Clinical Faculty: Credentialing/Onboarding Requirements
The qualifications of all newly hired faculty are reviewed by the Clinic Advisory Committee for recommendation of hiring to the Associate Dean of Clinical Affairs. Once approved for hire and in order to see patients in clinic, faculty must go through a credentialing process. Please provide Clinic Administration with copies of the following within two weeks of hire date and prior to having access to electronic medical records.
- Recent CV
- Your unexpired Optometric License (or request of Statement of Licensure) – TPA licensed OR Medical License
- NPI number
- DEA number (if you have one)
- Medicare and MediCal provider numbers
- CAQH number
- CPR Card (if you have one); CPR certification is not required by the California State Board of Optometry
- Copy of TB testing or chest x-ray due by March 31 of each year
- Copy of flu shot if in the fall/winter
Please initiate the following items within two weeks of hire date. These items must be completed prior to having access to electronic medical records. Please submit forms to Clinic Administration (to Vikki Yu, OD at firstname.lastname@example.org) in one pdf:
- FBI/Department of Justice Background Check (Fingerprinting – does not need to be done if obtaining a California Optometric license within six months of UC employment)
- HIPAA Training Completion Certificate
- FERPA Acknowledgement Form
- CANRA and Elder Abuse Statements
- Health Care Vendor Relations Policy acknowledgement form
- Blood Borne Pathogen Training
- Clinical Faculty Credentialing Attestation
- Clinical Faculty Information Release Acknowledgement
- Clinical Faculty Peer References Form
- Clinical Faculty Privileging Checklist
- Computer Use Policy Acknowledgement
Sign-up of insurances with Patrick Richards, Compliance Officer, at email@example.com:
- March Vision Care
- UC Care via Blue Shield
OPTOMETRIC LICENSE OR STATEMENT OF LICENSURE OR MEDICAL LICENSE
California Business and Professions (BPC) Code 3075 requires that optometrists or ophthalmologists post his or her current license or other evidence of current license status issued by the board in each location where he or she practices optometry/ophthalmology. The faculty member’s unexpired Optometric License or Statement of Licensure or Medical License must be on file in the Clinic Administration Office. If the UC Optometry Clinic is your principal place of practice, then please provide an Optometric or Medical license with the School of Optometry address listed.
If UC is NOT the principal place of practice, you must apply for a Statement of Licensure for the UC location (if you do not already have one on file with us). The Optometric license and Statement of Licensure or Medical license must be renewed. You may apply for an Optometric Statement of Licensure at this website:
The fee is $40 for a Statement of Licensure. When you receive your Statement of Licensure, please submit it to Vikki Yu in the Clinic Administration office. Please let me know if you have any questions. Thank you for being mindful of this requirement.
OBTAINING YOUR NATIONAL PROVIDER IDENTIFICATION (NPI) NUMBER
The Centers for Medicare & Medicaid Services mandates that all individuals who meet the definition of health care provider and who bills Medicare for services is to obtain a National Provider Identifier (NPI). As a member of the School of Optometry who provides services to our patients, some of whom are covered by Medicare, we ask that you complete this requirement. The School of Optometry does have an NPI Identifier for the school as an organization, however, this may not suffice for our billing purposes. Therefore, we are asking each faculty person to obtain their personal NPI Identifier Number and provide us, the School of Optometry, with a copy of a letter or email you receive from the NPI enumerator which states your NPI Identifier. You may need share your NPI with other offices with which you work. If you have already obtained your NPI Identifier, please forward us a copy of the confirmation letter or email sent to you. Learn more by visiting www.cms.hhs.gov/NationalProvIdentStand/. If you have questions or need technical assistance, please contact the NPI Enumerator at:
NPI Enumerator Contact Information:
By Phone: 800-465-3203 (Toll Free)
By e-mail: firstname.lastname@example.org
By mail: NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059
You may register by competing the on-line application at the NPPES web site: https://nppes.cms.hhs.gov/NPPES/Welcome.do
- Click on “National Provider Identifier (NPI)”
- Click on “Apply Online for NPI” and follow the directions.
- Normally, you will get an email with your NPI the same day. This is a number that you need to keep current. In the future, if you have more numbers associated with your name, e.g, insurance provider numbers, etc. You will need to update this information on their website.
Please have your license, Medical, Medicare, UPIN numbers (if you have them) readily available for entry as you are requested to provide that information. The online process is quick and easy and it is free. It takes only minutes to complete the online registration. Shortly thereafter, you will receive your NPI by email. Please make sure you keep the confirmation document that NPPES sends to you which contains your NPI and forward a copy to us.
