EVV Vendors and Providers Report

Description:

The EVV Vendors and Providers Report provides a list of program EVV Vendors and  Providers for a state program based on an entered date range.

Use:

State users are able to view a list of their providers and their vendors, along with their effective and termination dates.

Field and Columns:

Parameters

Use the following fields to limit the report output by:

Field	Description
Account	EVV Vendors and Providers associated with the selected account(s)
Provider ID	EVV Vendors and Providers associated with the entered Provider ID

Report Output

Each column of the report displays:

Field	Description
Account	the account name
Vendor	the name of the organization responsible for rendering EVV services
Effective	the date range for which the Vendor is considered effective for rendering EVV services
Address	the EVV Vendor’s address
Contact	the EVV Vendor’s defined contact person
Provider ID	the individual provider’s system generated ID number
Provider Last Name	the individual provider’s last name
Provider First Name	the individual provider’s first name
Medicaid ID	the state assigned identifier for the provider
Effective Date	the first date which the individual provider is considered effective for rendering EVV services
Termination Date	the last date which the individual provider is considered effective for rendering EVV services

Sample Report