Form E PCO Provider Management User Guide - Attachment E

Shortage Designation Management System

0906 0029 - Attachment E - Provider-Management-User-Guide

Designation, Planning, and Preparation

OMB: 0906-0029

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Bureau of Health Workforce
SDMS PCO Provider Management User Guide

Shortage Designation Management
System (SDMS)
PCO Provider Management User Guide

May 2025

OMB No. 0906‐0029 Expiration Date: xx/xx/xxxx
Public Burden Statement: The purpose of this information collection is to obtain performance data for the following: HRSA Grantees and
cooperative agreement recipients, programs operations, and surveys. In addition, these data will facilitate the ability to demonstrate alignment
between BHW discretionary programs, State Primary Care Offices (PCOs), and Shortage Designation Management System (SDMS). An agency
may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB control number for this information collection is 0906-0029 and it is valid until xx/xx/xxxx. Public reporting burden for this
collection of information is estimated to average 5.46 hours per response, including the time for reviewing instructions, searching existing data
sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B,
Rockville, Maryland, 20857.

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TABLE OF CONTENTS
Shortage Designation Management System (SDMS) Overview ............................................................................ 5
Content of This User Guide................................................................................................................................. 5
1. Shortage Designation Management System (SDMS) Main Page ...................................................................... 6
2. Provider Management Portal ......................................................................................................................... 8
2.1 Managing Provider Data Sources ........................................................................................................................ 9
2.1.1 Uploading Provider Data Sources ............................................................................................................... 11
2.1.2 Updating Provider Data Sources ................................................................................................................. 12
2.1.3 Searching For Provider Data Sources.......................................................................................................... 15
2.2 Searching for Providers...................................................................................................................................... 17
2.2.1 Using the Basic Search ................................................................................................................................ 17
2.2.2 Using the Advanced Search ........................................................................................................................ 19
2.2.3 Viewing Search Results ............................................................................................................................... 22
2.2.4 Editing Provider Locations in the Search Results Grid ................................................................................ 26
2.3 Viewing Provider Profiles ................................................................................................................................... 28
2.3.1 Viewing Provider Information..................................................................................................................... 29
2.3.2 Viewing NPI Addresses ............................................................................................................................... 30
2.3.3 Viewing Locations ....................................................................................................................................... 30
2.3.4 Viewing Taxonomies ................................................................................................................................... 31
2.3.5 Viewing Change History .............................................................................................................................. 32
2.3.6 Adding and Viewing Comments .................................................................................................................. 33
2.3.7 Viewing Revision History ............................................................................................................................ 34
2.4 Viewing Provider Locations ............................................................................................................................... 36
2.4.1 Viewing Location Information .................................................................................................................... 37
2.4.2 Viewing Needs Review Flags ....................................................................................................................... 40
2.4.3 Viewing FTE Calculations ............................................................................................................................ 40
2.4.4 Viewing Clinical Information and Populations Served Data ....................................................................... 41

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2.4.5 Viewing Employment Status ....................................................................................................................... 44
2.4.6 Viewing Designations.................................................................................................................................. 45
2.4.7 Viewing Location Address and Geocoded Results ...................................................................................... 46
2.4.8 Viewing Clinician Data Attestation ............................................................................................................. 49
2.4.9 Viewing Supporting Details ......................................................................................................................... 50
2.5 Editing Provider Locations ................................................................................................................................. 53
2.5.1 Adding Provider Locations .......................................................................................................................... 53
2.5.2 Updating Provider Locations ...................................................................................................................... 59
2.5.3 Managing Site Associations ........................................................................................................................ 65
2.5.4 Omitting Provider Locations ....................................................................................................................... 70
2.5.5 Addressing Needs Review Flags .................................................................................................................. 72
2.6 Using the Provider Import Tool ......................................................................................................................... 81
2.6.1 Viewing Provider Uploads........................................................................................................................... 82
2.6.2 Generating Provider Import Files ............................................................................................................... 85
2.6.3 Editing Provider Locations Using the Import File........................................................................................ 93
2.6.4 Importing Provider Data in Bulk ................................................................................................................. 99
2.6.5 Validating Provider Uploads ..................................................................................................................... 102
2.6.6 Viewing Provider Upload Reports ............................................................................................................. 110
2.7 Managing Provider Review Tasks .................................................................................................................... 119
2.7.1 Viewing Provider Review Tasks on the Provider Dashboard .................................................................... 119
2.7.2 Searching for Provider Locations that Require Review ............................................................................ 121
2.8 Attesting Provider Locations............................................................................................................................ 126
2.8.1 Viewing the Provider Location Attestation Tool ....................................................................................... 126
2.8.2 Searching for Provider Locations to Attest ............................................................................................... 128
2.8.3 Attesting Provider Locations..................................................................................................................... 128
Appendix A – Editable Provider Data Fields ..................................................................................................... 130
Appendix B – Changes to Last Updated By Banner ........................................................................................... 135

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Appendix C – Ineligible Reasons and PCO Omitted Reasons ............................................................................. 137
Appendix D – Import Tool Error Messages ....................................................................................................... 139

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SHORTAGE DESIGNATION MANAGEMENT SYSTEM (SDMS) OVERVIEW
Goal: The Shortage Designation Management System is used to manage, create, and update designations, and to
manage and update provider records in support of designations. The foundation of the Shortage Designation
Management System comes from nationally sourced data and the policies and procedures of the Division of Policy
and Shortage Designation (DPSD).
PCOs are able to complete the following:
•
•
•
•
•
•
•
•

Search for existing designations
View information about existing designations
Create and submit new designations
Update existing designations
Copy designations
Review and update POC-submitted designations
Create and manage inquiries
Create and update provider location records

Roles: The shortage designation role is required to be part of the PCO user account in order to have access to the
Shortage Designation Management System for Designations for their state. Please refer to the Create Account
Section to gain the role and permission to perform the Designation Management functions.

CONTENT OF THIS USER GUIDE
This user guide covers provider management functionality and business rules. For further information on
designation and user management related functionality and business rules, refer to the Designation Management
User Guide and User Management User Guide on your SDMS Portal Home Page.

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1. SHORTAGE DESIGNATION MANAGEMENT SYSTEM (SDMS) MAIN PAGE
The purpose of the Shortage Designation Main Page is for the PCO to view important updates, access helpful
resources and access the Designations portal, Providers portal, User Management portal, and Inquiries and Report
functionalities. The user can access this page by selecting “Link to the Shortage Designation Main Page” on the
main portal homepage.

Figure 1: PCO Shortage Designation Main Page

Feature

Description

1. Navigation Panel

The user may navigate to other sections of the PCO Portal using this toolbar.
Several of these menu items have sub-menus when clicked.

2. News and Alerts

This section provides the user with new information and updates pertaining
to Shortage Designation Management.

3. Helpful Resources

This section provides the user with resources on the policies and procedures
of SDMS.

4. SDMS Data Sources

This section lists the data sources currently being used in SDMS.

From the Shortage Designation Main Page Navigation Panel, PCOs can access:
•
•

•

SDMS Mapping tool (via the Designations Portal) to create and update designations
Designations Portal (Search for and View Designations, View HPSA Data on the Informational Mapping
Tool, Manage Tasks in My Activities, View Auto-HPSA and Geographic and Population Update Preview
Results)
Auto-HPSA Designations Portal (via the Designations Portal) to view and rescore Auto-HPSAs

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•

•
•

Provider Management Portal (Manage Provider Data Sources, Search for Providers, View Provider Profiles
and Locations, Download Provider State Reports, Use Provider Import Tool, Manage Provider Review
Tasks)
Tools
User Management Portal (Manage Auto-HPSA Points of Contact, Manage Stakeholder Notifications)

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2. PROVIDER MANAGEMENT PORTAL
The SDMS Provider Management Portal uses a data set from the Center for Medicaid and Medicare’s (CMS)
National Plan and Provider Enumeration System (NPPES). Providers that have a unique identifier known as an NPI
(National Provider Identifier) from CMS are imported to SDMS on a weekly basis. Once providers are imported to
SDMS, state PCOs can maintain and update data about the provider’s practice locations to be used in HPSA
designations.
In the SDMS Provider Management Portal, PCOs can search for providers and update provider information across
their state. PCOs can update providers by editing provider information through the Provider Search table, making
updates directly to a provider location, or by importing bulk provider updates using the Import Tool. PCOs can
manage provider locations that require review through the Provider Dashboard.
Users can navigate to the Provider Management Portal by selecting “Providers” in the Navigation Panel where they
will be directed to the Provider Management Landing Page.

Figure 2: Provider Management Landing Page

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2.1 MANAGING PROVIDER DATA SOURCES
PCOs can navigate to Provider Data Sources from the Provider Management Landing Page. On this page, PCOs can
upload and manage data sources used for updating provider locations.

Figure 3: Accessing the Provider Data Sources Page from the Provider Management Landing Page

Figure 4: Provider Data Sources

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Feature
1. Provider Data Sources Search

2.
(Upload New Data Source Button)

Description
This section allows users to search for uploaded provider data
sources. For more information about searching for provider data
sources, see Section 2.1.3 Searching For Provider Data Sources.
This button allows PCOs to upload new provider data sources. For
more information on how to upload provider data sources see
Section 2.1.1 Uploading Provider Data Sources.

3. File Name

This field displays the name of the uploaded file. Users can
download a copy of the file by clicking on the File Name.

4. Data Source Name

This field displays the short, descriptive name assigned to the file
by the PCO upon upload. This Data Source Name will display in the
Data Source drop-down when editing provider locations and on
provider locations if selected by PCOs.
For more information about viewing supporting details, see
Section 2.4.9 Viewing Supporting Details.

5. Data Source Agency

This field displays the name of the agency or organization that
published the provider data source identified by the PCO upon
upload.

6. Data Source Date

This field displays the date the data source was published as
indicated by the PCO upon upload. This Data Source Date will
display on provider locations if selected by PCOs.
For more information about viewing supporting details, see
Section 2.4.9 Viewing Supporting Details.

7. Uploaded User

This field displays the email of the PCO who uploaded the file.
PCOs can view all provider data sources uploaded to their state,
regardless of who uploaded it.

8. Uploaded Date

This field displays the date the file was uploaded by the PCO.

9. Status

This field displays the status of the provider data source assigned
by the PCO. Status selections include:
• Current
• Archive

10.
(Actions Drop-down)

This drop-down allows PCOs to update uploaded provider data
sources. For more information about editing provider data
sources, see Section 2.1.2 Updating Provider Data Sources.

While uploading a provider data source, PCOs can indicate which editable fields on a provider location this data
source applies to. The following fields can be selected as relevant fields for a provider data source:
•
•
•

Annual Medicaid Claims
Dental Auxiliaries
Direct Tour Hours

•
•
•

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Discipline
Federal Provider?
Homeless %

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•
•
•
•
•

Intern or Resident?
J1 Visa Waiver Holder?
Location Address (New and Copied)
Medicaid Patient %
Migrant Farmworker %

•
•
•
•
•

American Indian/Alaska Native %
Organizational NPI
PCO Omitted Reason
Site Type
Specialty

Once a relevant field has been selected for a provider data source, that data source will appear as an option in the
Data Source drop-downs when editing provider locations. For more information about updating provider locations,
see Section 2.5.2 Updating Provider Locations.

2.1.1 UPLOADING PROVIDER DATA SOURCES
New data sources can be uploaded to clicking the “Upload New Data Source” button. PCOs may only upload files to
their assigned state.

Figure 5: Upload New Data Source Button

INSTRUCTIONS
To upload provider data sources:
1.
2.
3.
4.
5.
6.
7.
8.

Click on the “Upload New Data Source” button. A pop-up will open titled “Upload New Data Source”
Select the file to be uploaded
Enter the short, descriptive name that should be displayed in the Data Source drop-downs in the “Data
Source Name” field
Enter the name of the agency or organization that published the file in the “Data Source Agency” field
Select the date the file was published in the Data Source Date field
Select the status of the file
Select the fields on a provider location this data source applies to in the Relevant Fields drop-down
Click “Save” to upload the new provider data source file. Users can click “Cancel” at any time if they no
longer want to upload the file

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Figure 6: Upload New Data Source Pop-Up

A success banner will display at the top of the page once the file has been uploaded.

Figure 7: Success Banner when Uploading a New Provider Data Source

USER NOTES
•

•
•
•

PCOs may upload the following file types: Rich Text Format, Word, PDF, Excel (.xls, .xlsm, .xlsx), and Image
files (.jpeg, .gif, .bpm, .tiff)
PCOs may upload file sizes up to 100 MB
PCOs may only enter up to 100 characters for the Data Source Name and Data Source Agency. Special
characters are allowed
PCOs cannot select future dates when entering the Data Source Date

2.1.2 UPDATING PROVIDER DATA SOURCES
Once a file has been uploaded to the Provider Source Data Portal, it cannot be deleted. PCOs can update the userentered information about a provider data source and change the status of the data source using the “Actions”
drop-down menu.

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Figure 8: Provider Data Sources Actions Drop-Down Menu

3.1.2A EDITING PROVIDER DATA SOURCES
PCOs can edit the user-entered information associated with a data source and the relevant fields the data source
applies to on a provider location by selecting “Edit Data Source” from the “Actions” drop-down menu. PCOs
cannot edit the file itself, the uploaded user, or the uploaded date once the file has been uploaded.

Figure 9: Edit Option in the Actions Drop-down Menu

INSTRUCTIONS
To edit an uploaded provider data source:
1.
2.
3.

4.

Click on the “Actions” drop-down next to the desired provider data source
Select the “Edit” option. A pop-up will open titled “Edit Data Source”
Edit any of the user-entered fields:
a. Data Source Name
b. Data Source Agency
c. Data Source Date
d. Relevant Fields on Provider Locations
Click “Save” to save the edits to the provider data source. Users can click “Cancel” at any time if they no
longer want to edit the provider data source information

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Figure 10: Edit Data Source Pop-Up

A success banner will display at the top of the page once the edits have been saved.

Figure 11: Success Banner when Editing a Provider Data Source

USER NOTES
•

•
•
•

The file name will appear as read-only. PCOs will not be able to change, edit, or delete the file once it has
been uploaded
The Save button will not be enabled unless the PCO makes at least one change to the Provider Data
Sources
PCOs may only enter up to 100 characters for the Data Source Name and Data Source Agency. Special
characters are allowed
PCOs cannot select future dates when entering the Data Source Date

3.1.2B CHANGING THE STATUS OF PROVIDER DATA SOURCES
PCOs can change the status of a provider data source using the “Actions” drop-down menu. If a PCO is no longer
using a file to make updates on provider locations, they should change the status to “Archive”. Only provider data
sources with a status of “Current” will appear as option in the Data Source drop-downs on a provider location.

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Figure 12: Archive Option in the Actions Drop-down Menu

INSTRUCTIONS
To change the status of a provider data source:
1.
2.
3.

Click on the “Actions” drop-down next to the desired provider data source
Select the “Archive” or “Current” button. The available selection will depend on the status of the chosen
provider data source
The provider data source will now display the updated status

The status of the provider data source will update automatically, and a success banner will display at the top of the
page. No further action by the PCO is needed.

Figure 13: Success Banner when Changing the Status of a Provider Data Source

2.1.3 SEARCHING FOR PROVIDER DATA SOURCES
PCOs can search across all provider data sources uploaded in their state, regardless of who uploaded the file.

Figure 14: Provider Data Sources Search

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Feature
1. File Name

Description
This field allows users to search for provider data sources by the
name of uploaded file.

2. Data Source Name

This field allows users to search for provider data sources by the
short, descriptive Data Source Name assigned to the file.

3. Data Source Agency

This field allows users to search for provider data sources by the
agency or organization that published the data sources.

4. Data Source Date

This field allows users to search for provider data sources by the
date the file was originally published. Users can search by a single
date or by date ranges.

5. Uploaded User

This field allows users to search for provider data sources by the
PCO who uploaded the file.

6. Uploaded Date

This field allows users to search for provider data sources by the
date when the file was uploaded. Users can search by a single date
or by date ranges.

7. Status

This field allows users to search for provider data sources by the
status assigned to the file.

8.
(Search Button)

When the desired fields are selected, users should click the Search
button to initiate the search. At least one field must be selected
before the Search button is enabled.

9.
(Clear Button)

Users may select this button to clear the fields used during a
search. Selecting the “Clear” button on this page will also remove
the search results from view.

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2.2 SEARCHING FOR PROVIDERS
PCOs can use the Provider Search and its predefined list of search criteria to search for providers, view a table
display of provider location search results where PCOs can edit provider information, and download search results
in a macro-enabled Excel file to make bulk updates through the Import Tool.
On the Provider Search, PCOs can view providers across all states and territories but can only edit providers within
their assigned states (the state associated with the PCO’s user account) or foreign countries. From the Search page,
users can navigate to provider profiles and locations.

2.2.1 USING THE BASIC SEARCH
Users can conduct a basic search from the Provider Management Landing Page.

Figure 15: Basic Search on the Provider Management Landing Page

Feature
1. State

Description
This field allows users to search for providers by any state, territory, or
Foreign Country.

2. County Name

This field allows users to search for providers by one or multiple counties in
a particular state. This field will only be enabled once a state or territory has
been selected. When a “County Name” is selected, the system will also
populate the “County FIP” drop-down with its corresponding value.

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Feature

Description
Search results will return providers that have been geocoded to the County.

3. Discipline

This field allows users to search for providers by one or multiple disciplines.
Discipline selections include:
• Primary Care
• Dental Health
• Mental Health

4. Specialty

This field allows users to search for providers by one or multiple specialties.
This field can only be completed once a discipline has been selected. Once a
discipline is selected, only the specialties that fall under that discipline will
be available for selection. If multiple disciplines were selected, all specialties
that apply will be available as drop-down menu options. Specialty selections
include:
• If Primary Care is chosen:
o Certified Nurse Midwife
o Family Practice
o General Practitioner
o Internal Medicine
o Obstetrics and Gynecology
o Pediatrics
• If Dental Health is chosen
o Dentist
• If Mental Health is chosen
o Psychiatrist
o Clinical Social Psychologist
o Clinical Social Worker
o Psychiatric Nurse Specialist
o Marriage and Family

5. First Name

This field allows users to search for providers by their first name. Only exact
matches will be returned.

6. Last Name

This field allows users to search for providers by their last name. Only exact
matches will be returned.

7. NPI

This field allows users to search for providers by their National Provider
Identifier (NPI). NPIs are unique 10-digit numerical identifiers assigned to
providers by the Center for Medicare and Medicaid Services and imported
into SDMS. Only exact matches will be returned.

8. Status

This field allows users to search for providers by status. Status selections
include:
• Eligible
• Ineligible

9.
(Search Button)

When the desired fields are selected, users should click the Search button to
initiate the search. At least one field must be selected before the Search
button is enabled.

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Feature
10.
(Clear Button)

Description
Users may click this button to clear the fields used during a provider search.

Users can conduct a more advanced search by clicking on the “Go to Advanced Search” link. This link will navigate
users to the Advanced Search page.
Once the user clicks the Search button, they will be directed to the Advanced Search page to view results. On this
page, any of the criterion they selected on the Basic Search will be prepopulated, and the search results will
display. For information on viewing search results see Section 2.2.3 Viewing Search Results.

