Common use of Group Affiliation Clause in Contracts

Group Affiliation. Required for Groups and members of groups (provider types, P, I, D or T and G) (This field may be NULL for other records not associated with a group)– This is the Plan Provider Number assigned by the HMO, PSN or MediPass to the group practice that the provider is affiliated with. The group affiliation number is the same for all providers within that group. While the Group Affiliation is not required to be used for PCPs that are not members of a group or for individual providers (i.e. non-PCPs), the provider file analysis is not able to determine which I, T or D providers (or P) are solo practitioners. Therefore, HMO or Reform PSNindividual providers that do NOT practice as members of a group plan should populate this field and may use the plan code (Plan Medicaid ID for the county) with leading zeroes or another number, such as a number assigned to the provider by the plan, provider’s Medicaid ID or other number.