Request a New Provider Office

To facilitate your request, here is the information we will need:

  • Requested go-live date?
  • Practice name, address, phone number, and fax number for each location
  • Whether or not provider is employed by Covenant HealthCare
  • If provider is employed by Covenant, is new hire process with payroll and HR completed?
  • Providers specialty
  • Will provider perform inpatient rounding at Covenant HealthCare?
  • Any progress note templates or letters
  • Will provider need EPCS?
  • Does provider use EPCS for inpatient rounding at Covenant HealthCare?
  • Does provider need EPIC training?
  • Has the provider been credentialed yet?
  • Providers date of birth
  • Providers MI License #, date issued, and expiration date
  • Providers NPI
  • Providers DEA
  • Providers MICR ID
  • Providers Quest ID
  • Will provider attest to Meaningful Use or has done so previously?
  • How should MyChart message pools be setup or is there another provider to mirror?
  • Providers scheduling template (days, start, end, and lunch times; length of visits, visit types, etc).
  • If adding new staff, please provide name of employee(s), their date of birth, and job function?
  • Affiliate Technical Contact Information