2.2.2 USING THE ADVANCED SEARCH
In addition to the criteria on the Basic Search on the Provider Management Landing Page, users can access
additional search criteria on the Advanced Search Page.

Figure 16: Provider Advanced Search Page

Feature
1. Designation/Organization
Name

Description
This field allows users to search for providers by the Designation or
Organization Name of their site association.

2. Designation ID

This field allows users to search for providers by the Designation ID of their
site association.

3. Organization Unique ID

This field allows users to search for providers by the Organization Unique ID
of their site association. This field will only return results for provider
locations associated to Auto-HPSA sites.

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Feature
4. Site Type

Description
This field allows users to search for providers by their Site Type. Site Type
selections include:
• Federal Correctional Facility
• Federally Qualified Health Center (FQHC)
• Federally Qualified Health Center Look-Alike (LAL)
• Indian Health Service Clinic
• Tribal Clinic
• Urban Indian Clinic
• Inpatient Facility/Hospital
• Other Facility (OFAC)
• Rural Health Clinic
• State Correctional Facility
• State/County Mental Hospital (Mental Health only)
• Unknown
• Veteran’s Facility
• Youth Detention Center

5. Ineligible Reason

This field allows users to search for providers by one or multiple ineligible
reasons. This field will be disabled if the user selected the “Eligible” status.
Ineligible Reason selections include:
• CMS Deactivated
• PCO Omitted
• Not Geocoded
• Is Federal Provider
• Is NHSC Provider
• J1 Visa Waiver Holder
• No Discipline/Specialty
• New, Not Reviewed

6. County FIP

This field allows users to search for providers in one or multiple county FIPs
in a particular state. This field can only be completed once a state or
territory has been selected. When a “County FIP” is selected, the system will
also populate the “County” drop-down with its corresponding value.
Search results will return providers that have been geocoded to the County
FIP.

7. CSD

This field allows users to search for providers by one or multiple county
subdivisions in their particular state. Users can begin entering the CSD and
then choose from a filtered list.
Search results will return providers that have been geocoded to the CSD.

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Feature
8. Census Tract

Description
This field allows users to search for providers by one or multiple census
tracts in their particular state. Users can begin entering the census tract and
then choose from a filtered list.
Search results will return providers that have been geocoded to the Census
Tract.

9. ZCTA Public ID

This field allows users to search for providers in a ZCTA Public ID by its 5-digit
numerical identifier. The 5 digit ZCTA must be preceded by the letter “Z.”
Only exact matches will be returned.
Search results will return providers that have been geocoded to the ZCTA
Public ID.

10. NPI Change Type

The field allows users to search for providers by the category of provider
changes as reported by CMS. NPI Change Type selections include:
• New Provider
• CMS Deactivated
• Taxonomy Change
• NPI Address Change

11. NPI Change Date

This field allows users to search for providers by one or multiple dates. This
field can only be completed once the “NPI Change Type” has been selected.

12. License Number

This field allows users to search for providers by their License Number.

13. Last Updated By

This field allows users to search for providers by one or multiple users who
last updated the provider. If a state is selected, only those users who
updated records in that state will be listed.

14. Clinician Data Reviewed

This field allows users to search for providers who have been attested to by
a PCO. Status selections include:
• Yes
• No

15.
(Search Button)

When the desired fields are selected, users should click the Search button to
initiate the search. At least one field must be selected before the Search
button is enabled.

16.
(Clear Button)

Users may click this button to clear the fields used during a provider search.
Selecting the “Clear” button on this page will also remove the search results
from view.

USER NOTES
•
•
•

Search fields are not case sensitive
Users can “Select All” for all multi-select fields
Some multi-select fields are responsive search fields. Users can begin typing in the search fields to narrow
drop-down options

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2.2.3 VIEWING SEARCH RESULTS
After entering all relevant search criteria, users can click “Search” to initiate the search. The search results will
display a list of provider locations that meet the user-entered criteria.

Figure 17: Provider Search Results Table

Feature
1.
(Customize Columns Button)
2.
(Generate Provider Import
File Button)
3.
(Download Results Button)

4.
(Customize Entries Drop Down)

Description
This button allows users to add, remove, and reorder the columns visible in
the search results table. For more information on customizing columns, see
Section 2.2.3A Customizing the Search Grid for more detail.
This button allows users to generate provider import files and create a
Provider Upload based on their search results. For more information on
generating provider import files from the Advanced Search grid, see Section
2.6.2B Generating Provider Import Files from the Advanced Search.
This button allows users to download the search results. This button will only
be enabled if the search criterion includes the PCO’s assigned state. For
more information on downloading search results, see Section 2.2.3B
Downloading Provider Search Results for more detail.
This drop-down allows users to customize the number of search results that
appear per page. The system will default to showing ten search results per
page. Once a new number is selected, the system will update the search
results table. The custom entries selections include:
• 10
• 50
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Feature

5.
(Showing X of X of X entries)
6.
(Scroll Bar)
7.
(Pagination)

Description
• 100
• 500
This field displays the total number of results returned and the subset of
results being displayed.
This scroll bar at the bottom of the search results table allows users to
navigate horizontally across the search results to view columns.
This page selection allows users to navigate across search results pages by
selecting the page number or the next button. If the user would like to go
back to a page, select the page number or the previous button.

Users can navigate from the Advanced Search to a Provider Profile by clicking on the hyperlinked NPI in the search
results table. For more information about Provider Profiles and Locations, see Section 2.3 Viewing Provider Profiles
and 2.4 Viewing Provider Location.

2.2.3A CUSTOMIZING THE SEARCH GRID
In the Search Results table, users can add, remove, or reorder columns by clicking on the “Customize Columns”
button. Customize column selections include:
• Display Address
• NPI
• County Name
• First Name
• Latitude
• Middle Name
• Longitude
• Last Name
• Match Level
• Suffix
• State FIPS
• Phone Number
• County FIPS
• Fax Number
• Census Tract
• Discipline
• CSD
• Specialty
• ZCTA Public ID
• Status
• Age
• Ineligible: CMS Deactivated
• Dental Auxiliaries
• Ineligible: PCO Omitted
• Direct Tour Hours
• Ineligible: Not Geocoded
• Reason Code
• Ineligible: Federal Provider
• Organizational NPI
• Ineligible: NHSC Provider
• Designation/Organization Name
• Ineligible: J1 Visa Waiver Holder
• Site Name
• Ineligible: No Specialty/Discipline
• Designation ID
• Ineligible: New, Not Reviewed
• Organization Unique ID
• Address Line 1
• Designation Status
• Address Line 2
• Site Type
• City
• Annual Medicaid Claims
• State
• Medicaid Patient %
• Postal Code
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•
•
•
•
•
•
•
•
•
•
•

Homeless %
Migrant Farmworkers %
American Indian/Alaska Native %
Sliding Fee %
Migrant Seasonal Farmworker %
Intern or Resident?
J1 Visa Waiver Holder?
Federal Provider?
NHSC Provider?
Activation Date
SDMS Last Modified Date

•
•
•
•
•
•
•
•
•
•
•

SDMS Last Modified By
NPI Address Change Date
NPI Deactivation Date
NPI Reactivation Date
NPI New Provider Date
NPI Taxonomy Change Date
Taxonomy Code
Taxonomy Type
License Number
License State
Clinician Review Date

Figure 18: Customize Columns in the Search Results Table

The following “Customize Columns” pop-up will display prompting users to customize their search results view:

Figure 19: Customize Column Layout in Search Results Table

INSTRUCTIONS

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To add, remove, or reorder columns on the search results table:
1.

2.

Check (to add) or uncheck (to remove) column options
a. The columns that display in the default search results table will be checked. Uncheck these
columns to remove them from the layout of the search results table
b. Additional columns can be added to the layout of the search results table by checking the
checkbox
c. Click and drag the checked columns in the desired order to be displayed
d. Click Select All to select all the possible search results table columns
e. Click Deselect All to deselect all the possible search results table columns
Click the “Save” button to save changes and return to the updated search results table layout

USER NOTES
•

•
•

If the user selects Taxonomy Code, Taxonomy Type, License Number, and License State, 15 columns for
each of these fields will be displayed to accommodate providers with multiple taxonomies and licenses
At least one column must be selected for the “Save” button to be enabled
Users can return to the default column selections by selecting the “Default Columns” button in the
bottom right hand corner of the Customize Columns modal

2.2.3B DOWNLOADING PROVIDER SEARCH RESULTS
In the Search Results table, users can download results by clicking on the “Download Results” button. PCOs will
only be able to download results if the search criterion includes the PCO’s assigned state. The downloaded Excel
file will not be compatible with the Provider Import Tool. To download a macro-enabled Excel file to use for bulk
updates from the search grid, see Section 2.6.2B Generating Provider Import Files from the Advanced Search.

Figure 20: Download Provider Location Records from Search Results Table

INSTRUCTIONS
To download provider search results:
1.
2.
3.
4.
5.
6.
7.

Select your state from the “State” search field
Apply any other desired filters using the search fields
Select the “Search” button to initiate the desired search
Select “Customize Columns” to add or remove columns on the search results grid
Click “Download Results.” A pop-up will appear notifying you that the required columns to upload the file
back through the import tool will be included in your search grid results download (see Figure 21:
Download Results Pop-up)
Click “Download” to continue
Results will download in a zipped file

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Figure 21: Download Results Pop-up

USER NOTES
•

Users can download up to 20,000 results per file. If the file would include more than 20,000 records, an
error message will display prompting users to narrow the search criteria. For larger downloads, users can
download a report of all provider locations in their state from the Tools Tab.

Figure 22: System Error Message for Attempted Downloads Over 20,000 Search Results

2.2.4 EDITING PROVIDER LOCATIONS IN THE SEARCH RESULTS GRID
In the Search Results table, PCOs can edit provider locations and save updates directly in the table without having
to navigate to the Provider Location page. PCOs will be able to edit provider locations in their assigned state or
Foreign Country (state code ZZ).

Figure 23: Editing Fields in the Search Results Table

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INSTRUCTIONS
To edit provider locations directly in the search results table:
1.
2.
3.

Click on the cell you want to edit. Be sure you are on the row of the correct provider location
Make edits to the fields that are editable. For more information about which fields can be edited, see
Appendix A – Editable Provider Data Fields
Press “Enter” on the keyboard to save changes after editing each row of provider information or click out
of the row

The text in the edited row will display in green while the system processes the update. If the system is unable to
process the edit, the row text will change to red and an error banner will display.

Figure 24: Error Message When System is Unable to Process Edits Made in the Search Grid

Depending on the field, the edit format will vary. Read-only fields will not change if users click them. For more
information on which fields use which editing format, see Appendix A – Editable Provider Data Fields.
Edit Format
1.
(Character Input)

Description
Fields that accept character inputs will highlight when the PCO clicks on the
cell and will switch to an editable format. PCOs can type their edits directly
into the cell.
Fields that accept pre-defined selections will display a drop-down menu
when the PCO clicks on the cell. PCOs can double-click in the cell to display
the drop-down, then select the desired option from the drop-down menu.

2.
(Drop Down)
3.
(Numerical with Input Stepper)

Fields that accept numerical inputs will have an up/down arrow option to
scroll to the desired numerical value. PCOs can also type the number directly
into the cell.

USER NOTES
•

•
•

If you click on a cell in another row or click outside of the row you are editing, the system will save your
changes. If you want to cancel any changes you’ve made, you must change the data back.
PCOs will not be able to edit providers that have been deactivated by CMS. All data will remain read only.
PCOs will not be able to edit provider locations that are outside their assigned state. All data will remain
ready only.

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2.3 VIEWING PROVIDER PROFILES
In the Search Results table, PCOs can click on the hyperlinked NPI number of a provider to navigate from the
Advanced Search to the Provider Profile. Users’ last search will be saved when navigating between the Provider
Search and provider profiles and locations.
Provider Profiles display read-only information about the provider. This information is reported to CMS and
imported by SDMS as read-only on a weekly basis. Updates to this data can only be made through the CMS NPPES
NPI registry.

Figure 25: Provider Profile

Feature
1. First Name Last Name (NPI)

Description
This page title displays the name and NPI of the provider.

2. Left Navigation

This left navigation allows users to navigate between the Provider Profile
and Location pages.

3. Last Updated By Banner

This banner displays the last date and time the provider data was updated
by a user or the system (e.g., CMS NPPES NPI delta file import). The format
for display is: MM/DD/YYYY HH:MM AM/PM (12-hour time). The last
updated date and time will be captured after the user makes an update
through the search grid, location page, or import tool. For more information
on when last updated times and dates are changed, see
Appendix B – Changes to Last Updated By .

4.
(Revision History Drop Down)

This drop-down allows users to view previous versions of the provider profile
and locations. For more information about viewing previous versions of a
provider see, Section 2.3.7 Viewing Revision History.

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Provider Profiles contain the following sections:
•
•
•
•
•
•

Provider Information
NPI Addresses
Locations
Taxonomies
Change History
Comments

2.3.1 VIEWING PROVIDER INFORMATION
The Provider Information section displays demographic information about the provider. This information is
reported to CMS and imported by SDMS as read-only on a weekly basis. Updates to this data can only be made
through the CMS NPPES NPI registry.

Figure 26: Provider Profile - Provider Information Section

Feature
1. National Provider Identifier
(NPI)

Description
This field displays the NPI of the provider. NPIs are unique 10-digit numerical
identifiers assigned to providers by the Center for Medicare and Medicaid
Services.

2. First Name

This field displays the first name of the provider.

3. Middle Name

This field displays the middle name of the provider. If the provider did not
enter a middle name, “Not Available” will display.

4. Last Name

This field displays the last name of the provider.

5. Suffix

This field displays the suffix of the provider. If the provider did not enter a
suffix, “Not Available” will display.

6. Age

This field displays the age of the provider. Age is only considered for
calculating FTEs for Dental Health providers. If the provider does not have a
location with a Dental Health discipline, “Not Available” will display.

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Feature
7. Phone

Description
This field displays the primary phone number for the provider. If CMS does
not have a phone number on record for the provider, “Not Available” will
display.

8. Fax

This field displays the primary fax number for the provider. If CMS does not
have a fax number on record for the provider, “Not Available” will display.

2.3.2 VIEWING NPI ADDRESSES
The NPI Addresses section displays the provider’s NPI Primary and Secondary Addresses. This information is
reported to CMS and imported by SDMS as read-only on a weekly basis. Updates to a provider’s NPI Primary or
Secondary Addresses can only be made through the CMS NPPES NPI registry.
Other location addresses for a provider can be added to the provider by a PCO. For more information on adding
new provider locations, see Section 2.5.1 Adding Provider Locations.

Figure 27: Provider Profile - NPI Addresses Section

Feature
1. NPI Primary Address

Description
This field displays the provider’s primary practice address.
When a new provider is added to SDMS, the system automatically creates a
provider location for the NPI Primary Address. The new location record will
be created Ineligible as “New, Not Reviewed”. If the NPI Primary Address of
an existing provider record is changed, a new provider location record will be
created and marked Ineligible as “New, Not Reviewed”.

2. NPI Secondary Address

This field displays the provider’s secondary practice addresses. If the
provider did not report additional practice addresses to CMS, “There are no
NPI Secondary Addresses for this provider” will display.
The system will not automatically create a provider location for these
secondary addresses. If these addresses require a location to be created by a
PCO, see Section 2.5.1 Adding Provider Locations.

2.3.3 VIEWING LOCATIONS
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The Locations section displays a table of all locations associated with the provider and summary information about
those locations. Users can navigate to the respective provider locations to view additional details. For information
on the data available on provider locations, see Section 2.4 Viewing Provider Locations.

Figure 28: Provider Profile - Locations Section

Feature
1.
(Add New Location Button)

Description
This button allows PCOs to add a new location for a provider. For more
information about adding a new location, see Section 2.5.1 Adding Provider
Locations.

2. Status

This field displays the Status of the provider location.

3. Location Status

This field displays the system generated Provider Location ID for each
location.

4. Address

This field displays the Address of the provider location.

5. Display Address

This field indicates which address is being displayed in the Provider
Management Portal. Display Address options include:
• Physical
• Standardized

6. Discipline

This field displays the Discipline of the provider location.

7. Specialty

This field displays the Specialty of the provider location.

8. Direct Tour Hours

This field displays the Direct Tour Hours of the provider location.

9.
(Copy Address Button)

This button allows PCOs to copy an existing provider location. For more
information about copying an existing location, see Section 2.5.1A Copying
Provider Locations.

2.3.4 VIEWING TAXONOMIES
The Taxonomies section displays information about a provider’s specializations and license information. This
information is reported to CMS and imported by SDMS as read-only on a weekly basis. Updates to a provider’s
taxonomy can only be made through the CMS NPPES NPI registry.

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This section will display up to 15 taxonomies and licenses for a provider.

Figure 29: Provider Profile - Taxonomies Section

Feature
1. Primary Taxonomy

Description
This field displays the primary taxonomy for the provider identified by a .
A provider may have one or more taxonomies, but they can have only one
primary taxonomy.
If there is an identified primary taxonomy and it is active, the system will
automatically populate the “Discipline” and “Specialty” fields on the
provider location page with the corresponding “Discipline” and “Specialty.” If
there is no primary taxonomy identified, the “Discipline” and “Specialty”
fields will not be populated by the system, resulting in an “Ineligible” status
of “No Discipline / Specialty.”
If the weekly CMS NPPES NPI Delta File updates the taxonomy information
for a provider, the system will not automatically update the “Discipline” and
“Specialty” fields on provider locations.
PCOs can override the NPI-determined “Discipline” and “Specialty” by
entering a new discipline or specialty that may or may not match the
taxonomy code and taxonomy type. For more information about editing
“Discipline” and “Specialty,” see Section 2.5.2 Updating Provider Locations.

2. Taxonomy Code

This field displays the provider’s associated Taxonomy Code. This
information is based on the CMS-defined specialty of practice. A list of
active taxonomies can be found in the Manual for Policies and Procedures.

3. Taxonomy Type

This field displays the provider’s associated Taxonomy Type as determined
by the “Taxonomy Code.” For more information on how taxonomy types are
determined, see the Manual for Policies and Procedures.

4. License Number

This field displays the provider’s license number. A provider must have at
least one license number for each state in which they practice and may have
more than one license number per state if they have more than one
specialization. A provider may have two of the same taxonomy codes with
two different license numbers and states if they are providing the same
service in two different geographic locations.

5. License State

This field displays the state in which the provider is providing services for the
taxonomy type/code.

2.3.5 VIEWING CHANGE HISTORY
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The Change History section displays a historical record of updates to provider information reported to CMS.
Updates to provider information through the CMS NPPES NPI registry are imported by SDMS as read-only on a
weekly basis. The change history section does not capture any updates made by PCOs.
The change history section captures the following types of changes:
•
•
•
•
•

New Providers
NPI Taxonomy Changes
NPI Address Changes
NPI Provider Deactivations
NPI Provider Reactivations

Figure 30: Provider Profile - Change History Section

Feature
1. Date

Description
This field displays the date and time the provider was updated.

