Last Modified: 7/28/2018 Location: FL, PR, USVI Business: Part A, Part B
How many EIDM accounts vs. SPOT profiles FAQ
Q: How do I determine how many EIDM accounts my organization needs? Do I need multiple EIDM accounts or SPOT profiles if we have more than one provider in the practice?
A: Any member of your organization who requires access to the SPOT must have his or her own EIDM Account. The number of practitioners belonging to your organization does not determine the number of EIDM accounts your organization needs; however, whether the members of your organization bill Medicare as a group or as individuals does determine how many SPOT profiles your organization needs.
There are three different types of profiles for SPOT:
1. EIDM SPOT Application Access Profile -- created and managed in EIDM
2. Default profile within The SPOT -- automatically created when the EIDM SPOT Application Access Profile was approved; information is stored in the SPOT database
3. Additional SPOT Profiles -- created by the user; information is stored in the SPOT database
The primary differences between your EIDM SPOT Application Access Profile, the Default profile within the SPOT, and any Additional SPOT Profiles include how the profile was created, types of information included within the profile, and where the profile’s information is stored.
One EIDM account per individual requiring access
The number of EIDM accounts you will need is directly determined by the number of individuals in your organization who require access to the Medicare information provided through SPOT. EIDM accounts may not be shared.
• If you have only one individual who requires access to SPOT, then your organization will require only one EIDM account
• If you have multiple individuals in your organization who require access to SPOT, then your organization will require multiple EIDM accounts -- one per staff member.
Note: The individuals requiring access do not have to be practice officials; however, each must know the provider-specific information (NPI, PTAN, TIN, and Practice Official’s identity/role) associated with the billing entity or billing entities.
One billing entity: One ‘default profile’
If your organization bills Medicare as a group, professional association, or corporation -- even if the organization has only one practitioner -- only information about the billing entity will be available through the SPOT.
Note: If your organization has more than one practitioner and they all bill Medicare as part of the same group/billing entity, then claims and payment information will not be available for each individual practitioner.
Your default profile, which was automatically created when your EIDM SPOT Application Access Profile was approved, should reflect only the NPI, PTAN, TIN, and practice official information associated with the billing entity not each individual practitioner.
Note: An additional SPOT profile is a profile that contains provider-specific information that differs from the default profile associated with the EIDM SPOT Application Access Profile. If you only have one billing entity (i.e., group, professional association, or corporation), you will not need any additional SPOT profiles.
Your organization may have multiple EIDM accounts for the SPOT (one for each staff member requiring access), but all accounts will have the same provider profile (NPI, PTAN, TIN, and Practice Official’s identity/role) based upon the billing entity.
Multiple billing entities: Multiple additional SPOT profiles
If each practitioner bills Medicare under his or her own NPI, PTAN, and SSN -- not as part of a group -- then each user will need one default profile and multiple additional SPOT profiles -- one per billing entity.
Note: Your organization may have multiple EIDM accounts for the SPOT (one for each staff member requiring access), but each account may also require one or more additional SPOT profile (one for each separate billing entity).
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