OBTAINING YOUR DEA LICENSE
Optometrists who apply for a DEA may be considered for mid-level practitioners and only have access to Schedule III Narcotics. The fee is around $700. However, faculty whose main place of practice is at UC Berkeley may have their fees waived. To apply, please go to http://www.deadiversion.usdoj.gov/drugreg/ Click on New Applications and click on Form 224 for Practitioners (MD,DO,DDS,DMD,DVM,DPM), Mid Level Practitioners (NP, PA, OD, etc.), Pharmacies, Hospitals/Clinics, Teaching Institutions. Please select “Practitioner.” Complete the form.
- Visit DEA Website
- You should use DEA form 224. The local DEA office has indicated that there is a button to push if you are exempt from the filing fee (fee waiver). As faculty member teaching at our Minor and Tang clinics, you are exempt and should therefore NOT pay the filing fee for your DEA number. You should put Dr. Vikki Yu, OD as the certifying official. Title: Externship Director, email@example.com, 510-642-0945
- The following are instructions provided by the COA. You may not need some of this information since the DEA has gone to an on-line format, but it may be helpful to have.
- Use a business address. The DEA will not process an application that appears to list a home address, and it will delay your application. If your business address ever changes, you must send a letter to your regional DEA office advising them of the change in address.
- Section 1 (Business Activity): Optometrists must check Mid-Level Practitioner and indicate “O.D.”
- Section 3 (Drug Schedules): Check Schedule III (Narcotic) ONLY. Do not check Schedules II, III (Non-Narcotic), IV, or V. These schedules are outside the scope of practice in CA.
- Section 4 Check “N/A” on the State Controlled Substances line. Check Schedule III (Narcotic) boxes labeled “Prescribe”, “Administer”, “Dispense” and “Procure”
OBTAINING A FBI/DEPARTMENT OF JUSTICE BACKGROUND CHECK
To protect the campus community, our students and our patients, the School of Optometry needs to ensure that our faulty have no history of criminal behavior as it pertains to patient care and student interaction. Newly appointed faculty are required to obtain a background check on the following information: Sex Offender Registry, OIG/GSA, SSN Address Locator and County Criminal databases). (Fingerprinting – does not need to be done if obtaining a California Optometric license within six months of UC employment)
You will need to complete the a digital Fingerprinting/Live Scan requirement, which will result in an FBI and CA Dept. of Justice background check. These background checks must be done in the state of California and cannot be done in any other state. Please standby for updated instructions on how to obtain a background check.
All providers should obtain the following annually:
- Tuberculosis: 1 PPD tuberculosis (TB) skin or 1 T-Spot or 1 Quantiferon blood test annually
- You can call the Tang Center at (510) 642-2000 to schedule a T-Spot TB test or if you have any questions or need additional information about the process.
- Influenza: 1 dose of vaccine annually
Professional ethics require us to protect the confidentiality of patient information. Our patients put their trust in us for their care and to protect their privacy. We are required by the University to demonstrate HIPAA training for all participants in health care, therefore all providers must complete HIPAA training. It is required that you complete a web-based training program about HIPAA. Once you are employed and have a CalNet ID, please go to this HIPAA Training course and take the course. Please turn in the completion certificate to the Clinic Administration Office.
The Family Educational Rights and Privacy Act (FERPA) is a federal law that protects the privacy of student records and prohibits University staff from disclosing certain information to parents or other individuals without the permission of the student. This legislation gives parents of minor students, and students who are over 18, the right to inspect, correct, amend, and control the disclosure of information in education records. It obliges educational institutions to inform parents and students of their rights, and to establish policies and procedures through which their rights can be exercised.
FERPA gives students of any age enrolled in a university or college the right to give or withhold consent for the educational institution to use or disclose personal information about them. There are a number of exceptions to this general right. The main one is that institutions may use student information for legitimate business purposes. Please review the Berkeley Campus Policy on FERPA at http://registrar.berkeley.edu/ferpa.html.
Please submit the Clinical Faculty FERPA Acknowledgement to Clinic Administration.
CANRA AND DEPENDENT ADULT OR ELDER ABUSE REPORTING
The California State Board of Optometry requires optometrists to report known or suspected child, dependent adult or elder abuse or neglect. California’s Child Abuse and Neglect Reporting Act (CANRA) outlines the obligation to report. The University of California at Berkeley has also implemented a policy that requires those who work with children or dependent adults and elders to report crimes against them to law enforcement or social services authorities. As a health care provider in our clinic, student interns are subject to the policy as well. If you have such a case, please report it to your attending doctor who will report it to the appropriate authorities.