2. Change

This field identifies the type of change imported. NPI Change Types include:
• New Providers
• NPI Taxonomy Changes
• NPI Address Changes
• NPI Provider Deactivations
• NPI Provider Reactivations

3. From

This field displays the original data before the CMS update. The purpose of
this field is to aid users in determining what changes have been made.

4. To

This field displays the new data after the CMS update. Users can compare
this data to the “From” column to determine what changes have been made.

2.3.6 ADDING AND VIEWING COMMENTS
The Comments section allows PCOs to publish comments to the Provider Profile to communicate important
information with other users. Comments will display with the PCO commenter, the date and time the comment
was published, and the comment text. Comments cannot be deleted once the “Publish Comment” button has been
clicked, and all system users can view published comments regardless of their assigned state or user role.

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Figure 31: Provider Profile - Comments Section

Feature
1. Comment

Description
This field displays published comments. If there are no comments, “There
are no comments for this provider” will display.

2. User

This field displays the email of the PCO who published the comment.

3. Date

This field displays the date and time the comment was published.

INSTRUCTIONS
To add a comment to a provider profile:
1.
2.

Enter comment in the text box
Select “Publish Comment”

A success message will display if the comment is saved by the system.

Figure 32: Success Banner after Entering a Comment

2.3.7 VIEWING REVISION HISTORY
Users can view previous versions of provider profiles and locations using the Revision History dropdown at the top
of a provider profile. Previous versions of the provider can be viewed by selecting a timestamp from the
dropdown. Users can see up to ten previous versions of the provider profiles and locations. The Revision History
drop down will default to Current, the most up to date version of the provider profile and location.

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Figure 33: Revision History Drop Down on Provider Profiles

INSTRUCTIONS
To view previous versions of provider profiles and locations:
1.
2.
3.

Navigate to a provider profile
Select an option from the Revision History drop down
The previous version of a provider profile and locations will display. A gray banner will appear on the top
of the page notifying users they are viewing a previous revision and not real-time provider data

To return to the current version of the provider profile, users can navigate back to the provider profile and select
‘Current’ from the Revision History drop down.

Figure 34: Viewing a Previous Revision of a Provider Profile

USER NOTES
•

When viewing previous versions, PCOs will not be able to add new locations, copy existing locations, or
make any updates, including attestation, to provider locations.
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2.4 VIEWING PROVIDER LOCATIONS
Users can click on the hyperlinked Address from the left navigation or Location section to navigate from the
Provider Profile to the Provider Location.
Provider Locations display additional information about the provider and the care provided at each unique practice
location. This information is editable by PCOs for locations in their assigned state or with a state code of Foreign
County (ZZ). For information on editing provider locations, see Section 2.5 Editing Provider Locations.

Figure 35: Provider Location

Feature

Description

1. First Name Last Name

This field displays the name of the provider.

2. Location Address and Provider
Location ID

This title displays the address of the provider location and the
system-generated Provider Location ID being viewed.

3. Left Navigation

This left navigation allows users to navigate between the Provider
Profile and Location pages.

4.
(View Supporting Details Toggle)

5. Last Updated By Banner

This toggle allows users to view additional supporting details for
each editable field on the location. For more information on
viewing supporting details, see Section 2.4.9 Viewing Supporting
Details.
This banner displays the last date and time the provider data was
updated by a user or the system (e.g., CMS NPEES NPI delta file
import). The format for display is: MM/DD/YYYY HH:MM AM/PM
(12-hour time). The last updated date and time will be captured
after the user makes an update through the search grid, location
page, or import tool. For more information on when last updated
times and dates are changed, see
Appendix B – Changes to Last Updated By .

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Provider Locations consist of the following sections:
•
•
•
•
•
•
•
•
•

Location Information
Needs Review
Full Time Equivalent (FTE) Calculations
Clinical Information and Populations Served Data
Employment Status
NHSC Program Information
Designations
Location Address and Geocoded Results
Attestation

2.4.1 VIEWING LOCATION INFORMATION
The Location Information section displays the eligibility status and other general information about the provider
location. From this section, users can also view additional data points related to the healthcare delivery site
associated with the provider location.

Figure 36: Provider Location - Location Information Section

Feature

Description

1. Location Status

This field displays the Status of the provider location. Statuses
include:
• Eligible
• Ineligible
If a provider location is eligible, that provider location may be
counted or otherwise used in the designation application process
and/or HPSA update for that state. If a provider location is
ineligible, that provider location will not be counted or otherwise
used in the designation process and/or HPSA update for that state.

2. Ineligible Reason

This field displays if the location has an ineligible status. If the
location is ineligible, this field shows the reason(s) it is ineligible.
Ineligible Reasons include:
• CMS Deactivated
• PCO Omitted
• Not Geocoded
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Feature

Description
•
•
•
•
•

Is Federal Provider
J1 Visa Waiver Holder
Is NHSC Employee
No Discipline / Specialty
New, Not Reviewed

For more information about ineligible reasons, see Appendix C –
Ineligible Reasons and PCO Omitted Reasons.
3. PCO Omitted Reason

This field displays if the location is ineligible with an ineligible
reason of “PCO Omitted”. If the location has been omitted by a
PCO, this field will display the selected reason code. This field will
only display if the location has an ineligible status. PCO Omitted
Reasons include:
• Admin Only
• Core Mental Health
• Deceased
• Duplicate Entry
• Faculty
• Incorrect Profession
• Inpatient Facility Only
• License Suspended by State / In Disciplinary Status by
State
• Locum Tenens / PRN
• Military Address
• Non-Fed Not Licensed in State
• Not a Service Delivery Site
• Not in Clinical Practices
• Not Public Access Facility
• Open-ended Long Term Leave
• Relocated
• Retired
• Specialist / Subspecialist
• Urgent Care Clinic
For more information about PCO Omitted reasons, see Appendix C
– Ineligible Reasons and PCO Omitted Reasons.

4. SDMS Activation Date

This field displays the date the provider location was activated. If
the location was added by a PCO using the “Add New Location”
button or the Import Tool, the SDMS Activation Date is populated
with the date the location was created. If the location was added
by the system through the weekly CMS NPPES NPI Delta File, the
SDMS Activation Date is populated when the “New, Not Reviewed”
ineligible reason is removed by the PCO.

5. Phone

This field displays the user-entered phone number for the provider
location. If no information has been entered for this field, a “—”
will display.

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Feature

Description

6. Fax

This field displays the user-entered fax number for the provider
location. If no information has been entered for this field, a “—”
will display.
This field displays the user-entered Organizational NPI for the
provider location. Organizational NPIs are unique 10-digit
numerical identifiers assigned to providers by the Center for
Medicare and Medicaid Services if they bill at the organization
level. If no information is available for this field, “N/A” will display.

7. Organizational NPI

8. Designation/Organization Name

This field displays the Designation/Organization Name for the
healthcare delivery site associated to the provider location. If the
provider location is associated to a Facility Designation, this field
will display the Designation Name. If the provider location is
associated to an Auto-HPSA, this field will display the Organization
Name. If no information has been entered for this field, a “—” will
display.

9. Site Name

This field displays the Site Name for the healthcare delivery site
associated to the provider location. This field will only be
populated if the healthcare delivery site is an Auto-HPSA. If no
information has been entered for this field, a “—” will display.

10. Designation ID

This field displays the Designation ID for the healthcare delivery
site associated to the provider location. If no information has been
entered for this field, a “—” will display.

11. Organization Unique ID

This field displays the Organization Unique ID for the healthcare
delivery site associated to the provider location. This field will only
be populated if the healthcare delivery site is an Auto-HPSA. If no
information has been entered for this field, a “—” will display.

12. Designation Status

This field displays the Designation Status for the healthcare
delivery site associated to the provider location. If no information
has been entered for this field, a “—” will display.

13. Site Type

This field displays the site type for the provider location. Site Types
options include:
• Federal Correctional Facility
• Federally Qualified Health Center (FQHC)
• Federally Qualified Health Center Look-Alike (LAL)
• Indian Health Service Clinic
• Tribal Clinic
• Urban Indian Clinic
• Inpatient Facility/Hospital
• Other Facility (OFAC)
• Rural Health Clinic
• State Correctional Facility
• State/County Mental Hospital (Mental Health only)
• Unknown
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Feature

Description
•
•

Veteran’s Facility
Youth Detention Center

Provider locations that have “Federal Correctional Facility,” “State Correctional Facility,” or “State/County Mental
Hospital” as their Site Type will not be usable for Geographic or Population HPSA designations. PCOs will still be
able to add these providers to Correctional Facility and State/County Mental Hospital Facility HPSA applications.

2.4.2 VIEWING NEEDS REVIEW FLAGS
The Needs Review section displays Needs Review flags indicating if there are one or more reasons a provider
location requires PCO review or action to be taken. This section will only appear if a Needs Review flag is present
on the provider location.

Figure 37: Provider Location - Needs Review Section

PCOs will be able to see flags on all provider locations within SDMS but can only take action on provider locations
in their state. For more information on addressing Needs Review flags, see Section 2.5.5 Addressing Needs Review
Flags.

2.4.3 VIEWING FTE CALCULATIONS
The Full Time Equivalent (FTE) Calculations section displays the FTE values calculated based on the number of
direct tours or percent of time spent serving each population at this provider location. The calculations are
dynamic, with values updating after PCOs edit and save changes for fields that impact FTE calculations. All FTE
values displayed in this section are read-only. For more information on how FTE values are calculated and the
fields used, see the Manual for Policies and Procedures.

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Figure 38: Provider Location - FTE Calculations Section

Provider Locations with the Obstetrics and Gynecology or Certified Nurse Midwife Specialty will show FTE
Calculations for both Primary Care HPSAs and Maternity Care Target Areas.

Figure 39: Provider Location - FTE Calculations Table for OBGYNs and CNMs

2.4.4 VIEWING CLINICAL INFORMATION AND POPULATIONS SERVED DATA
The Clinical Information and Populations Served Data section displays information about the services provided and
the special populations served at this location.
Updates made to the fields in the Clinical Information section will impact a provider’s FTE. For more information on
how clinical information and population served data affect FTE calculations, see the Manual for Policies and
Procedures.
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Figure 40: Provider Location - Clinical Information Section

Feature
1. Discipline

Description
This field displays the discipline of the provider associated with the provider
location. Discipline options include:
• Primary Care
• Mental Health
• Dental Health
The assigned discipline will determine if additional fields are displayed on
the location record:
• If Dental Health discipline, Dental Auxiliaries field will appear in the
Clinical Information section
• If Mental Health discipline, State/County Mental Hospital selection
will appear as an option in the Site Type section
The system will automatically populate Discipline and Specialty for new
location records if the provider has a primary taxonomy that is active. For
more information about how Disciplines and Specialties are mapped to
different taxonomies, see the Manual for Policies and Procedures.
If there is no eligible primary taxonomy, the system will populate the
Discipline and Specialty based on the default provider location.

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Feature
2. Specialty

Description
This field displays the specialty of the provider associated with the provider
location. The assigned discipline will determine which specialty options are
available for the location. Specialty options include:
• If Primary Care discipline:
o Certified Nurse Midwife
o Family Practice
o General Practitioner
o Internal Medicine
o Obstetrics and Gynecology
o Pediatrics
• If Mental Health discipline:
o Psychiatrist
o Clinical Psychologist
o Clinical Social Worker
o Psychiatric Nurse Specialist
o Marriage and Family
• If Dental Health discipline:
o Dentist

3. Direct Tour Hours

This field displays the amount of time the provider spends providing care at
the location. When a new location is created, the Direct Tour Hours will
automatically default to 40 hours, and Geographic HPSA will be 1 in the FTE
Calculations.

4. Dental Auxiliaries

This field displays the number of Dental Auxiliary staff for the provider
location. This field only displays for provider locations with a Dental Health
discipline. Dental Auxiliaries options include:
• Unknown
• 0
• 1
• 2
• 3
• 4 or more
The “Auxiliary Weight” when calculating the FTE for a Dental Health provider
is determined by the Dentist’s Age and Auxiliary Number entered. The
system will not count dental auxiliaries when calculating FTEs based on
Medicaid claims. For more information on how dental auxiliaries affect
provider FTEs, see the Manual for Policies and Procedures.

5. Annual Medicaid Claims

This field displays the number of Medicaid Claims made by the provider at
this location.

6. Medicaid Patient %

This field displays the percentage of time the provider serves Medicaid
patients at this location.

7. Sliding Fee Scale %

This field displays the percentage of time the provider serves Sliding Fee
Scale patients at this location.

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Feature
8. American Indian/Alaska
Native %

Description
This field displays the percentage of time the provider serves American
Indian/Alaska Native patients at this location.

9. Homeless %

This field displays the percentage of time the provider serves Homeless
patients at this location.

10. Migrant Farmworker %

This field displays the percentage of time the provider serves Migrant
Farmworker patients at this location.

11. Migrant Seasonal
Farmworker %

This field displays the percentage of time the provider serves Migrant
Seasonal Farmworker patients at this location.

2.4.5 VIEWING EMPLOYMENT STATUS
The Employment Status section displays information about the provider that may impact a provider’s eligibility
status and FTE calculations.

Figure 41: Provider Location - Employment Status Section

Employment Status
1. Intern or Resident?

Description
This field displays an indicator if the provider is an Intern or Resident at the
provider location. Intern or Resident? options include:
• Yes
• No

2. J1 Visa Waiver Holder?

This field displays an indicator if the provider is a J1 Visa Waiver Holder at
the provider location. J1 Visa Waiver Holder? options include:
• Yes
• No

3. Federal Provider?

This field displays an indicator if the provider is Federal Provider at the
provider location. Federal Provider? options include:
• Yes
• No

4. NHSC Provider?

This field displays an indicator if the provider if a NHSC Provider at the
provider location. NHSC Provider? options include:
• Yes
• No
If the provider is an active NHSC participant, all provider locations for the
provider will automatically be marked as Ineligible with an ineligible reason
of “Is NHSC Employee.” The system will indicate if the provider is a NHSC
Provider based on data sourced from BMISS and will display as read-only.
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2.4.5A VIEWING NHSC PROGRAM INFORMATION
The NHSC Program Information section displays details about the NHSC program status of a provider that could
impact a provider’s eligibility status. This section will only appear if a provider has been enrolled in an NHSC
program. The data displayed is imported from BMISS and is read-only.

Figure 42: Provider Location - NHSC Program Information Section

Feature
1. Program Name

Description
This field displays the name of the NHSC program the provider is enrolled in.

2. Program Status

This field displays if the providers is an active NHSC participant. All locations
for an active NHSC participant will be considered Ineligible with an ineligible
reason of “Is NHSC Employee”

3. Contract Type

This field displays the type of NHSC contract the provider is enrolled in.
Contract types include:
• Full Time
• Part Time

4. Contract Start Date

This field displays the date the provider started their NHSC service.

5. Contract End Date

This field displays the date the provider finished their NHSC service.

2.4.6 VIEWING DESIGNATIONS
The Designations section displays any designations where the provider location was included in the Rational
Service Area or chosen as the Nearest Source of Care. The designations listed in the tables could include
Geographic and Population HPSAs, MUA/Ps, or AutoHPSAs.

Figure 43: Provider Location – Designations Section

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Feature
1. Designation ID / Organization
Unique ID

Description
This column will list the Designation ID for a Geo/Pop HPSA and
MUA/P and the Organization Unique ID for an AutoHPSA. Selecting
this link will take the user to the corresponding designation or
organization profile.

2. Designation Name

This column will list the Designation Name for a Geo/Pop HPSA or
an MUA/P and the Organization Name for an AutoHPSA.

3. Designation Type

This column will list the Designation Type. Options include:
• Geographic HPSA
• Population HPSA
• MUA/P
• AutoHPSA

4. Designation Option

This column will list the Designation Option.

5. Status

This column will list the status of the designation and will update
in real-time if the designation status changes.

6. Save Date

This column will list the date the RSA or the NSC was saved. Any
changes to the provider data made after this date will not be
reflected in the designation score or data.

7. Designation Date

This column will list when the Designation was approved by SDB
and officially designated.
This column will list the name of the AutoHPSA site where the
provider location was listed as the Nearest Source of Care.

8. Site Name

2.4.7 VIEWING LOCATION ADDRESS AND GEOCODED RESULTS
The Location Address and Geocoded Results section displays the provider location’s address and geographical
information returned by the HDW geocoding service.

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Figure 44: Provider Location - Location Address Section

Feature
1. Physical Address

Description
These fields display the physical address line information for the provider
location.
If the location was added by a PCO using the “Add New Location” button or
the Import Tool, these fields will display the user-entered address
information. If the location was added by the system through the weekly
CMS NPPES NPI Delta File, these fields will display the provider’s NPI Primary
Address information.

2. Standardized Address

These fields display the standardized address for the provider location
returned by the HDW geocoding service.
Standardized addresses will not display for locations that are manually
geocoded (Match level = 0 – User Override) or that have not been geocoded.

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Feature
3.
(Display Address)

4. Address Successfully
Geocoded?

Description
This tag shows the address that is used across the Provider Management
Portal. The display address appears in the following places:
• Title of Provider Location
• Left Hand Navigation
• Location Summary Section on Provider Profiles
• Provider Search Results
• Provider Downloaded Reports
This field displays an indicator if the system has geocoded the provider
location successfully. Address Successfully Geocoded? options include:
• Yes
• No
Provider locations that have not been geocoded successfully will be
Ineligible with a reason of “Not Geocoded.”

5. Match Level

This field displays the confidence level with which this address has been
geocoded by the HDW geocoding service. The location is considered
successfully geocoded if it has a match level of 3 or lower. Match Levels
include:
• 00 – User override
• 01 – Address point / Point Address
• 02 – Interpolated street address
• 03 – Zip code extended
• 04 – Street name / segment
• 05 – Zip code
• 06 – Place name
• 07 – State
• 99 – Ungeocoded

6. Latitude

This field displays the latitude coordinate of the provider location. The
Latitude will be prepopulated by the system based on the results of the
HDW geocoding service.
PCOs can override the system-generated latitude and longitude. For more
information on how to regeocode a provider location, see Section 2.5.2B ReGeocoding Provider Locations.

7. Longitude

This field displays the longitude coordinate of the provider location. The
Longitude will be prepopulated by the system based on the results of the
HDW geocoding service.
PCOs can override the system-generated latitude and longitude. For more
information on how to regeocode a provider location, see Section 2.5.2B ReGeocoding Provider Locations.

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Feature
8. County Name, FIPS

Description
This field displays the County Name and FIPS of the provider location. This
field will be prepopulated by the system based on the results of the HDW
geocoding service.

9. State, FIPS

This field displays the State and FIPS of the provider location. This field will
be prepopulated by the system based on the results of the HDW geocoding
service.

10. CSD FIPS

This field displays the CSD FIPS of the provider location. This field will be
prepopulated by the system based on the results of the HDW geocoding
service.

11. Census Tract

This field displays the Census Tract of the provider location. This field will be
prepopulated by the system based on the results of the HDW geocoding
service.

