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