insurer has been added
If everything appears to be configured correctly and the invoice remains in Action Required, contact Effra support from the invoice.