12. ZCTA Public ID

This field displays the ZCTA Public ID of the provider location. This field will
be prepopulated by the system based on the results of the HDW geocoding
service.

13. Address Map

This map displays a visual representation of the provider location. This view
is based on the results of the HDW geocoding service or PCO entered
latitude and longitude. If a location has a match level of 99 or N/A, the
address map will not display on the provider location.

USER NOTES
•

Locations that are created by the CMS-NPPES Delta File or by the Provider Import File are geocoded on an
hourly basis. Before they are picked up by the SDMS Batch Geocoding process, these locations will not
have a Standardized Address, Match Level, or any other Geocoded Results. PCOs do not have to take any
action for the system to geocode these locations.

2.4.8 VIEWING CLINICIAN DATA ATTESTATION
This section displays details of the provider location’s attestation status including when the location was last
attested to and the PCO who completed attestation.

Figure 45: Provider Location - Attestation Banner

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Feature
1. Attestation Banner

Description
This banner displays details of the last attestation. The banner will display
the email of the PCO who last attested to the provider location and the date
and time the attestation was completed. If the location was attested to using
the Import Tool, the banner will display the email of the PCO who uploaded
the import file and the date and time the bulk upload was processed by the
system.
If the provider location has not been attested to, no banner will display.

2.
(Attest Provider Location)

This button allows PCOs to complete their provider location attestations. For
information on how to attest to the data in a provider location, see Section
2.5.2C Attesting Provider Locations.

2.4.9 VIEWING SUPPORTING DETAILS
This toggle controls the display of additional details for editable fields on provider locations. Users can expand or
collapse these additional details by selecting the “View Supporting Details” toggle at the top of a provider location.
When selected, the “View Supporting Details” toggle will expand the following supporting details fields to provide
additional details regarding the provider data point and its last updated by information:
•
•
•
•

Last Updated Date
Last Updated By
Data Source Name
Data Source Date

Figure 46: Provider Location with Supporting Details Displayed

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Feature
1. Last Updated Date

Description
This field displays the date and time when the editable field was last
updated.

2. Last Updated By

This field displays the email of the PCO who last updated the editable field. If
an editable field was automatically set by SDMS, a “System” or “NPPESImport” user tag will display.

3. Data Source Name

This field displays the short, descriptive name assigned to the provider data
source selected by the PCO for this editable field.

4. Data Source Date

This field displays the published date assigned to the provider data source
selected by the PCO for this editable field.

Users can view supporting details for the following editable fields on a provider location:
•
•
•
•
•
•
•
•
•
•
•
•

PCO Omitted Reason
Organizational NPI
Designation/Organization Name
Site Name
Designation ID
Organization Unique ID
Designation Status
Site Type
Discipline
Specialty
Dental Auxiliaries
Direct Tour Hours

•
•
•
•
•
•
•
•
•
•
•

Annual Medicaid Claims
Medicaid Patient %
Sliding Fee Scale
American Indian/Alaska Native %
Homeless %
Migrant Farmworker %
Migrant Seasonal Farmworker %
Intern or Resident?
J1 Visa Waiver Holder?
Federal Provider?
Physical Address Line Fields

If a location was last updated prior to March 20, 2021, the supporting details fields will display without any data.

Figure 47: Clinical Information Section on Provider Location with Blank Supporting Details

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USER NOTES
•

•

Address Line Fields (Address Line 1, Address Line 2, City, State, and Postal Code) cannot be updated after
a location is created, and their supporting details will not change. For locations imported by the weekly
CMS NPPES NPI Delta File, the Last Update By field will display NPPES-import. For user created locations,
the Last Updated By field will display the PCO’s username.
When viewing previous revisions of a provider location, users can see the Supporting Details for any
revision after November 18, 2023.

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2.5 EDITING PROVIDER LOCATIONS
On the Provider Profile and Location pages, PCOs can take various actions to edit provider data including adding
new locations, updating locations, and omitting locations. PCOs can only edit locations in their assigned state or
with a state code of Foreign County (ZZ). PCOs can view Provider Locations across all states and territories but will
not be able to edit.

2.5.1 ADDING PROVIDER LOCATIONS
On the Provider Profile, PCOs can add new location addresses to any provider in SDMS, even if the provider does
not already have a location in their state.

Figure 48: Provider Profile – Add New Location Button

INSTRUCTIONS
To add a new location address:
1.
2.
3.
4.

Select the “Add New Location” button in the Location Summaries section of the Provider Profile
Input the “Address Line 1,” “Address Line 2”, “City,” and “Postal Code” information for the new location
Update the Discipline and Specialty as necessary
Click “Continue”

Figure 49: Add New Location Modal - Address Information Step

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5.
6.

Review the geocoded information for the provider location. The location must be successfully geocoded
(match level of 3 or lower) before it can be created. For more information on how to geocode a provider
location, see Section 2.5.5C Re-geocode Provider Location
Click “Continue”

Figure 50: Add New Location Modal - Geocode Review Step

7.

8.

Select a site association for a provider location
a. To select a site association, PCOs can choose one of the suggested site associations based on a
table of system-generated potential site options. The system will list AutoHPSA sites and Facility
Designations that have the same discipline as the provider location and are within one mile of
the provider location. Choose the correct site by clicking on the radio button next to the desired
healthcare delivery site.
b. If the PCO does not see the expected site association, they can manually search for an AutoHPSA
site or Facility Designation by selecting the Search for Matching Organization button. Selecting
the button will allow PCOs to search for a site association by Designation/Organization Name,
Designation ID, or Organization Unique ID. Choose the correct site by clicking on the radio
button next to the desired healthcare delivery site. The search criteria will appear automatically
if no AutoHPSA sites or Facility Designations are found within a one-mile radius of the provider
location.
c. PCOs can continue without a site association by selecting the “Skip” button next to the continue
button
Click “Continue”

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Figure 51: Add New Location – Site Association Step

9.

Confirm the display address for the provider location. The display address will be defaulted to the
standardized address unless the location has been manually geocoded by the PCO
10. Review the information related to the new provider location. To fix any errors, use the “Back” button to
navigate to the correct screen and make any necessary changes
11. Click “Save”

Figure 52: Add New Location Modal - Review Location Step

Upon saving, PCOs will be redirected to the new provider location and can update other information about the
provider as needed. The system will automatically set certain fields to default values. However PCOs can override
default values at any time. For more information on which data fields are set automatically by the system, see
Appendix A – Editable Provider Data Fields.
For more information on how to update data in an existing provider location, see Section 2.5.2 Updating Provider
Locations.
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A provider location cannot be deleted once it has been created. To remove the address fully from FTE Calculations,
PCOs can omit the address. For more information on how to omit a provider location, see Section 2.5.4 Omitting
Provider Locations.
In the case of a typo or other user error, the user can change the display address to use the standardized address.
For more information on setting the display address, see Section 2.5.2A Changing the Display Address for Provider
Locations. If changing the display address does not correct the error in the address fields, the location will need to
be omitted, and a new location will have to be created. For more information about copying existing provider
locations, see Section 2.5.1A Copying Provider Locations.

USER NOTES
•

SDMS does not calculate primary care FTEs when only office hours are known. It is the responsibility of
the user to enter the correct tour hours (adjusted or otherwise) into SDMS. See Section IV of the Manual
for Policies and Procedures for more detail.

2.5.1A COPYING PROVIDER LOCATIONS
This button will generate a copy of the existing provider location selected. PCOs can only copy addresses in their
assigned state.
The address of a location cannot be updated once created. If changing the display address for the provider location
does not address any concerns with the address line fields, PCOs should copy the location, fix any incorrect
information in the address fields, and then omit the original location with a PCO Omitted Reason of “Duplicate.”
For more information on how to omit a provider location, see Section 2.5.4 Omitting Provider Locations.

Figure 53: Copy Address Button on Provider Profile

INSTRUCTIONS
To copy an existing location:
1.
2.
3.
4.

Select the “Copy Location” button next to the desired location in the Location Summaries section of the
Provider Profile
Update the address information as necessary
Update the Discipline and Specialty as necessary
Click “Continue”

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Figure 54: Copy Location Modal - Address Information Step

5.
6.

Review the geocoded information for the provider location. The location must be geocoded before it can
be created. For more information on how to geocode a provider location, see Section 2.5.5C Re-geocode
Provider Location
Click “Continue”

Figure 55: Copy Location Modal - Geocode Review Step

7.

Select a site association for a provider location
a. To select a site association, PCOs can choose one of the suggested site associations based on a
table of system-generated potential site options. The system will list AutoHPSA sites and Facility
Designations that have the same discipline as the provider location and are within one mile of
the provider location. Choose the correct site by clicking on the radio button next to the desired
healthcare delivery site.

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b.

8.

If the PCO does not see the expected site association, they can manually search for an AutoHPSA
site or Facility Designation by selecting the Search for Matching Organization button. Selecting
the button will allow PCOs to search for a site association by Designation/Organization Name,
Designation ID, or Organization Unique ID. Choose the correct site by clicking on the radio button
next to the desired healthcare delivery site. The search criteria will appear automatically if no
AutoHPSA sites or Facility Designations are found within a one-mile radius of the provider
location.
c. PCOs can continue without a site association by selecting the “Skip” button next to the continue
button
Click “Continue”

Figure 56: Copy Location Modal – Site Association Step

9.

Confirm the display address for the provider location. The display address will be defaulted to the
standardized address unless the location has been manually geocoded by the PCO
10. Review the information related to the new provider location. To fix any errors, use the “Back” button to
navigate to the correct screen and make any necessary changes
11. Click “Save”

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Figure 57: Copy Location Modal - Review Location Step

Upon saving, PCOs will be redirected to the new provider location and can update other information about the
provider as needed. All data in the copied provider location will be carried over to the new provider location
including any system default values or PCO-entered values from the original location. For more information on
how to update data in an existing provider location, see Section 2.5.2 Updating Provider Locations.

2.5.2 UPDATING PROVIDER LOCATIONS
PCOs can update provider locations by selecting the “Edit” button in the top right corner of each section of the
location.

Figure 58: Editing Provider Locations

INSTRUCTIONS
To update data in an existing provider location:
1.
2.

Select the “Edit” button in the top right corner of the desired section
Update the necessary information in the Edit Pop-up
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3.
4.

Select the data source that supports this update (optional)
Select the “Save” button

Figure 59: Edit Clinical Information Pop-Up

Users can edit the following information on a provider location:
•
•
•
•
•
•
•
•
•
•
•
•

PCO Omitted Reason
Phone and Fax Number
Organizational NPI
Site Type
Discipline
Specialty
Direct Tour Hours
Dental Auxiliaries (If Dental Health provider)
Clinical Information and Populations Served Data (e.g. Annual Medicaid Claims)
Employment Status (e.g., Intern or Resident?)
Display Address
Latitude and Longitude

For more information about the fields that can be edited, see Appendix A – Editable Provider Data Fields.

2.5.2A CHANGING THE DISPLAY ADDRESS FOR PROVIDER LOCATIONS
PCOs can change the display address between the physical address and standardized address by selecting the
“Edit” button in the top right hand corner of the Location Address and Geocoded Results section.

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Ima
Figure 60: Editing the Location Address and Geocoded Results Section on Provider Locations

INSTRUCTIONS
To set the display address for an existing location:
1.
2.
3.

Select “Edit” in the Location Address section of a provider location
Select the radio button next to the desired display address
Select the “Save” button

Figure 61: Edit Location Address Pop-Up

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If the location has been manually geocoded or if the location has an unacceptable match level (4 or greater), the
Standardized Address option will be disabled. The display address can only be set to the Physical Address.

2.5.2B RE-GEOCODING PROVIDER LOCATIONS
PCOs can update the geocoding of a provider location by selecting the “Edit” button in the top right hand corner of
the Location Address and Geocoded Results section. Re-geocoding a provider location could change the
standardized address.

Figure 62: Editing the Location Address and Geocoded Results Section on Provider Locations

INSTRUCTIONS
To initiate the system geocoding process:
1.
2.
3.

Select “Edit” in the Location Address section of a provider location
Delete the existing latitude and longitude
Select the “Save” button.

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Figure 63: Edit Location Address Pop-Up

If the system is unable to geocode the record, PCOs can manually geocode the location by manually dragging the
map on the pin or entering the exact latitude and longitude for the provider location. Locations that have been
manually geocoded will receive a match level of “0 – User Override.” When a location is manually geocoded, the
location will no longer have a standardized address, and the display address will be set to the Physical Address.

INSTRUCTIONS
To manually geocode provider locations:
1.
2.
3.

Select “Edit” in the Location Address section of a provider location
Manually drag the pin on the map or enter coordinates in the “Latitude” and “Longitude” fields
Select the “Save” button

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Figure 64: Provider Location that has been Manually Geocoded

2.5.2C ATTESTING PROVIDER LOCATIONS
PCOs can attest to the data in a provider location by selecting the “Attest this Location” button at the bottom of
the provider location.

Figure 65: Attesting Provider Locations

INSTRUCTIONS
To attest a provider location:
1.
2.
3.

Select the “Attest Provider Location” button
Select the checkbox
Select the “Confirm” button

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Figure 66: Provider Attestation Pop-Up

Once the data in provider location has been attested to, a banner will display with information on who last
attested to the location and when the attestation occurred.

2.5.3 MANAGING SITE ASSOCIATIONS
PCOs can associate a provider location to a healthcare delivery site in the Location Information Section. Healthcare
delivery sites are limited to locations that already exist in SDMS: Auto-HPSA Organizations and Facility
Designations.

2.5.3A INITIATING SITE ASSOCAITIONS
PCOs can add a new site association to a provider location by selecting the “Initiate Site Association” button in the
top right hand corner of the Location Information section.

Figure 67: Initiating a Site Association from the Location Information Section on Provider Locations

INSTRUCTIONS
To initiate a site association:
1.
2.

Select “Initiate Site Association” in the Location Information section of a provider location
To select a site association
a. To select a site association, PCOs can choose one of the suggested site associations based on a
table of system-generated potential site options. The system will list AutoHPSA sites and Facility
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3.
4.

Designations that have the same discipline as the provider location and are within one mile of
the provider location. Choose the correct site by clicking on the radio button next to the desired
healthcare delivery site.
b. If the PCO does not see the expected site association, they can manually search for an AutoHPSA
site or Facility Designation by selecting the Search for Matching Organization button. Selecting
the button will allow PCOs to search for a site association by Designation/Organization Name,
Designation ID, or Organization Unique ID. Choose the correct site by clicking on the radio button
next to the desired healthcare delivery site.
Select the radio button next to the desired site association
Select the “Save” button

Figure 68: Initiate Site Association Modal

After saving the site association, the system will populate the following fields in the Location Information section
based on the chosen site: Designation/Organization Name, Site Name, Designation ID, Organization Unique ID,
Designation Status, and Site Type. PCOs can override the defaulted Site Type for a provider location using the Edit
Location Information modal. For more information on editing existing provider locations, see Section 2.5.2
Updating Provider Locations.

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USER NOTE
•

•

The system will automatically show the manual search criteria for a site association if the system is unable
to find an AutoHPSA site or Facility Designation within a one-mile radius of the provider location (see
Figure 69: Searching for a Site Association When the System Does Not Display System Suggestions).
The system cannot find system suggested site associations for locations that have been unsuccessfully
geocoded (match level of 4 or greater). PCOs can search for a site association or manually geocoded the
location to generate the list of system suggestions. For additional information on manually geocoding a
provider location, see Section 2.5.2B Re-Geocoding Provider Locations.

Figure 69: Searching for a Site Association When the System Does Not Display System Suggestions

2.5.3B REPLACING EXISTING SITE ASSOCAITIONS
PCOs can change the site association of a provider location by selecting the “Manage” button in the top right hand
corner of the Location Information section.

Figure 70: Managing a Site Association from the Location Information Section on Provider Locations

INSTRUCTIONS
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To replace a site association:
1.
2.
3.

4.
5.

Select “Manage Site Association” in the Location Information section of a provider location
Select the “Replace Site Association” radio button
To select a site association
a. To select a site association, PCOs can choose one of the suggested site associations based on a
table of system-generated potential site options. The system will list AutoHPSA sites and Facility
Designations that have the same discipline as the provider location and are within one mile of
the provider location. Choose the correct site by clicking on the radio button next to the desired
healthcare delivery site.
b. If the PCO does not see the expected site association, they can manually search for an AutoHPSA
site or Facility Designation by selecting the Search for Matching Organization button. Selecting
the button will allow PCOs to search for a site association by Designation/Organization Name,
Designation ID, or Organization Unique ID. Choose the correct site by clicking on the radio button
next to the desired healthcare delivery site.
Select the radio button next to the desired display address
Select the “Save” button

Figure 71: Replacing a Site Association in the Manage Site Association Modal with System Suggestions

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After saving the site association, the system will update the following fields in the Location Information section
based on the chosen site: Designation/Organization Name, Site Name, Designation ID, Organization Unique ID,
Designation Status, and Site Type.

USER NOTE
•

•

The system will automatically the manual search criteria for a site association if the system is unable to
find an AutoHPSA site or Facility Designation within a one-mile radius of the provider location (see Figure
72: Searching for a Site Association When the System Does Not Display System Suggestions).
The system cannot find system suggested site associations for locations that have been unsuccessfully
geocoded (match level of 4 or greater). PCOs can search for a site association or manually geocoded the
location to generate the list of system suggestions. For additional information on manually geocoding a
provider location, see Section 2.5.2B Re-Geocoding Provider Locations.

Figure 72: Searching for a Site Association When the System Does Not Display System Suggestions

2.5.3C REMOVING EXISTING SITE ASSOCIATIONS
PCOs can remove the site association of a provider location by selecting the “Manage” button in the top right-hand
corner of the Location Information section.

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Figure 73: Managing a Site Association from the Location Information Section on Provider Locations

INSTRUCTIONS
To remove a site association:
1.
2.
3.

Select “Manage Site Association” in the Location Information section of a provider location
Select the “Remove Site Association” radio button
Select the “Save” button

Figure 74: Removing a Site Association in the Manage Site Association Modal

Upon save, the system will remove the following fields in the Location Information section based on the chosen
site: Designation/Organization Name, Site Name, Designation ID, Organization Unique ID, and Designation Status.
The Site Type will not be removed from the provider location. PCOs can remove the Site Type using the Edit
Location Information modal.

2.5.4 OMITTING PROVIDER LOCATIONS
A PCO may omit a provider location at any time by selecting a “PCO Omitted Reason.”

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Figure 75: Location Information Section for an Ineligible Provider Location

INSTRUCTIONS
To omit a provider location:
1.
2.
3.
4.

Select the Edit button in the Location Information section
Select a “PCO Omitted Reason” from the drop-down menu
Select the data source that supports this omission (optional)
Click the “Save” button at the bottom of the modal

Figure 76: PCO Omitted Reason Field in the Edit Location Information Pop-up

For more information on specific PCO Omitted Reasons, see Appendix C – Ineligible Reasons and PCO Omitted
Reasons.
PCOs can remove a PCO Omitted Reason at any time. If there is more than one ineligible reason, the location will
remain ineligible until all the ineligible reasons have been addressed.

