Screen Name: IPMB

Screen Use: The IPMB screen is used to open, re-open or close a provider record.

IPMB Screen Description: Basic Provider Record Update

Scenario: As a support staff person, you just received a dated and signed provider application and need to open a new provider record.

This section of the IIS screens training will teach you how to access the IPMB screen

to enter a new provider record.

Open a blank DHR screen and Type IPDA,NAM=provider last name, (space) first name,new press Enter.

IPDA,nam=dark, chocolate,new

If the provider is not on the data base, Press F10 to continue.

If you enter a common name such as Smith, the Potential Provider Display screen appears with a list of names. If your provider does not appear on the list, press F10 to enter the new provider record.

555-44-3333333-55-4444

P12345P12345

04/12/3012/01/32

The Basic Provider Record Update screen is displayed.

Press the Tab key to the Date Opened field, Type the date the application was signed.

071506

To continue to open a new provider in the IPMB screen, you must determine the

Provider Type code. The next slide will display these codes. After selecting the appropriate

code, enter it in the ‘TYPE’ field.

Provider Type codes: ‘Type’ field

AA = Adopt Home AgencyAF = Foster ParentCA = Contracted Agency DC = Day Care CenterDF = Day Care FamilyDG = Day Care GroupDI = Day care in HomeFA = Sex Abuse TreatmentFB = FC Reg/ShelterHK = HousekeeperIF = Intensive Family ServiceIH = Intensive Home BaseIL = Independent Living FacilityNP = Nonpaid ProviderPT = Parent TrainingVN = Vendor

Press the Tab key to the TYPE field, Type the provider type code.

fb

24tg

Press the Tab key to the WKID field, Type load code.

24

Press the Tab key to the Provider Branch Location field, Type your division number.

24tg

Press the Tab key to the Provider Name field, Type provider last name, first name.

Dark, Chocolate

24tg

This step is not necessary. If you do not enter the provider name, it will automatically fill in for you.

040459

Press the Tab key to the DOB field, Type provider’s date of birth.

24tg

541789565

The curser will move to the SSN field, Type provider’s social security number.

24tg

p

Press the Tab key to the Name Desig field, Type ‘p’.

24tg

If you have a second provider, enter the name in the 2: field.

f

The curser will move to the Sex field, Type provider’s sex. F for female and M for male.

24tg

a

The curser will move to the ETH field, Type the provider’s race.

ETH codes can be found on the Provider Application (form CF 1260A).

24tg

u

The curser will move to the Origin field, Type the provider’s origin.

ORIGIN codes can be found on the Provider Application (form CF 1260A).

24tg

sep

The curser will move to the Mar-Stat field, Type the provider’s marital status.

See form CF331 for code details.

24tg

The Relig, Empl, Income and LEDS fields are not mandatory data entry fields. Refer to the provider application (CF 1260A); if the information is documented on the application enter the data into the appropriate fields.

24tg

3781234

Press the Tab key to the Work Phone field, Type 7 digit provider work phone number.

24tg

2748 se milner

You must enter a physical address, a P.O. Box address is not allowed in this field.

Press the Tab key to the Street field, Type provider’s street address.

24tg

Press the Tab key to the City field, Type the provider’s city.

portland2748 se milner

24tg

or Press the Tab key to the State field, Type the provider’s state.

24tg

97232 Press the Tab key to the Zip field, Type the provider’s zip code.

24tg

mult

Press the Tab key to the CNTY field, Type a 4 digit county code.

24tg

503

The curser will move to the A/C field, Type the providers 3 digit area code.

24tg

2342789

The curser will move to the Phone field, Type the providers 7 digit phone number.

24tg

Press Enter to complete the data entry.

24tg

A new provider record has been created and a provider number is assigned.

24tg

When all data entries have been completed in the IPMB screen, press the Pause Break key.

A blank DHR screen will appear so that you can complete work for other screens.

Quick Review!

T or F If the provider does not appear on the Potential Provider Display list, press F 7 to enter the new provider record.

On the Basic Provider Record Update screen in the Date Opened field you must type the date the application was received.

A physical address is needed in the Basic Provider Update screen; a P.O. Box address is not allowed in this field.

Ethnicity codes can be found on the CF 1260A.

T or F

T or F

T or F

See the next slide for the answers.

Check Your Answers

If the provider does not appear on the Potential Provider Display list, press F 7 to enter the new provider record.FALSE. Press F10 to enter the new provider record.

On the Basic Provider Record Update screen in the Date Opened field you must type the date the application was received.FALSE. You must type the date the application was signed.

A physical address is needed in the Basic Provider Update screen; a P.O. Box address is not allowed in this field.TRUE.

Ethnicity codes can be found on the CF 1260A.TRUE.

Congratulations!

YOU have successfully completed the DHS IIS

Data Entry Screens Training.

Special thanks to Christina Latham-Brown and Leslie Burr in the CAF

Training Unit, and all the branches who participated in creating the IIS Data

Entry Screens Training.

Created By:

Training & Development Specialists:

Jenene HinsonCheryl Hamilton-Jefferson

Program System Support Unit2850 Broadway St NE

Salem, OR 97303

QUESTIONS?Contact Service Desk

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