Please review the attached statement and policy (Statement Acknowledging Requirement to Report Child Abuse AND Elder Abuse: Clinical Faculty CANRA and Dependent Elder Abuse Statements Acknowledgement Form) and sign/date each of the first two pages. Please submit the CANRA and CANRA and Dependent Elder Abuse Statements Acknowledgement Form to Clinic Administration.
HEALTH CARE VENDOR RELATIONS POLICY
Research shows that certain health care vendor activities allowed under the Political Reform Act, such as the provision of gifts of nominal value, may affect provider behavior and give the appearance of favoritism. This policy supplements the provisions of the Political Reform Act and University Business and Finance Bulletin G-39 (the Conflict of Interest Policy), adding restrictions to health care vendor relationships in those circumstances where the potential drawbacks of the relationship outweigh the anticipated benefit.
All faculty, students, and staff are required to read the full UC Health Care Vendor Relations Policy and supporting documents and complete and sign an acknowledgement form. Click on the links and you will be guided through the documents. Complete and submit the Acknowledgement of Health Care Vendor Relations Policy and submit it to Clinic Administration.
Please review these links regarding the Health Care Vendor Relations Policy:
Please submit the Health Care Vendor Relations Policy Acknowledgement Form.
BLOOD BORNE PATHOGEN TRAINING
Please note that the system is not compatible with Internet explorer. Chrome and Firefox with the most recent Flash Player installed should work fine. Chrome is most reliable.
Biosafety training is given by the UC Learning Center. You must have an employee ID and CalNet ID to be able to login in to the website.
Please go to: UC Learning Center Blood Borne Pathogen Training
- Click on the Start button to start the training session.
- A new window for the training may open.
- When you have completed the training, please submit a pdf copy of the certificate of completion to Clinic Administration.
Here is an alternate way to complete the training:
- Begin by signing in with your Calnet ID and PW at the Blu Portal. (When first signing up for this e-course, you cannot skip to steps 2, 3, or 4.)
- Select Systemwide Mandatory Training from the menu in the left hand column.
- Scroll down the page to Catalog => Click on “Environmental, Safety and Emergency Management.”
- In Subcategories, scroll down to select Laboratory Research & Training.
- Select “EHS 202 Bloodborne Pathogens (BBP) Online Training,” which will display buttons for registering and viewing details (the latter with drop-down subtopics).
- Read the training presentation and answer the questions. Click on the arrow in the bottom left hand corner to advance the page.
- At the end of the training, you will receive an email confirmation for course completion.
- Print the email and submit it with your credentialing documents to Clinic Administration. Keep a copy for your records.
- Read the Standard Operating Procedures for Exposure to Blood-Borne Pathogens summarized below (this web page) in the SECP section.
Standard Exposure Control Plan (SECP)
It is the policy of the University of California, Berkeley and the School of Optometry to ensure practice of Universal Precautions to reduce exposure to infectious agents. Universal Precautions are methods of infection control in which all human blood, tissue, and certain body fluids are treated as if infectious.
The Associate Dean of Clinic Affairs, the Clinic Chief, and the Department Safety Coordinator have identified positions and procedures in the Clinic and Research Units which present the possibility of occupational exposure to human blood or other potentially infectious materials. This determination is based on the risk of potential exposure to blood-borne pathogens in the course of performing assigned job duties. Self-inspection for these risks is also ongoing under the Illness and Injury Prevention Program (inj_ill_prevent2006).
The purpose of this Exposure Control Plan is to describe how to eliminate or minimize the danger of exposure to human blood or other potential infectious materials, in compliance with the California OSHA Blood-borne Pathogens Standard (8CCR §5193, effective Jan. 8, 1993), and the School of Optometry’s Illness and Injury Prevention Plan (inj_ill_prevent2006).
COMPUTER USE POLICY
These policies have been adapted for use by the UC Eye Clinics from policies developed by the University Health Services Information Systems staff in consultation with the Administrative Coordinating Team. The need for these policies has been driven by the wide-spread use of computing services throughout The UC Eye Clinic and the sensitivity of the personal and healthcare data that is used to conduct UC Eye Clinic business. Now that almost every staff member uses computers to perform their job duties, it is important that UC Eye Clinic clarifies expectations for appropriate use of the technology.