INSTRUCTIONS
To remove a PCO Omitted Reason:
1.
2.
3.

Select the Edit button in the Location Information section
Select the “x” in the PCO Omitted Reason drop-down (see Figure 77: Removing a PCO Omitted Reason)
Select the data source file that supports making this location eligible (optional)
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4.

Click the “Save” button at the bottom of the modal

Figure 77: Removing a PCO Omitted Reason

2.5.5 ADDRESSING NEEDS REVIEW FLAGS
PCOs can clear Needs Review flags on provider locations by selecting the hyperlinked text indicating what action
needs to be taken to resolve the flag.
The following flags can appear on provider locations:
•
•
•
•
•
•
•
•

Complete Annual Provider Location Attestation
Review Direct Tour Hours Greater Than 40
Re-geocode Provider Location
Review New Provider Location
Review State Geocoded Mismatch
Review Foreign Country Location
Review New NPI Primary Address
Review Primary Taxonomy Change

Figure 78: Needs Review Section on Provider Locations

INSTRUCTIONS
To address a Needs Review flag:

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1.
2.

Click the hyperlinked text next to the Needs Review Flag
Complete the suggested action in the selected Needs Review pop-up modal

2.5.5A COMPLETE ANNUAL PROVIDER LOCATION ATTESTATION
The provider location has not been attested to in the last 12 months. For new provider locations, this flag
will first appear 12 months after its SDMS Activation Date. Provider locations must also have a status of
‘Eligible’ for one year before this flag will appear. This flag will not apply to provider locations that are
ineligible for any reason or locations with the state code Foreign Country (ZZ).

Figure 79: Needs Review Section on Provider Locations

This flag can be resolved by completing the provider location attestation. Selecting the hyperlinked text for this
Needs Review flag will open the Attest Provider Location pop-up modal. For more information on attesting to
provider locations, see Section 2.5.2C Attesting Provider Locations.

2.5.5B REVIEW DIRECT TOUR HOURS GREATER THAN 40
The total sum of direct tour hours across the provider’s eligible locations are greater than 40. This flag will
be present if a single eligible location has greater than 40 direct tour hours or if a provider has multiple
locations whose total sum of direct tour hours are greater than 40. This flag will not apply to provider
locations that are ineligible for any reason or locations with the state code Foreign Country (ZZ).

Figure 80: Review Tour Hours Greater Than 40 Flag

This flag can be resolved in two ways:
1.
2.

Confirming the data is correct in the Review Direct Tour Hours pop-up modal (see Figure 81). Selecting the
hyperlinked text for this Needs Review flag will open the Review Direct Tour Hours pop-up modal.
Adjusting the tour hours or eligibility of the provider’s locations so the total sum of direct tour hours of
eligible locations are 40 hours or less.

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In the Review Direct Tour Hours pop-up modal, PCOs will be able to view a list of the provider’s eligible
locations and each location’s direct tour hours. Selecting the location address will navigate the PCO to the
chosen provider location where any needed updates can be made.

Figure 81: Review Direct Tour Hours Pop-Up Modal

If the PCO clears the flag by confirming the data in the Review Direct Tour Hours pop-up modal, the flag will
need to be individually cleared from each impacted provider location. If the flag is cleared using this
method, the flag will be re-thrown in 12 months if the direct tour hours across a provider’s eligible locations
remain greater than 40.
Adjusting the tour hours and eligibility of provider locations will automatically clear the flag from all
impacted locations once the total sum of Direct Tour Hours are no longer greater than 40.

USER NOTES
•

The Confirm button will not be enabled until the checkbox indicating the data has been reviewed is
selected.

2.5.5C RE-GEOCODE PROVIDER LOCATION
The provider location has a “Not Geocoded” ineligible reason due to a HDW geocoding match level of 4 or
greater. This flag will not apply to provider locations that have been deactivated by CMS (Ineligible Reason
of “CMS Deactivated”), locations that do not have a discipline or specialty (Ineligible Reason of “No
Discipline/Specialty), locations that have been omitted by a PCO (Ineligible Reason of “PCO Omitted”), or
locations with a state code of Foreign Country (ZZ).

Figure 82: Re-geocode Provider Location Flag

This flag can be resolved by re-geocoding the provider location and receiving an acceptable match level (3 or
lower). Selecting the hyperlinked text next to this flag will open the Edit Location Address pop-up modal. For
more information on re-geocoding provider locations, see Section 2.5.2B Re-Geocoding Provider Locations.

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If the system cannot geocode the provider location and the latitude and longitude is unknown, PCOs will need to
omit the existing provider location using the “Duplicate” PCO Omitted Reason and create a new location with the
correct address. For more information on omitting a provider location, see Section 2.5.4 Omitting Provider
Locations. For more information on adding new provider locations, see Section 2.5.1 Adding Provider Locations.

2.5.5D REVIEW NEW PROVIDER LOCATION
The provider location has recently been imported by CMS through the CMS-NPPES Delta file and has a “New, Not
Reviewed” ineligible reason. Provider locations receive the “New, Not Reviewed” ineligible reason when the
provider location was imported into SDMS from CMS but has not been reviewed and/or updated by the PCO. This
flag will not apply to locations that have been deactivated by CMS (Ineligible Reason of “CMS Deactivated”),
locations that do not have a discipline or specialty (Ineligible Reason of “No Discipline/Specialty), or
locations with a state code of Foreign Country (ZZ).

Figure 83: Review New Provider Location Flag

This flag can be removed in several ways:
1.

2.

3.

If data needs to be updated in the provider location, PCOs can remove the “New, Not Reviewed” Ineligible
Reason by:
a. Updating any data point using the pop-up edit modals in any section on a provider location. For
more information on updating provider locations using the pop-up edit modals, see Section 2.5.2
Updating Provider Locations.
b. Updating any data point on the Search Grid. For more information on editing provider locations
using the Provider Search Results Grid, see Section 2.2.4 Editing Provider Locations in the Search
Results Grid.
If no data needs to be changed, PCOs can remove the “New, Not Reviewed” Ineligible Reason by:
a. Confirming the data is correct in the Review Provider Location pop-up modal (see Figure 84).
Selecting the hyperlinked text for this Needs Review flag will open the Review New Provider
Location pop-up modal
b. Attesting to the data in the provider location. For more information on attesting to a provider
location, see Section 2.5.2C Attesting Provider Locations.
The “New, Not Reviewed” Ineligible Reason can be removed in bulk using the “Update” action on an
import file. No additional data needs to be changed for the Ineligible Reason to be removed. For more
information on updating existing provider locations using the Provider Import Tool, see Section 2.6.3C
Updating an Existing Provider Location.

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Figure 84: Review New Provider Location Pop-Up Modal

If the New Provider Location flag is present on a provider location for six months, the location does not have the
Certified Nurse Midwife specialty, and no action has been taken by a PCO, the system will automatically remove
the “New, Not Reviewed” ineligible reason and populate the SDMS Activation Date. If no other ineligible reason is
present, the location will become eligible. For locations with the Certified Nurse Midwife specialty, the system will
automatically remove the “New, Not Reviewed” ineligible reason and populate the SDMS Activation Date after one
year.

USER NOTES
•

The Confirm button will not be enabled until the checkbox indicating the data has been reviewed is
selected.

2.5.5E REVIEW STATE GEOCODED MISMATCH
The provider location’s location address state and geocoded state are not the same. The location address state is
the state reported by the provider to CMS or added by PCOs. The geocoded address state is returned by HDW
when the provider location is geocoded. This flag will not apply to provider locations that have been
deactivated by CMS (Ineligible Reason of “CMS Deactivated”), locations that do not have a discipline or
specialty (Ineligible Reason of “No Discipline/Specialty), locations that have been omitted by a PCO
(Ineligible Reason of “PCO Omitted”), or locations with a state code of Foreign Country (ZZ).

Figure 85: Review State Geocoded Mismatch Flag

If the location address state is incorrect, this flag can be resolved by changing the display address for the provider
location. For more information on changing the display address of a provider location, see Section 2.5.2A Changing
the Display Address for Provider Locations. For more information on omitting provider locations, see Section 2.5.4
Omitting Provider Locations.

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If the geocoded address state is incorrect, this flag can be resolved by re-geocoding the provider location so the
location address state and geocoded state match. For more information on geocoding provider locations, see
Section 2.5.2B Re-Geocoding Provider Locations.

Figure 86: Review State Geocoded Mismatch Pop-Up Modal

2.5.5F REVIEW FOREIGN COUNTRY LOCATION
The provider location has a state code of Foreign Country (ZZ) and has been geocoded to a U.S. State or Territory.
This flag will not apply to provider locations that are ineligible for any reason.

Figure 87: Review Foreign Country Location Flag

This flag can be resolved by omitting the provider location. For more information on omitting provider
locations, see Section 2.5.4 Omitting Provider Locations.
If the provider location is a valid practice location, a new location should be created with the correct U.S.
State or Territory. For more information on creating new provider locations, see Section 2.5.1 Adding
Provider Locations.

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Figure 88: Review Foreign Country Location Pop-Up Modal

2.5.5G REVIEW NPI PRIMARY ADDRESS CHANGE
The provider reported a new practice address to CMS. This flag will appear on the provider’s other eligible
locations and the new provider location created for the NPI Primary Address Change. This flag will not apply to
locations with a state code of Foreign Country (ZZ).

Figure 89: Review NPI Primary Address Change Flag

This flag can be cleared by confirming the data is correct in the Review NPI Primary Address pop-up modal (see
Figure 90). Selecting the hyperlinked text for this Needs Review flag will open the Review NPI Primary Address popup modal.

Figure 90: Review NPI Primary Address Change Pop-Up Modal

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The Review New NPI Primary Address flag will need to be individually cleared from each impacted provider
location. If the location has both the Review New NPI Primary Address flag and the “New, Not Reviewed” ineligible
reason, clearing the Review New NPI Primary Address flag will also clear the “New, Not Reviewed” ineligible reason
and populate the SDMS Activation Date.

2.5.5H REVIEW PRIMARY TAXONOMY CHANGE
The provider reported a new primary taxonomy to CMS, and the new taxonomy has been mapped to a discipline
and specialty. For more information on active taxonomies, see the Manual for Policies and Procedures. This flag
will not apply to provider locations that have been deactivated by CMS (Ineligible Reason of “CMS
Deactivated”), locations that have been omitted by a PCO (Ineligible Reason of “PCO Omitted”), or locations
with a state code of Foreign Country (ZZ).

Figure 91: Review NPI Primary Address Change Flag

This flag can be cleared by confirming the data is correct in the Review Primary Taxonomy Change pop-up modal
(see Figure 90). Selecting the hyperlinked text for this Needs Review flag will open the Review Primary Taxonomy
Change pop-up modal.

Figure 92: Review NPI Primary Address Change Pop-Up Modal

The Review Primary Taxonomy Change flag will need to be individually cleared from each impacted provider
location. If the location has both the Review Primary Taxonomy Change flag and the “New, Not Reviewed”
ineligible reason, clearing the Review Primary Taxonomy Change flag will also clear the “New, Not Reviewed”
ineligible reason and populate the SDMS Activation Date.
If the Review Primary Taxonomy Change flag is present on a provider location for six months and no action has
been taken by a PCO, the system will automatically remove the flag and update the Discipline and Specialty to

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match the new primary taxonomy. If the provider’s new primary taxonomy is not an active taxonomy, the system
will remove the discipline and specialty from the provider location and add the “No Discipline/Specialty” ineligible
reason.

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2.6 USING THE PROVIDER IMPORT TOOL
The Provider Import Tool provides PCOs the capability to add, update, or omit provider locations in bulk by
modifying a system-generated Excel file. With the newly re-designed Provider Import Tool, PCOs can create
Provider Uploads using a deconstructed download process. In addition, they can review additional information
about their processed files and download new import files with any rejected records.
To access the import tool, PCOs can navigate to the Provider Upload page from the Provider Management Landing
Page.

Figure 93: Navigation to the Provider Upload Page and Import Tool

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2.6.1 VIEWING PROVIDER UPLOADS
On the Provider Upload Landing Page, PCOs can view summary information about the import files they are actively
working on and any files they previously uploaded to the system.

Figure 94: Provider Upload Landing Page

Feature
1. Generate Provider Import
File

Description
This button allows PCOs to create new Provider Uploads and systemgenerated Import Files. For more information on creating new Provider
Uploads, see 2.6.2A Generating Provider Import Files from the Provider
Upload Landing Page

2. Provider Upload Search

This section allows users to search for Provider Uploads. For more
information about searching for Provider Uploads, see 2.6.1A Searching for
Provider Uploads.

3. Provider Upload Summary
Card

This section shows a summary of a Provider Upload. Each Provider Upload in
a PCO’s state will appear as a separate card on the Provider Upload Landing
Page.

On the Provider Upload Landing Page, PCOs will be able to see a summary of the import files processed by the
system for their state.

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Figure 95: Provider Upload Summary Card

Feature
1. Provider Upload Title

Description
This field shows the user-entered title of the Provider Upload.

2. Report ID

This field shows the system-assigned Report ID for the Provider Upload.

3. Created By

This field shows the PCO who initiated the Provider Upload.

4. Data Source(s)

This field shows the Data Sources associated with the Provider Upload. If the
PCO did not assign a data source to the editable columns in their import file,
this field will show “No Data Source.”

5. Last Updated

This field shows the last time a PCO updated the Provider Upload. Updates
include generating the Provider Upload, uploading the import file to the
system, and closing the Provider Upload.

6. Status

This field shows the status of the Provider Upload. Status options include:
• In Progress
• Processing
• Canceled
• Ready for Review
• Closed

7. Document Description

This field shows the user entered description for the Provider Upload.

8. Results Summary

This field shows the number of accepted and rejected records for the
Provider Upload. The Results Summary will only appear for Provider Uploads
with a “Ready for Review” or “Closed” status.

9. Start Upload / View Upload
Button

The Start Upload button will display if the Provider Upload has an “In
Progress” status. Selecting the “Start Upload” button will navigate the PCO
to the document upload screen for the Provider Upload.
The View Upload button will display in the Provider Upload has a “Ready for
Review” or “Closed” status. Selecting the “View Upload” button will navigate
the PCO to the Provider Upload Report.

USER NOTE

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•

Import Files uploaded before August 27, 2022 will not have a description or associated data source. The
Provider Upload Name will be the name of the file uploaded to the system, including the file extension
(see Figure 96).

Figure 96: Provider Upload Summary Card for a File Upload before August 27, 2022

2.6.1A SEARCHING FOR PROVIDER UPLOADS
PCOs can filter the Provider Uploads in their state.

Figure 97: Provider Upload Search

Feature
1. Search Uploads

Description
This field allows users to filter Provider Uploads by their name.

2. Filter by Status

This field allows users to filter Provider Uploads by Status. Status
selections include:
• In Progress
• Processing
• Canceled
• Ready for Review
• Closed

3. Filter by Data Source

This field allows users to filter Provider Uploads by data source.
The Data Source options will include all data sources that have
been uploaded to the Provider Data Sources page.

4. Filter by Last Updated Date

This field allows users to filter Provider Uploads by the date the
Provider Uploads was last updated by the system. Users can
search by a single date or by date ranges.

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2.6.1B DELETING PROVIDER UPLOADS
PCOs can delete any Provider Upload with an “In-progress” status. Once a Provider Upload is deleted, PCOs will not
be able to upload the associated import file to the system to make bulk uploads.

Figure 98: Deleting an In Progress Provider Upload

INSTRUCTIONS
To delete an “In-progress” Provider Upload
1.
2.

Select the “Delete Upload” button to the right of the “Start Upload” button
Select the “Confirm” button in the pop-up modal
a. Selecting the “Cancel” button will close the pop-up modal and not delete the Provider Upload

Figure 99: Delete Provider Upload Pop-up Modal

2.6.2 GENERATING PROVIDER IMPORT FILES
PCOs can start new Provider Uploads by generating import files through the Generate Import File modal. New
import files can be created on the Provider Upload Landing Page or the Advanced Provider Search page.

2.6.2A GENERATING PROVIDER IMPORT FILES FROM THE PROVIDER UPLOAD LANDING PAGE
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PCOs can create a new Provider Upload by selecting the “Generate Provider Import File” button in the top right
corner of the Provider Upload Landing Page.

Figure 100: Generate Provider Import File Button on the Provider Upload Landing Page

INSTRUCTIONS
To generate an import file on the Provider Upload Landing Page
1.
2.

3.

Enter a name for the Provider Upload. This name will appear as the title of the card associated with this
import file
Choose a filter for the Provider Upload.
a. Once a filter has been selected, a second dropdown will appear underneath the filter option to
allow PCOs to select the values they would like to see in their file
b. To add an additional filter, select the “Add Filter” button in the bottom right corner of the modal
Select the “Continue” button

Figure 101: Generate Provider Import File Modal - Provider Upload Details Step

4.

5.
6.

Add the editable columns that will be updated in this Provider Upload
a. The Reason Code column will always be pre-selected. PCOs can remove Reason Code from the
import file by deselecting the checkbox next to the Reason Code option in the Editable Columns
dropdown
Add any desired read-only columns to the import file
Select the “Continue” button

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Figure 102: Generate Provider Import File Modal - Configure File Step

7.

8.

Select a data source for any editable columns chosen in the previous step
a. The data source drop down will be populated based on the Current data sources on the Provider
Data Sources page
b. If no Data Source has been uploaded for that field, select the “No Data Source” option
c. If Phone Number, Fax Number, or Clinician Data Reviewed were selected as editable columns, no
data source is required
Select the “Continue” button

Figure 103: Generate Provider Import File Modal - Select Data Sources Step

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9. Review the information entered in the modal
10. Select the “Save and Generate” button

Figure 104: Generate Provider Import File Modal - Review and Generate Step

Once the “Save and Generate” button has been selected, the system will create a macro-enabled Excel file and add
a new card for the created Provider Upload to the Provider Upload Landing Page. The Provider Upload will have an
“In Progress” status.

Figure 105: In Progress Provider Upload on the Provider Upload Landing Page

Import files can contain the following columns (in order) and be populated with data for each location if the data
exists for those records:
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1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.

Action
NPI
First Name
Middle Name
Last Name
Suffix
Phone Number
Fax Number
Discipline
Specialty
Status
Ineligible: CMS Deactivated
Ineligible: PCO Omitted
Ineligible: Not Geocoded
Ineligible: Federal Provider
Ineligible: NHSC Provider
Ineligible: J1 Visa Waiver Holder
Ineligible: No Specialty/Discipline
Ineligible: New, Not Reviewed
Provider Location ID
Address Line 1
Address Line 2
City
State
Postal Code
Display Address
County Name
Latitude
Longitude
Match Level
State FIPS
County FIPS
Census Tract
CSD
ZCTA Public ID
Age

37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.

