Health Care Provider
Once you Save Draft on the Contact Information section, the Health Care Provider and Funding Request Details tabs will appear. Completion of these tabs is mandatory.
- Click the Health Care Provider tab to toggle to that view.
- Click New to input a new HCP.
- All entered HCPs will appear in the table displayed. You can scroll across and down the table to view all details. If you have not submitted any HCPs, this will be blank as on the previous slide.
- Enter the Provider’s HCP Number.
- Enter the Facility Name.
- Identify if the Provider is the Lead HCP.
- `Note: Applicants must designate a Lead HCP to submit their application.
- Enter the HCP Street Address.
- Enter the Provider’s FCC Registration Number (FRN)(optional).
- Select the Provider’s Eligibility Type from the drop-down (optional) (see Slide 15).
- Enter the Provider’s ten-digit National Provider Identifier (optional).
Reminder: Only the Lead HCP is required to have a USAC Eligibility Determination.
- Enter the County in which the HCP is located.
- Indicate if the HCP is a Hospital.
- Enter the Total Patient Population treated by the HCP site each year.
- Estimate the total number of patients to be served by the funding request.
- Click Add to include the HCP in the application.
- Reminder: You can use the paperclip icon to submit supporting documentation for each HCP.
- The total number of entered HCPs appears at the top of the tab.
- Use the hamburger menu (three horizontal lines, above the Actions column) to see additional table options (e.g., export to Excel).
- Use Actions to make table updates, including:
- If you wish to edit an HCP entry, click the pencil icon to return to the HCP details screen.
- If you wish to delete the HCP entry, click the ‘X’ icon.
Application Tip: Be sure to click Save after completing the HCP tab.
Disclosure Notice: The Name, Address, DUNS Number and Business Type will be disclosed in accordance with Federal Funding Accountability and Transparency Act of 2006 (FFATA)/DATA Act reporting requirements.