Dental Auxiliaries
Direct Tour Hours
Reason Code
Organizational NPI
Designation/Organization Name
Site Name
Designation ID
Organization Unique ID
Designation Status
Site Type
Annual Medicaid Claims
Medicaid Patient %
Homeless %
Migrant Farmworkers %
American Indian/Alaska Native %
Sliding Fee %
Migrant Seasonal Farmworker %
Intern or Resident?
J1 Visa Waiver Holder?
Federal Provider
NHSC Provider?
Review Tasks
Clinician Data Reviewed
Attestation Date
Activation Date
SDMS Last Modified Date
SDMS Last Modified By
NPI Address Change Date
NPI Deactivation Date
NPI Reactivation Date
NPI New Provider Date
NPI Taxonomy Change Date
Taxonomy Code
Taxonomy Type
License Number
License State

•
•
•
•
•

Specialty
Provider Location ID
Address Line 1
Address Line 2
City

The spreadsheet must always contain the following columns:
•
•
•
•
•

Action
NPI
First Name
Last Name
Discipline

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•

State

•

Postal Code

USER NOTES
•

•

•

If the file would contain more than 20,000 records, the system will not create the file. A card for the
Upload will be generated, and the PCO will need to manually delete the Upload. For more information on
deleting Provider Uploads, see 2.6.1B Deleting Provider Uploads.
Once a file has been generated, PCOs can include additional columns in their import files. Any user
entered columns cannot have a column header that matches a header for any of the system generated
column.
If Taxonomy Code, Taxonomy Type, License Number, and License State are selected as read-only columns,
PCOs can adjust how many of these columns appear in their downloaded import file (see Figure 106).
PCOs can view up to 15 columns each to accommodate providers with multiple taxonomies and licenses.

Figure 106: Adjusting Number of Taxonomy and License Related Columns when Generating an Import File

2.6.2B GENERATING PROVIDER IMPORT FILES FROM THE ADVANCED SEARCH
PCOs can create a new Provider Upload by selecting the “Generate Provider Import File” button in the top right
corner of the Search Grid. The downloaded file will include the provider locations and columns displayed in the
Search Grid. User can add and remove columns using the Customize Columns modal to adjust the columns that will
appear in the file. For additional information on customizing the columns that appear in the Provider Search Grid,
see Section 2.2.3A Customizing the Search Grid.

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Figure 107: Generating Provider Import Files from the Advanced Search

INSTRUCTIONS
To generate an import file on the Provider Upload Landing Page
1.
2.
3.

Select the Generate Provider Import File button in the top right corner of the Advanced Search Grid
Enter a name for the Provider Upload. This name will appear as the title of the card associated with this
import file
Select the “Continue” button

Figure 108: Generate Provider Import File Modal - Provider Upload Details Step

4.

5.

Select a data source for any editable columns displayed in the Search Grid
a. The data source drop down will be populated based on the Current data sources on the Provider
Data Sources page
b. If no Data Source has been uploaded for that field, select the “No Data Source” option
c. If Phone Number, Fax Number, or Clinician Data Reviewed are displayed in the Search Grid, no
data source is required
Select the “Continue” button

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Figure 109: Generate Provider Import File Modal - Select Data Sources Step

6.
7.

Review the information entered in the modal
Select the “Save and Generate” button

Figure 110: Generate Provider Import File Modal - Review and Generate Step

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Once the “Save and Generate” button has been selected, the system will create a macro-enabled Excel file and add
a new card for the created Provider Upload to the Provider Upload Landing Page. The Provider Upload will have an
“In Progress” status.

USER NOTES
•

If the file would contain more than 20,000 records, the system will not create the file. A card for the
Upload will be generated, and the PCO will need to manually delete the Upload. For more information on
deleting Provider Uploads, see 2.6.1B Deleting Provider Uploads.

2.6.3 EDITING PROVIDER LOCATIONS USING THE IMPORT FILE
The generated import file will have all provider data for that state based on columns and criteria selected. The file
will have a Provider Locations tab and a Metadata tab (see Figure 111). The Provider Locations tab can be edited to
modify provider data through the Import Tool. The Metadata tab has a creation date that informs the system
when the file was generated and the required Report ID. The Metadata tab also provides the Reason Code values
and the Discipline, Specialty, and Site Type lists.

Figure 111: Excel Import File tabs

The Provider Locations and Metadata tabs should not be relabeled or deleted, as they are needed for the system
to properly recognize the file. Relabeling these tabs will cause the system to reject the file and display an error
message in the Provider Upload Report. Users have the ability to add additional columns if required. The system
will ignore all but the system-generated columns. Should any of the required system columns be modified or
deleted, the system will reject the file, and no updates will be made to provider data.
The first time a file is opened, users may encounter one or both of the following firewall warnings (depending on
the Excel version and firewall settings) as illustrated in Figure 112 and Figure 113.

Figure 112: Enabling Editing Capability

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Figure 113: Enabling Macro Capability

To use the import file, users may need to click the “Enable Editing” and “Enable Content” buttons if prompted by
Excel.

2.6.3A ACTIVATING THE BUILT-IN MACRO
In order for the system to know the action the user is attempting to make, the user will need to select one of the
options (Add, Update or Omit) in the drop-down under the “Action” column. These options have been built into a
macro in the import file to facilitate user’s ability to modify the data. The macro can be activated by pressing
(Ctrl + Shift + I) on the keyboard.
Activating the macro will populate the Action, Discipline, Specialty, Dental Auxiliaries, Reason Code, Facility
Information, and Site Type columns’ options as illustrated in Figure 114 and Figure 115. The system will only accept
values from the provided options for all columns that were prepopulated by the macro. Entering any other value
will cause the record to be rejected, and no updates will be made to that particular record.
The system will only consider records that have an action type selected. If the selected option in the drop-down is
“Select”, the system will ignore that row’s record and move on to the next record without providing an error
message or warning to the user. Users can change the formatting of the original file, add additional columns, or
reorder the columns, and the system will still be able to process the file as long as the required columns are still
present in the file.

Figure 114: Macro Populated Action Column

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Figure 115: Macro Populated Reason Code

2.6.3B ADDING A NEW PROVIDER LOCATION
The Import Tool will allow users to add new locations for existing providers within SDMS by selecting the “Add”
option from the drop-down under the Action column. There can only be one unique address with an “Eligible”
status per provider. If a user attempts to add a new location with the exact same address as an existing location,
the system will return an error message.
The user must provide the NPI for the provider that the location is being added to. The Import Tool will only accept
NPIs already known to SDMS.
The system will accept the following information when the Add action is selected:
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Discipline
Specialty
Address Line 1
Address Line 2
City
State
Postal Code
Dental Auxiliaries (If DH provider)
Organizational NPI
Direct Tour Hours
Site Type
Clinical Information (e.g., Annual Medicaid Claims)
Employment Status (e.g., Intern or Resident)
Clinician Data Reviewed

Any field where the PCO does not enter data will be set to the system default. For more information on which data
fields on a provider location are set automatically by the system, see Appendix A – Editable Provider Data Fields.

INSTRUCTIONS
To add a new location:
1.
2.

Copy an existing row, then right click and insert the copied row as a new row
Select ‘Add’ from the Action column

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3.

4.
5.

Enter new location’s address information with at least all the required fields:
o Address Line 1
o Address Line 2 (column must be included but may be blank)
o City
o State (Must be within PCO’s state)
o Zip Code
o Direct Tour Hours (Must be greater than zero)
Update any other necessary information. For more information on which other fields can be updated, see
Appendix A – Editable Provider Data Fields
Save the file once all provider locations have been updated

The example below illustrates the process of adding a new location by copying and inserting an existing location.

Figure 116: Adding Provider Locations - Copying Data

Figure 117: Adding Provider Locations - Inserting Provider Data

Figure 118: Adding Provider Locations - Selecting Add Action

Figure 119: Adding Provider Location - Completed Cell

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USER NOTE
•

Locations that are added using the import file are geocoded hourly. If PCOs navigate to a location
immediately after the import tool is processed, the standardized address will not display. To geocode the
location and populate the standardized address, PCOs can initiate a system geocode on the provider
location.

2.6.3C UPDATING AN EXISTING PROVIDER LOCATION
The Import Tool will give users the ability to modify any eligible provider’s location information in the PCO’s state
by selecting the “Update” option from the drop-down under the Action column. When attempting to update an
existing location’s information, the system will accept changes to information in the following columns:
•
•
•
•
•
•
•
•
•
•
•

Discipline
Specialty
Match Level*
Dental Auxiliaries (If Dental Health provider)
Organizational NPI
Direct Tour Hours
Reason Code (Remove reason code to un-omit location)
Site Type
Clinical Information (e.g. Annual Medicaid Claims)
Employment Status (e.g., Intern or Resident)
Clinician Data Reviewed (Attesting to a provider location)

*Ineligible Locations with geocoded match levels greater than 3 or no match level will be automatically regeocoded with the “Update” action. No additional action is required by the user to initiate re-geocoding.
When attempting to update provider locations using the Import Tool, NPI and Address information must match the
system’s records 100% with the following fields:
•
•

NPI
Provider Location ID

The system will reject the attempted updated and return an error message if the required fields listed above do
not match a provider location in the system.

INSTRUCTIONS
To update an existing provider location:
1.
2.
3.
4.

Select ‘Update’ from the Action column
Update all the necessary information.
Make sure all rules have been followed as described in Appendix A – Editable Provider Data Fields.
Save the file once all provider locations have been update.

The example below illustrates the process of updating Direct Tour Hours and Serves at Correctional Facility.

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Figure 120: Updating an Existing Provider Location - Selecting Update Action

Figure 121: Updating an Existing Provider Location - Changing Additional Information

USER NOTES
•

•
•

Address Line fields (Address Line 1, Address Line 2, City, State, Zip Code) cannot be changed for existing
locations. If the address line fields need to be updated, a new location should be added and the existing
location should be omitted.
The system will return an error if a user updates a record with a populated Reason Code. If a user wishes
to update an ineligible provider, the reason code must be removed for the update to be processed.
The system will ignore user-entered latitude and longitudes in the import file. Provider locations with a
match level greater than 4 will automatically be re-geocoded when using the update action.

2.6.3D OMITTING AN EXISTING PROVIDER LOCATION
The Import Tool allows users to omit provider locations in the PCO’s state by selecting the “Omit” option from the
drop-down under the Action column and selecting an option under the Reason Code column. A reason code must
be selected, or the system will reject the omit attempt.
When attempting to omit provider locations using the Import Tool, NPI and Address information must match the
system’s records 100% with the following fields:
•
•

NPI
Provider Location ID

The system will reject the attempted omit and return an error message if the required fields listed above do not
match a provider location in the system.

INSTRUCTIONS
To omit an existing provider location:
1.

Select ‘Omit’ from the Action column

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2.
3.

Select an option from the ‘Reason Code’ column
Save the file once all provider locations have been updated

For more information about possible reason codes, see Appendix C – Ineligible Reasons and PCO Omitted
Reasons.
The example below illustrates the process of omitting an existing location.

Figure 122: Omitting Provider Location - Selecting Omit Action

Figure 123: Omitting Provider Location - Omit Reason Code

2.6.4 IMPORTING PROVIDER DATA IN BULK
PCOs can upload an import file to its corresponding Provider Upload by selecting the “Start Upload” button in the
bottom right corner of the Provider Upload card on the Provider Upload Landing Page. To successfully upload an
import file to the system, the Report ID in the metadata tab and the Report ID for the Provider Upload must
match.

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Figure 124: Starting a Provider Upload from the Provider Upload Landing Page

INSTRUCTIONS
To upload an import file:
1.
2.

Select the “Start Upload” button for the desired Provider Upload
Select the “Select or Drop File Here” button
a. Users may also drag and drop their chosen file into the Upload File box

Figure 125: Uploading a File to a Provider Upload

3.
4.
5.

Choose the file with the matching Report ID in one of the following formats: xlsm, .xlsx, .zip. Users will not
be able to upload a file in a different file format
Enter a description of the chosen file (Optional)
Select the “Upload” button
a. If the wrong file is accidently chosen, select the “Cancel” button and restart the document
upload process

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Figure 126: Entering a Document Description for a Provider Upload

USER NOTES
•
•

Files must be smaller than 50 mb
If multiple files are included in a single .zip file, the system will only process the first file.

Figure 127: Uploading a File that is Greater Than 50 MB on the Provider Upload Page

Once a file has been uploaded, the system will navigate the user back to the Provider Upload Landing Page. The
Provider Upload will now have a status of “Processing.” If a large file is uploaded, the file may remain in
“Processing” for several minutes. Once the system finishes processing the import file, the status of the Provider
Upload will change to “Ready for Review.” PCOs will need to refresh the page to see the latest status of the
Provider Upload.

Figure 128: Provider Upload with a Processing Status

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2.6.4A RETRYING PROVIDER UPLOADS
Before processing changes to provider locations in an import file, the system will check to ensure the file is
compatible. It will not process any changes if it encounters one of the following issues:
•
•
•
•

The metadata tab has been deleted or modified.
One of the required columns has been deleted.
No values were entered in the Actions column.
An identical file has been uploaded.

If the system encounters any of the aforementioned criteria, the Provider Upload will be given a “Canceled” status.
When PCOs view the Provider Upload Report, they will see an error message letting them know what issue the
system encountered.

Figure 129: Retying a Provider Upload

INSTRUCTIONS
To retry a Provider Upload
1.
2.

Navigate to the Provider Upload Report for the affected Provider Upload
Select the “Retry Upload” button in the bottom left of the Provider Upload Report Header Card

Once a Provider Upload is cancelled, it will be given an “In-progress” status, and PCOs will be able to upload a
corrected version of their import file to the system.

USER NOTES
•

If a file with one of the aforementioned issues was uploaded to the system prior to August 27, 2022, PCOs
will not be able to retry the Provider Upload.

2.6.5 VALIDATING PROVIDER UPLOADS
Once the system has finished processing an import file, PCOs will be able to review the uploaded data before any
changes are made to the provider data used in the designation process. The Provider Upload will receive a “Ready
for Review” status, and PCOs can access the Upload Review by selecting the “Review Upload” button.

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Figure 130: Provider Upload with a Ready for Review status

When the PCO selects “Review Upload,” they will be navigated to the Provider Upload Review page to preview the
rejected and accepted updates before the data is reflected across the Provider Management portal or available to
use in designation applications.

Figure 131: Provider Upload Review

USER NOTES
•

Locations that are included in a cannot be edited. PCOs will view a banner on the provider location
informing them the location is included in a Provider Upload, and all Edit buttons will be removed from
the provider location (see Figure 131). After a Provider Upload is accepted or canceled, PCOs will be able
to edit those locations again.

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Figure 132: Provider Location included in a Ready for Review Provider Upload

2.6.5A REVIEWING REJECTED RECORDS
PCOs can see a summary of the records the system was unable to process in the uploaded import file.

Figure 133: Review Rejected Results during Provider Upload Review

Feature
1. Error Message

Description
This field shows the error that caused the system to reject the
change to the provider location. PCOs can expand the error
message to see additional details about the impacted provider
locations.

2. NPI

This column shows the NPI for the processed provider location.

3. Location Address

This column shows the address for the processed provider
location.

4. Provider Name

This column shows the name of the provider for the processed
provider location.

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Feature
5. Impacted Field

Description
This column shows the data fields that were changed for the
processed provider location. If multiple columns are changed for a
provider location, they will appear in a single list, separated by
commas.

6. Entered Value

This column shows the value that was entered in the Impacted
Fields.

7. Row Number

This column shows the row number for the processed provider
location in the uploaded import file.

GENERATING A NEW IMPORT FILE FROM REJECTED RECORDS
PCOs can create new Provider Uploads from their rejected records. The new import file will include all the rejected
records from the original Provider Upload across Actions.
To generate an import file from rejected records
1.
2.
3.

Select the “Generate New Import File” button
Enter a name for the Provider Upload. This name will appear as the title of the card associated with this
import file
Select the “Continue” button

Figure 134: Generate Provider Import File Modal - Provider Upload Details Step

4.

5.
6.

Add the editable columns that will be updated in this Provider Upload. The selected columns do not need
to match the columns included in the original import file
a. The Reason Code column will always be pre-selected. PCOs can remove Reason Code from the
import file by deselecting the checkbox next to the Reason Code option in the Editable Columns
dropdown
Add any desired read-only columns to the import file
Select the “Continue” button

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Figure 135: Generate Provider Import File Modal - Configure File Step

7.

8.

Select a data source for any editable columns chosen in the previous step
a. The data source drop down will be populated based on the Current data sources on the Provider
Data Sources page
b. If no Data Source has been uploaded for that field, select the “No Data Source” option
c. If Phone Number, Fax Number, or Clinician Data Reviewed were selected as editable columns, no
data source is required
d. If a data source was chosen for the original import file, the Data Source dropdown will be
prepopulated by the system
Select the “Continue” button

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Figure 136: Generate Provider Import File Modal - Select Data Sources Step

9. Review the information entered in the modal
10. Select the “Save and Generate” button

Figure 137: Generate Provider Import File Modal - Review and Generate Step

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Once the “Save and Generate” button has been selected, the system will create a macro-enabled Excel file and add
a new card for the created Provider Upload to the Provider Upload Landing Page. The Provider Upload will have an
“In Progress” status. PCOs can use this new card to upload their macro-enabled Excel file to the system for
processing.

USER NOTE
•
•

PCOs will not be able to download the rejected records for the “Add” action.
If Taxonomy Code, Taxonomy Type, License Number, and License State are selected as read-only columns,
PCOs can adjust how many of these columns appear in their downloaded import file. PCOs can view up to
15 columns each to accommodate providers with multiple taxonomies and licenses.

2.6.5B REVIEWING ACCEPTED RECORDS
PCOs can view a summary of the accepted changes in their import file. PCOs can see the number of locations that
were added, updated, or omitted in their import file. If the action was included in an impot file, PCOs can see the
number of locations that were updated for each column in the import file. These accepted changes will not be
accepted in the system until the PCO accepts the Provider Upload on the Finalize Upload step.

Figure 138: Review Accepted Results during Provider Upload Review

2.6.5C FINALIZING A PROVIDER UPLOAD
Once a PCO has completed the review of their Provider Upload, they can accept or cancel the Provider Upload.

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Figure 139: Finalize Upload during Provider Upload Review

ACCEPTING PROVIDER UPLOADS
PCOs can accept the Provider Upload by selecting the “Accept” button on the Finalize Upload step of a Provider
Upload Review. Once a Provider Upload is accepted, the PCO will be navigated back to the Provider Upload
Landing Page.
After a Provider Upload is accepted by the PCO, the Provider Upload will receive a “Closed” status. The data
included in the accepted Provider Upload will be reflected across the Provider Management Portal and will be used
in future designation updates. PCOs will be able to edit the provider locations included in the import file through
the Search Grid and on the individual locations.

CANCELING PROVIDER UPLOADS
If the PCO does not want the data included in the uploaded file to be used for designation purposes, they can
cancel the Provider Upload. Provider Uploads can also be canceled at any time during the review process by
selecting the “Cancel Upload” button in the header card.

INSTRUCTIONS
To cancel a Provider Upload:
1.
2.

Select the Cancel Upload button on the Finalize Upload step or from the header card
Confirm the upload should be canceled in the pop-up modal (see Figure 138)

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Figure 140: Cancel Upload Pop Up Modal

Once the Provider Upload is canceled, the system will give the Upload an “In Progress” status, and the PCO can
either make corrections to their import file and re-upload or delete the Provider Upload. For more information on
updating data in an import file, see Section 2.6.3 Editing Provider Locations Using the Import File. For more
information on deleting Provider Uploads, see Section 2.6.1B Deleting Provider Uploads.

2.6.6 VIEWING PROVIDER UPLOAD REPORTS
Once the PCO has accepted the Provider Upload, the user can review the information about their processed import
files and take additional action on the Provider Upload Report. Provider Upload Reports can be accessed by
selecting the “View Upload” button on Provider Uploads with a “Closed” status.

Figure 141: Provider Upload with a Closed Status

PCOs can view additional details about the accepted and rejected records in the processed import file in the
Provider Upload Report.

Figure 142: Provider Upload Report

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Feature
1. Provider Upload Report Header Card

Description
This section shows summary information about the Provider
Upload. Summary information includes:
• Provider Upload Name
• Report ID
• Created By User
• Data Sources
• Last Updated By
• Status
• Results Visual Summary
This section matches the information shown on the Provider
Upload Summary card on the Provider Upload Landing Page.

2. Left-Hand Navigation

The Left-Hand Navigation allows PCOs to move between the
Results Summaries for the different actions in their Provider
Upload. Actions include:
• Results Summary
• Add
• Update
• Omit
• Invalid Action

3. Results Summary

This section shows a summary of the processed, accepted, and
rejected records in the import file across the different potential
actions.
These sections show information about the Accepted and Rejected
Records for each Action in the processed import file.

3. Action Results

2.6.6A VIEWING THE RESULTS SUMMARY
When PCOs navigate to a Provider Upload Report, they will be directed to the overall Results Summary for the
uploaded import file. On the Results Summary tab, PCOs can view the number of records that were processed,
accepted, and rejected in the Provider Upload.

Figure 143: Results Summary

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Feature
1. Results Summary Bar Graph

Description
This section shows a visualization of how many records were
accepted and rejected for each Action included in an import file as
percentages.
A bar will only appear for Actions that were included in the
uploaded import file. If any provider locations have an invalid
action in the Action columns, a bar will not appear for the Invalid
Results Summary.

2. Results Summary Table

This section shows the number of processed, accepted, and
rejected records in the import file. All the Actions will appear in
the table regardless of which Actions were included in the import
file.

2.6.6B VIEWING ACTION-SPECIFIC RESULTS
PCOs can view more details about their accepted and rejected records by selecting an Action Specific Results tab in
the left-hand navigation. On an Action Specific Results tab, PCOs can view information about accepted and
rejected records for each action and download rejected records in a new import file. If the PCO did not select one
of the Actions in their import file, the action will not be listed in the left-hand navigation.

VIEWING ACCEPTED RECORDS
PCOs can see a summary of the records the system successfully processed for each particular action in the
Accepted Records table.

Figure 144: Accepted Updates in the Results Summary

Feature
1. NPI

Description
This column shows the NPI for the processed provider location.

2. Location Address

This column shows the address for the processed provider
location.

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Feature
3. Provider Name

Description
This column shows the name of the provider for the processed
provider location.

4. Updated Columns

This column shows the data fields that were changed for the
processed provider location. If multiple columns are changed for a
provider location, they will appear in a single list, separated by
commas.

5. Row Number

This column shows the row number for the processed provider
location in the uploaded import file.

USER NOTES
•

•

If a file was uploaded prior to August 27, 2022, the Accepted Update section will not appear in the
Provider Upload Report.
The Invalid Action Summary will not have an Accepted Updates Section.

VIEWING REJECTED UPDATES
PCOs can see a summary of the records the system was unable to process for each particular action in the
Accepted Records table.

Figure 145: Rejected Updates in the Update Results Summary

Feature
1. View Error Report

Description
Selecting this button will download an Excel report with the listed
error message and impacted row number.

2. Error Message

This field shows the error that caused the system to reject the
change to the provider location. PCOs can expand the error
message to see additional details about the impacted provider
locations.

3. NPI

This column shows the NPI for the processed provider location.

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Feature
4. Location Address

Description
This column shows the address for the processed provider
location.

5. Provider Name

This column shows the name of the provider for the processed
provider location.

6. Impacted Field

This column shows the data fields that were changed for the
processed provider location. If multiple columns are changed for a
provider location, they will appear in a single list, separated by
commas.

7. Entered Value

This column shows the value that was entered in the Impacted
Fields.

8. Row Number

This column shows the row number for the processed provider
location in the uploaded import file.

USER NOTES
•
•

Results will only appear in the Invalid Actions section if a PCO entered a value other than “Add,”
“Update,” or “Omit” in the Actions column of an import file.
If a file was uploaded prior to August 27, 2022, the Rejected Updates section will only show the NPI and
Row Number for the rejected record when expanded, see Figure 140).

Figure 146: Rejected Records Section for a Provider Upload from before August 27, 2022

2.6.6C GENERATING NEW PROVIDER IMPORT FILES FROM REJECTED RECORDS
PCOs can create new Provider Uploads with the locations with the “Update” or “Omit” action from their import file
that the system could not process.

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Figure 147: Rejected Records Section with Selected Rows for a New Import File

INSTRUCTIONS
To generate an import file from rejected records
1.
2.
3.
4.

Select the desired records to include in the new Import File
Select the “Generate New Import File” button
Enter a name for the Provider Upload. This name will appear as the title of the card associated with this
import file
Select the “Continue” button

Figure 148: Generate Provider Import File Modal - Provider Upload Details Step

5.

6.
7.

Add the editable columns that will be updated in this Provider Upload. The selected columns do not need
to match the columns included in the original import file
a. The Reason Code column will always be pre-selected. PCOs can remove Reason Code from the
import file by deselecting the checkbox next to the Reason Code option in the Editable Columns
dropdown
Add any desired read-only columns to the import file
Select the “Continue” button

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Figure 149: Generate Provider Import File Modal - Configure File Step

8.

9.

Select a data source for any editable columns chosen in the previous step
a. The data source drop down will be populated based on the Current data sources on the Provider
Data Sources page
b. If no Data Source has been uploaded for that field, select the “No Data Source” option
c. If Phone Number, Fax Number, or Clinician Data Reviewed were selected as editable columns, no
data source is required
d. If a data source was chosen for the original import file, the Data Source dropdown will be
prepopulated by the system
Select the “Continue” button

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Figure 150: Generate Provider Import File Modal - Select Data Sources Step

10. Review the information entered in the modal
11. Select the “Save and Generate” button

Figure 151: Generate Provider Import File Modal - Review and Generate Step

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Once the “Save and Generate” button has been selected, the system will create a macro-enabled Excel file and add
a new card for the created Provider Upload to the Provider Upload Landing Page. The Provider Upload will have an
“In Progress” status. PCOs can use this new card to upload their macro-enabled Excel file to the system for
processing.

USER NOTE
•
•

PCOs will not be able to download the rejected records for the “Add” action.
If Taxonomy Code, Taxonomy Type, License Number, and License State are selected as read-only columns,
PCOs can adjust how many of these columns appear in their downloaded import file. PCOs can view up to
15 columns each to accommodate providers with multiple taxonomies and licenses.

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2.7 MANAGING PROVIDER REVIEW TASKS
PCOs can use the Provider Dashboard to manage Needs Review flags indicating if there are one or more reasons a
provider location requires review.

Figure 152: Provider Review Task Summary on the Provider Management Landing Page

Feature
1.
(Go to Dashboard)

Description
This button allows PCOs to navigate to the Provider Dashboard.
For more information on viewing review tasks on the Provider
Dashboard, see 2.7.1 Viewing Provider Review Tasks on the
Provider Dashboard.

2. System Action Pending in the next
30 days

These provider locations have an associated system action that will
occur in the next 30 days.

3. Complete Annual Provider Location
Attestation

These provider locations have the "Complete Annual Provider
Location Attestation" flag.

4. Review Direct Tour Hours Greater
than 40

These provider locations have the "Review Direct Tour Hours
Greater than 40" flag.

5. Review New Provider Location

These provider locations have the "Review New Provider Location"
flag.

6. Geocoding Issues

These provider locations have the "Re-geocode Provider Location",
"Review Geocoded State Mismatch", or "Review Foreign Country
Location" flags.

7. NPPES Updates

These provider locations have the "Review NPI Primary Address
Change" or "Review Primary Taxonomy Change" flags.

2.7.1 VIEWING PROVIDER REVIEW TASKS ON THE PROVIDER DASHBOARD
PCOs can search for and manage provider locations that require review in their state. From this page, PCOs can
navigate to provider locations to take action on open Needs Review flags.

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Figure 153: Provider Dashboard

Feature
1. Provider Dashboard Search

2.
(Download Results)

2. Review Task

Description
This section allows users to search for provider locations that
require review across their state. For more information on
searching for provider locations that require review, see Section
2.7.2 Searching for Provider Locations that Require Review.
Users will have the ability to download the Reviews report by
clicking the “Download Results” button. The downloaded report
will be an Excel file. This Excel file cannot be used with the
Provider Import Tool. A search must be executed for the Download
Results button to be enabled.
This field displays the Needs Review flag present on the provider
location. Review tasks options include:
• Complete Annual Provider Location Attestation
• Review Direct Tour Hours Greater Than 40
• Re-geocode Provider Location
• Review New Provider Location
• Review State Geocoded Mismatch
• Review Foreign Country Location
• Review NPI Primary Address Change
• Review Primary Taxonomy Change
PCOs can navigate to provider locations by selecting the hyperlinked Review Task. For more information on viewing Needs
Review flags on provider locations, see Section 2.4.2 Viewing
Needs Review. For more information on addressing Needs Review
flags on provider locations, see Section 2.5.5 Addressing Needs
Review Flags.

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Feature
3. System Action Pending

Description
This field shows if the system will take action on the provider
location to clear the Review Task.

4. System Action Date

This field displays the date when the system will take action on the
provider location. If there is no system action pending, “N/A” will
display.

5. NPI

This field displays the NPI of the provider with a location that
requires review.

6. Provider Name

This field displays the first and last name of the provider with a
location that requires review.

7. Discipline

This field displays the Discipline of the provider location that
requires review.

8. Specialty

This field displays the Specialty of the provider location that
requires review.

9. Status

This field displays the Status of the provider location that requires
review.

10. County

This fields displays the geocoded County of the provider location
that requires review. If the location has not been geocoded yet,
this field will display as blank.

11. CSD

This fields displays the geocoded County Subdivision of the
provider location that requires review. If the location has not been
geocoded yet, this field will display as blank.

12. Census Tract

This fields displays the geocoded Census Tract of the provider
location that requires review. If the location has not been
geocoded yet, this field will display as blank.

13. Task Created Date

This field displays the date when the Needs Review flag was added
to the provider location.

2.7.2 SEARCHING FOR PROVIDER LOCATIONS THAT REQUIRE REVIEW
PCOs can search for all Needs Review flags present on provider locations across their state.

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Figure 154: Provider Location Search Card

Feature
1. Review Task
2. System Action Pending

3. System Action Pending
Date

Description
This field allows users to search for provider locations by the assigned Needs
Review flag.
This field allows PCOs to search for provider locations with an automatic
system action. System Action Pending options include:
• Yes
• No
This field allows users to search for provider locations by the date when the
system will take action on the provider location. Users can search by a single
date or by a date range.

4. NPI

This field allows users to search for providers by their National Provider
Identifier (NPI). Only exact matches will be returned.

5. Provider Name

This field allows users to search for provider locations by First or Last Name.

6. Discipline

This field allows users to search for provider locations by one or multiple
disciplines. Discipline selections include:
• Primary Care
• Dental Health
• Mental Health

7. Specialty

This field allows users to search for provider locations by one or more
specialty. This field can only be completed once a discipline has been
selected. Once a discipline is selected, only the specialties that fall under
that discipline will be available for selection. If multiple disciplines were
selected, all specialties that apply will be available as drop-down menu
options. Specialty selections include:
• If Primary Care is chosen:
o Certified Nurse Midwife
o Family Practice
o General Practitioner
o Internal Medicine
o Obstetrics and Gynecology

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Feature

Description
•
•

o Pediatrics
If Dental Health is chosen
o Dentist
If Mental Health is chosen
o Psychiatrist
o Clinical Social Psychologist
o Clinical Social Worker
o Psychiatric Nurse Specialist
o Marriage and Family

8. Status

This field allows users to search for providers by status. Status selections
include:
• Eligible
• Ineligible

9. County

This field allows users to search for providers by one or multiple counties in
their particular state.

10. CSD

This field allows users to search for providers by one or multiple county
subdivisions in their particular state. Users can begin entering the CSD and
then choose from a filtered list.

11. Census Tract

This field allows users to search for providers by one or multiple census
tracts in their particular state. Users can begin entering the census tract and
then choose from a filtered list.

12. Task Created Date

This field allows users to search for provider locations by the date when the
Needs Review flag was added to the provider location. Users can search by a
single date or by a date range.

13.
(Search Button)

When the desired fields are selected, users should click the Search button to
initiate the search. At least one field must be selected before the Search
button is enabled.

14.
(Clear Button)

Users may select this button to clear the fields used during a search.
Selecting the “Clear” button on this page will also remove the search results
from view.

2.7.2A SAVING COMMON PROVIDER DASHBOARD SEARCHES
PCOs can save commonly used searches using by selecting “Save this Search” link and entering the required
information.

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Figure 155: Create New Saved Search on Provider Dashboard

INSTRUCTIONS
To create a new saved search:
1.
2.
3.

4.

Select the desired search criteria
Enter a name for the saved search
Select the “Make Default” button (Optional)
a. If selected, the chosen search criteria will be pre-populated with the Saved Search when the user
navigates to the Provider Dashboard
b. If a user already has a default search selected, the newly created search will override the existing
default search
Select the “Save” button

Once a search has been saved, PCOs can view the saved search filters by opening the “Save this Search” accordion
in the Provider Dashboard Search section. If a saved search is selected as the default search, the search filters will
be populated automatically when the user navigates to the Provider Dashboard using the “Go to Dashboard”
button.

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Figure 156: Provider Dashboard Existing Saved Searches

Feature
1. Search Name

Description
This field shows the user entered name of the saved search. If the saved
search has been set as the default, a purple “Default tag will appear next to
the search name.

2. Make / Remove Default

Users can only have one default search at a time. This button allows the
users to remove or change the default saved search.

3. Apply Saved Search

This button allows users to apply their saved search. Selecting this button
will populate the search criteria included in the saved search. The user must
select the “Search” button to see the filtered results in the Reviews table.

4. Delete

This button allows users to delete a saved search. The deleted saved search
will no longer appear in the Provider Dashboard search card. No provider
data will be impacted by deleting a saved search.

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2.8 ATTESTING PROVIDER LOCATIONS
PCOs can navigate to the Provider Location Attestation page from the Provider Management Landing Page. PCOs
can attest to provider locations using a new tool located on the Provider Management Homepage. On this page,
PCOs can manage provider locations with the “Complete Annual Provider Location Attestation” Needs Review Flag.

Figure 157: Navigation to the Provider Location Attestation Page

2.8.1 VIEWING THE PROVIDER LOCATION ATTESTATION TOOL

Figure 158: Provider Location Attestation Page

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Feature
1. Provider Location Search

Description
This section allows users to search for provider locations that have
a “Complete Annual Provider Location Attestation” Needs Review
flag.

2. Provider Name

This field displays the first and last name of the provider with a
location that needs to be attested.

3. NPI

This field displays the NPI of the provider with a location that
needs to be attested.

4. Provider Address

This field displays the address of the provider with a location that
needs to be attested.

5. Discipline

This field displays the discipline of the provider with a location that
needs to be attested.

6. Specialty

This field displays the specialty of the provider with a location that
needs to be attested.

7. Direct Tour Hours

This field displays the direct tour hours of the provider with a
location that needs to be attested.

8. Annual Medicaid Claims

This field displays the annual Medicaid Claims of the provider with
a location that needs to be attested.

9. Medicaid Patient %

This field displays the percentage of time the provider serves
Medicaid patients at the location that needs to be attested.

10. Sliding Fee Scale %

This field displays the percentage of time the provider serves
Sliding Fee Scale patients at the location that needs to be attested.

11. Intern or Resident?

This field displays if a provider with a location that needs to
attested is an intern or resident.

12. Site Type

This field displays the site type of the provider with a location that
needs to be attested.

13. Last Modified Date

This field displays the last modified date of the provider with a
location that needs to be attested.

14. Clinician Review Date

This field displays the clinician review date of the provider with a
location that needs to be attested.

15. Task Created Date

This field displays the task created date of the provider with a
location that needs to be attested.

16.
Attest Provider Location (button)
17. Needs Review Flags

This button allows the user to complete location attestation. The
button opens to a pop-up where attestation can be completed.
This field displays flags that are pending review. The flags are
displayed in yellow highlighted text.

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18.
Edit Location (button)

This button will navigate the user to the provider location to make
any required updates. For more information on editing provider
locations, see Section 2.5.2 Updating Provider Locations.

2.8.2 SEARCHING FOR PROVIDER LOCATIONS TO ATTEST
PCOs can use filters to search for provider locations that require attestation.

Figure 159: Provider Location Search Card

Feature
1. County

Description
This field allows users to search for provider locations by one or
multiple counties in their particular state.

2. Discipline

This field allows users to search for provider locations by
discipline. Discipline selections include:
• Primary Care
• Dental Health
• Mental Health

3. Specialty

This field allows users to search for provider locations by specialty.
Specialty selections include:
• Family Practice
• Internal Medicine
• Pediatrics

4.

5.

(Search Button)

When the desired fields are selected, users should click the Search
button to initiate the search. At least one field must be selected
before the Search button is enabled.

(Clear Button)

Users may select this button to clear the fields used during a
search. Selecting the “Clear” button on this page will also remove
the search results from view.

2.8.3 ATTESTING PROVIDER LOCATIONS

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PCOs can attest provider location after reviewing the provider card. After clicking the “Attest Provider Location”
button, a pop-up will appear to complete the attestation.

Figure 160: Attest Provider Information Pop-Up

INSTRUCTIONS
To attest a provider location:
1.
2.
3.

Select the “Attest Provider Location” button
Select the checkbox
Select the “Confirm” button

Once a user has confirmed the attestation, a success banner will display at the top of the page. No further action
by the PCO is needed.

Figure 154: Success Banner when Completing a Provider Location Attestation

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APPENDIX A – EDITABLE PROVIDER DATA FIELDS
PCOs can edit provider locations in their state and for locations with the state code Foreign Country (ZZ). PCOs can
edit provider data on provider locations, in the Search Results Grid, or in bulk using the Provider Import Tool
(locations in their state only).
When a new provider location is created in SDMS, the system will automatically set certain fields to default values.
Default fields will display “Last Updated By: System” when viewing supporting details for the respective fields
indicating that this is a default value. PCOs can override default values at any time.
Below is a list of editable fields and relevant business rules. All other fields displayed are read-only.

Data Field
Reason Code /
PCO Omitted
Reason

Provider
Location
Section

Location
Information

Search
Grid Edit
Format

Drop-down

Import
File
Action
- Omit

User Notes
Default value will be blank.
If a reason code is added to a location
record, “Status” will update to Ineligible and
the “Ineligible: PCO Omitted” column in the
Search Grid will be set to Yes.
The PCO Omitted Reason will also be
displayed on the provider location

Phone Number

Location
Information

Character
Input

- Add
- Update

Location
Information

Character
Input

- Add
- Update

Organizational
NPI

Location
Information

Character
Input

- Add
- Update

Site Type

Site Type

Drop-down

- Add
- Update

Fax Number

If a reason code is removed and the location
has no other ineligible reasons, “Status” will
update to eligible.
Default value will be blank.
Users can enter up to 30 digits (10 for the
phone number and up to 20 for the
extension).
Default value will be blank
Users can enter up to 30 digits (10 for the
phone number and up to 20 for the
extension).
Default value will be N/A.
Users must enter 10 digits.
Default value will be blank.
If the location is associated to a site, the Site
Type will be defaulted based on the site type
of the site association.
“State/County Mental Hospital” will only be
an available option if the provider’s
discipline is Mental Health.

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Data Field

Discipline

Provider
Location
Section

Search
Grid Edit
Format

Import
File
Action

Clinical
Information

Drop-down

- Add
- Update

User Notes
PCOs seeking to identify a provider who is
serving at a correctional facility should only
be selecting State or Federal Correctional
Facility as the Site Type. They should not
also be omitting the provider using the “Not
Public Access Facility” omission code.
Default value will be set based on the
provider’s primary, active taxonomy.
If the user changes the discipline, the
specialty must also be updated.

Specialty

Clinical
Information

Drop-down

- Add
- Update

Setting the discipline and specialty will clear
the “No Discipline/Specialty” ineligible
reason and the “Ineligible: No
Discipline/Specialty” column on the Search
Grid.
Default value will be set based on the
provider’s primary, active taxonomy.
This field is dynamic based on which
discipline is selected.
If the user changes the discipline, the
specialty must also be updated.

Dental Auxiliaries

Direct Tour Hours

Clinical
Information

Drop Down

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update
- Add
- Update

Setting the discipline and specialty will clear
the “No Discipline/Specialty” ineligible
reason and the “Ineligible: No
Discipline/Specialty” column on the Search
Grid.
Default value will be set to Unknown.
This field is only enabled if Dental Health is
selected as the discipline.
Default value will be set to 40.
Users can enter a whole integer between 0
and 168.
The user may enter Direct Tour Hours
greater than 40 and up to 168, but a
maximum of 40 hours will be used by the
system in order to calculate FTE.
If the direct tour hours are set to 0, the
provider must be omitted by selecting a
Reason Code/PCO Omitted Reason.

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Data Field
Annual Medicaid
Claims

Medicaid %

Provider
Location
Section

Clinical
Information

Search
Grid Edit
Format
Numerical
with Input
Stepper

Import
File
Action

- Add
- Update

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

Sliding Fee Scale
%

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

Homeless %

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

Migrant
Farmworker %

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

Migrant Seasonal
Farmworker %

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

American
Indian/Alaska
Native %

Clinical
Information

Numerical
with Input
Stepper

- Add
- Update

Intern or
Resident?

Employment
Status

Drop-down

- Add
- Update

J1 Visa Waiver
Holder?

Employment
Status

Drop-down

- Add
- Update

User Notes
Default value will be set to 0.
Users can enter a whole integer between 0
and 999,999,999.
For Primary Care, any value 5000 and above
results in an FTE of 1. For Mental Health
and Dental Health, any value 4000 and
above results in an FTE of 1.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value will be set to 0.
Users can enter a whole integer between 0
and 100.
Default value be set to No.
If Yes is selected, the location’s FTE values
will be affected as follows:
• For Primary Care, the FTE will be set
to 0.1
• For Mental Health, the FTE will be set
to 0.5
Default value will be set to No.
If Yes is selected, the location’s FTE values
will be set to 0.
If Yes is selected, the location will become
ineligible with a reason of “Is J1 Visa Waiver

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Data Field

Federal Provider

Display Address

Clinician Data
Reviewed

Provider
Location
Section

Employment
Status

Location
Address

Attestation
Banner

Search
Grid Edit
Format

Drop-down

Drop-down

N/A

Import
File
Action

User Notes
Holder” the “Ineligible: J1 Visa Waiver
Holder” column in the Search Grid will be
set to Yes.
If No is selected and no other ineligible
reason applies, the location will become
eligible.
Default value will be set to No.

- Add
- Update

If Yes is selected, the location will become
ineligible with an ineligible reason of “Is
Federal Provider” and the “Ineligible:
Federal Provider” column in the Search Grid
will be set to Yes.
If No is selected and no other ineligible
reason applies, the location will become
eligible.
For locations that have been successfully
geocoded (Match Levels between 1 and 3),
the display address will default to the
standardized address.

N/A

For locations that are not successfully
geocoded (Match Level of 4 or greater) or
manually geocoded (Match Level of 0), the
display address will default to the physical
address.
Default value will be set to No.

- Add
- Update

The following data fields can only be edited on provider locations.

Data Field

Designation/Organization
Name
Site Name

Designation ID

Organization Unique ID

Provider Location Section

User Notes

Location Information

This field will be automatically populated if a
PCO initiates a site association.
Default value will be blank.

Location Information

This field will be automatically populated if a
PCO initiates a site association.
Default value will be blank.

Location Information

This field will be automatically populated if a
PCO initiates a site association.
Default value will be blank.

Location Information

Default value will be blank.

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Data Field

Provider Location Section

Designation Status

Location Information

Latitude

Location Address

Longitude

Location Address

Manually Moving the Pin
on the Map

Location Address

User Notes

This field will be automatically populated if a
PCO initiates a site association.
Default value will be blank.
This field will be automatically populated if a
PCO initiates a site association.
Default value will be set based on HDW
geocoding service.
Users can enter up to 10 decimal values.
Default value will be set based on HDW
geocoding service.
Users can enter up to 10 decimal values.
Moving the pin on the map will change the
values in the Latitude and Longitude fields in
real time.

The following data fields can only be edited in an import file when adding a new provider location using the Import
Tool.

Data Field
Address Line 1

Import File
Action
- Add

Address Line 2
City

- Add
- Add

Postal Code

- Add

State

- Add

User Notes
Must be a valid address containing alphanumeric characters.
This field cannot be blank.
May be included in new location records.
Must be within the state of the PCO modifying the record. This
field cannot be blank and must contain alphabetic characters
Must be within the state of the PCO modifying the record. This
field cannot be blank and must be a 5 to 9 digit number.
When adding new locations using the Add New Locations popup modal, state will default to the PCO’s assigned state and
cannot be edited.
Must be within the state of the PCO modifying the record. The
field cannot be blank and must be a valid state/territory
abbreviation.

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APPENDIX B – CHANGES TO LAST UPDATED BY BANNER
Updates to provider data and provider locations cause the Last Updated By Banner at the top of the provider
profiles and locations and in the supporting details for editable fields on a provider location to be changed. Below
is a list of possible updates and relevant business rules.

Update Type

New Provider
NPI Address
Taxonomy
Change
DoB Update
Deactivate
Provider
Reactivate
Provider
NHSC Nightly
Job
Needs Review
Flags Nightly
Job
New Location
through Portal
New Location
Through
Import Tool
Location
Updated
Through Search
Page
Location
Updated
Through
Location Page
(includes
geocoding)

Update
Initiator

Updates
Location
Last
Modified
Date?

Updates
Location
Last
Modified
by?

Updates
Profile
Last
Updated
Date?

Updates
Profile
Last
Updated
by?

Updates
Supporting
Details?

NPPES Import

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

Yes

Yes

No

No

No

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

User

Yes

Yes

Yes

Yes

Yes

User

Yes

Yes

Yes

Yes

Yes

User

Yes

Yes

Yes

Yes

Yes

User

Yes

Yes

Yes

Yes

Yes

NPPES Import
NPPES Import
NPPES - DoB
NPPES Import
NPPES Import
System NHSC
System –
Needs
Review

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Update Type

Location
Updated
Through
Import Tool
(includes
geocoding)
Location
Updated by the
System
Location
Updated by
approval of a
Facility HPSA
Designation
Batch
Geocoding
Updates

Update
Initiator

Updates
Location
Last
Modified
Date?

Updates
Location
Last
Modified
by?

Updates
Profile
Last
Updated
Date?

Updates
Profile
Last
Updated
by?

Updates
Supporting
Details?

User

Yes

Yes

Yes

Yes

Yes

Admin

Yes

Yes

Yes

Yes

Yes

User

No

No

No

No

Yes

System Geocode

No

No

No

No

No

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APPENDIX C – INELIGIBLE REASONS AND PCO OMITTED REASONS
If a provider location is ineligible, it must have one or more ineligible reasons. Ineligible locations will not be
considered during the designation process. Below is a list of possible Ineligible Reasons and relevant descriptions.

Reason

Description

PCO Omitted

The PCO selected a PCO Omitted Reason. For more information on how to
omit provider locations, see Section 2.5.4 Omitting Provider Locations.

CMS Deactivated

CMS deactivated the provider. This ineligible reason can only be removed by
a change in the CMS NPPES NPI Delta file.

Not Geocoded

The system received a geocoded match level of 4 or higher. This ineligible
reason can be removed by prompting the system to attempt to geocode the
address again or by manually geocoding the address. For more information
on resolving geocoding issues, see Section 2.5.2B Re-Geocoding Provider
Locations.

Is Federal Provider

The PCO indicated that the provider is a federal provider. This ineligible
reason can be removed by indicating that the provider is not a federal
provider in the “Employment Status” section on the provider location page.

Is J1 Visa Waiver Holder

The PCO indicated that the provider is a J1 Visa Waiver Holder. This
ineligible reason can be removed by indicating that the provider is not a J1
Visa Waiver Holder in the “Employment Status” section on the provider
location page.

Is NHSC Employee

The provider is an Active NHSC participant. This ineligible reason can only be
removed by a change in the participant’s status in BMISS.

No Discipline/Specialty

The provider’s primary taxonomy does not map to a valid discipline/specialty
combination in SDMS. This ineligible reason can be removed by adding a
valid discipline and specialty. For more information on how to add a valid
discipline and specialty see Section 2.5.2 Updating Provider Locations.

New, Not Reviewed

The provider was imported into SDMS but has not been reviewed and/or
updated by the PCO. This ineligible reason can be removed by making any
change to a provider location. For more information on removing this
ineligible reason, see Section 2.5.5D Review New Provider Location.

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PCO OMITTED REASON DEFINITIONS
If a provider location is ineligible and has been omitted by a PCO, a PCO Omitted Reason must be provided. Below
is a list of possible PCO Omitted Reasons and relevant descriptions.

Reason

Description

Admin Only

Medical care not provided at this location, only used for administrative
purposes

Core Mental Health Provider

Provider has a Core Mental Health specialty
This PCO Omitted Reason will only display on provider locations with a Mental
Health Discipline.

Deceased

Provider is deceased

Duplicate Entry

Duplicate of an existing location

Faculty

Location is an academic or research location

Incorrect Profession

Provider is listed with an incorrect taxonomy

Inpatient Facility Only

Facility has no outpatient services

License Suspended by State/In
Disciplinary Status by State

Provider is not practicing due to a suspended license

Locum Tenens/As Necessary

Provider is standing in for the permanent full-time provider at this site

Military Address

Location is a military facility

Non-Fed Not Licensed in State

Provider not working at federal facility and also not licensed in state

Not a Service Delivery Site

Medical care cannot be accessed at this location (Possible home address or an
administrative location)

Not in Clinical Practices

Provider not currently in clinical practice

Not Public Access Facility

Facility does not offer care to the general public

Open-Ended Long-Term Leave

Provider is on an extended leave from practice

Relocated

Location omitted because provider moved

Retired

Provider has retired

Specialist/Subspecialist

Provider has an eligible taxonomy but practices an ineligible subspecialty

Urgent Care Clinic

Location is an urgent care clinic and does not provide full scope of Primary,
Mental, or Dental care

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APPENDIX D – IMPORT TOOL ERROR MESSAGES
In a Provider Upload Report, PCOs can see a detailed error message for each record in an import file that was not
processed. Below is a list of possible error messages and recommended resolution.
Any issue with updating a record using the import tool can also be addressed by editing using the Provider Search
Results table or from a provider location. For more information on editing in the Provider Management portal, see
Section 2.2.4 Editing Provider Locations in the Search Results Grid and Section 2.4 Viewing Provider Location.

Error Message

Action

Address Line 1 does not contain any letters
Address Line 1 is blank
Address Line 1 length greater than 255 characters
Address Line 2 length greater than 255 characters
All fields are blank

- Add
-Update
- Omit
- Add
-Update
- Omit
- Add
- Update
- Omit
- Add
- Update
-Omit
- Add
- Update
- Omit

American Indian/Alaska Native Percentage
greater than 100

- Add
- Update

An identical location exists that has not been
geocoded, please manually geocode location

- Add

Annual Medicaid Claims less than 0
Both Discipline and Specialty should contain a
value
City cannot contain numeric values

- Add
- Update
- Add
- Update
- Add

City is blank

- Add

Dental Auxiliaries contains an invalid value

- Add
- Update
- Add
- Update

Direct Tour Hours are 0
Direct Tour Hours greater than 168
Direct Tour Hours less than 0

- Add
- Update
- Add
- Update

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Resolution

Review the address and update the
Address Line 1 column to contain
letters.
Review the address and update the
Address Line 1 column.
Review the address and decrease the
characters in the Address Line 1 column.
Review the address and decrease the
characters in the Address Line 2 column.
Enter data in the following fields: NPI,
First Name, Last Name, Discipline,
Specialty, Address Line 1, Address Line
2, City, State, Postal Code
Update the American Indian/Alaska
Native % Column to be between 0 and
100.
Select the Update action for the existing
location. No additional data needs to be
changed to trigger a regeocode.
Update the Medicaid Claims column so
it is 0 or greater.
Enter a discipline and specialty for the
impacted record.
Review the city name and remove any
numeric values. The City column should
only contain letters.
Review the address and update the City
column.
Choose an option from the drop-down
in the Dental Auxiliaries column.
Include a Reason Code and set the
Action to Omit. Eligible providers
cannot have 0 Direct Tour Hours.
Update the Direct Tour Hour column to
be between 0 and 168
Update the Direct Tour Hour column to
be between 0 and 168

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Error Message

Action

Direct Tour Hours not numeric
Discipline must be Mental Health if the Site Type
is State/County Mental Hospital

- Add
- Update
- Add
- Update

Duplicate Existing Address.

- Add

Fax number must be between 10 - 30 digits

- Add
- Update

Homeless Percentage greater than 100

- Add
- Update
- Add
- Update
- Omit
- Add
- Update
- Omit

Invalid Zip Code
Location included in another Provider Upload that
is ready for review.
Location has been modified since the location
data was exported

- Update
- Omit

Location not found.

- Update
- Omit

Medicaid Patient Percentage greater than 100

Migrant Seasonal Farmworker Percentage greater
than 100

- Add
- Update
- Add
- Update
- Add
- Update

Not all address fields exist

- Add

NPI does not exist

- Add
- Update
- Omit

NPI is blank

- Add
- Update

Migrant Farmworker Percentage greater than 100

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Resolution

Update the Direct Tour Hour column to
be between 0 and 168
Change the Discipline to Mental Health
or change the Site Type to a different
selection. Locations that do not have a
Mental Health discipline cannot have
“State/County Mental Hospital” as their
Site Type.
This address already exists for this
provider NPI.
Fax number must be between 10 and 30
digits and should be formatted as (xxx)
xxx-xxxx
Update the Homeless % Column to be
between 0 and 100.
Review the address and update the Zip
Code column. The Zip Code column
should contain at least 5 numbers.
Finalize the previously uploaded import
file. Update the location through the
web portal or cancel the more recent
Provider Upload.
The provider location has been changed
since the file was initially downloaded.
Update the location through the web
portal or download a new import file.
The Provider Location ID must match for
the system to identify a provider
location.
Update the Medicaid Patient % Column
to be between 0 and 100.
Update the Migrant Farmworker %
Column to be between 0 and 100.
Update the Migrant Seasonal
Farmworker % Column to be between 0
and 100.
The following address columns must be
present when adding a new location:
Address Line 1
Address Line 2
City
State
Postal Code
PCOs can only add locations for
providers that have been imported from
CMS. If the NPI cannot be found,
locations cannot be added or updated.
Review the entered NPI and ensure it
matches an NPI already in the system
Review the provider and enter a value
in the NPI column.

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SDMS PCO Provider Management User Guide

Error Message

Action

NPI is not the correct length
PCO Omitted Reason cannot be Core Mental
Health Provider if Discipline is not Mental Health

- Omit
- Add
- Update
- Omit
- Omit

Phone number must be between 10 - 30 digits

- Add
- Update

Provider has been deactivated by CMS

- Add
- Update
- Omit
- Omit

Reason code is blank

Reason code is not blank

- Add
- Update

Sliding Fee Percentage greater than 100

- Add
- Update
- Add

State abbreviation is invalid

State does not match PCO state

- Add
- Update
- Omit

Resolution
NPIs are all ten digits. Review the
entered NPI and ensure it has 10
numbers.
The Core Mental Health Provider PCO
Omitted Reason cannot be added to
provider locations with a Primary Care
or Dental health discipline.
Phone number must be between 10 and
30 digits and should be formatted as
(xxx) xxx-xxxx
The provider can no longer be edited.
All data for providers deactivated by
CMS are read-only.
The Reason Code column must be
populated if the Direct Tour Hours
column is set to 0 or if the provider is
being omitted.
The Reason Code column should not be
populated for eligible providers. If a
provider should be marked as ineligible,
use the Omit action.
Update the Sliding Fee % Column to be
between 0 and 100.
The state in the location must match
the state abbreviation associated with
the PCO. The system only accepts State
Postal Codes.
The state in the location should match
the state associated with the PCO. The
system only accepts State Postal Codes.

If the system could not process the import file, one of the following error messages will display:

Error Message

Error! This file is missing a required column.
Error! This file could not be processed.

Error! The file creation date is missing or invalid.
Error! This file is a duplicate.
Error! No Actions were selected in this file.

Resolution

Cancel the Provider Upload. Ensure the file has all of the
required columns.
Cancel the Provider Upload. Upload a new version of the
import file. Ensure both “Provider Locations” and
“Metadata” tabs are present, the tab names have not been
modified, and the macro has been enabled. =
Cancel the Provider Upload. Ensure the timestamp on the
“Metadata” tab is formatted as follows: MM/DD/YYYY
HH:MM:SS, and the cell format is set to text.
Cancel the Provider Upload. Upload a different file that has
not previously been uploaded to the system.
Cancel the Provider Upload. Ensure values are entered in
the Actions column.

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File Typeapplication/pdf
File TitlePCO Provider Management User Guide
AuthorPublicis Sapient Government Services
File Modified2025-06-23
File Created2025-05-09

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