Access to the UCBSO Clinic computer network requires a commitment by all staff to certain terms and conditions in order to ensure network efficiency, reliability, and security. The policies outlined below are necessary for legal, security, and reliability reasons, as well as to ensure network efficiency, safety, and effective use of resources.
Use of UC Eye Clinic computing resources is subject to all existing federal and state laws, University regulations and policies, including the campus Computer Use Policy.
All staff members are required to review both the UC Eye Clinic computer use and e-mail policies. New staff members are required to read this policy and sign a statement of understanding and acceptance; this statement is incorporated into their personnel file. Staff failing to accept these policies are subject to termination of network and e-mail privileges. Staff members failing to abide by these policies are subject to disciplinary action up to and including termination of employment. Volunteers who use UC Eye Clinic computers during their duties at UC Eye Clinic are also required to review and abide by UC Eye Clinic and campus computer use policies.
The following are excerpts from campus Information Systems & Technology policy:
- “Computers and networks can provide access to resources on and off campus, as well as the ability to communicate with other users worldwide. Such open access is a privilege, and requires that individual users act responsibly. Users must respect the rights of other users, respect the integrity of the systems and related physical resources, and observe all relevant laws, regulations, and contractual obligations.”
- “Misuse of computing, networking, or information resources may result in the loss of computing privileges. Additionally, misuse can be prosecuted under applicable statutes. Users may be held accountable for their conduct under any applicable University or campus policies, procedures, or collective bargaining agreements.”
- The campus and UC Eye Clinic policies that govern UC Eye Clinic computer use are available from the UC Eye Clinic Systems Administrator upon request, and UC Eye Clinic policies are distributed to all new users by the UC Eye Clinic Human Resources unit as part of the employee hiring process. Policies are also available on the internal UC Eye Clinic web page.
- 1. All computer equipment is the property of the UC Regents, and may not be taken out of the Eye Clinics for personal use. Equipment may be taken out for work use that has been authorized by the UC Eye Clinic Systems Administrator. Computer equipment and network bandwidth is for work-use only. Computers may not be used for personal use except incidental use.
- Additional Reference: UC’s Electronic Communications Policy on Personal Use (III. D.8):http://www.ucop.edu/ucophome/policies/bfb/g46.pdf
- 2. Staff may not bring in non-University owned equipment and connect it to the UC Eye Clinic network without the permission and assistance of UC Eye Clinic Systems Administrator. This includes but is not limited to desktop computers, laptops, jump drives (memory sticks) cameras, external disks and PDAs.
- 3.Network storage, such as the user’s F:\ or G:\drive, is for storing confidential documents required for UC Eye Clinic work. Personal files (e.g. vacation photos, images from websites, unauthorized applications) are not permitted and will be deleted by the UC Eye Clinic Systems staff.
Access and Audit
- Individuals will only be granted access to UC Eye Clinic computer resources as part of their duties at UC Eye Clinic. Requests for new accounts or changes to current accounts must be made by the appropriate the UC Eye Clinic Manager or Supervisor. Certain restricted resources also require the approval of the resource owner and/or the user’s supervisor. Users may not make requests directly to the UC Eye Clinic Systems Administrator for access.
- Emergency access to electronic protected health information in cases of a medical emergency will be provided via one-time use accounts that are held in the Administrative Services unit. If there is a situation that requires use of this emergency access, the UC Eye Clinic Systems Administrator should be notified as soon as possible. Once the emergency has been resolved, the emergency account will be deactivated and a new emergency account created. Please see the Emergency Access to Protected Health Information policy in this manual for further details.
- System administrator accounts are provided to UC Eye Clinic Systems staff members that require full access to perform their job duties. Staff should only use system administrator accounts when required to perform their job duties and should conduct their normal computer use (such as e-mail and Internet use) under standard user accounts to limit security risks.
- As required by federal and state regulations, the UC Eye Clinic Systems staff will perform regular and on-demand audits of users’ computer and system access to ensure the security of UC Eye Clinic computing resources. Audits will include monitoring of user access to all clinic computing systems, patient and employee data stored within, use of the internet and all data traffic on the clinic network(s) including connections to the internet, as well as identification of any security incidents that must be reported to campus or government authorities.
- Staff should logout from their workstations when leaving the workstation for extended periods of time, or at the end of the day, in order to ensure data security.
- Staff are expected to lock their workstations when absent for shorter periods of time by pressing Ctrl-Alt-Del. To unlock the workstation, press Ctrl+Alt+Del again and enter your password. Shared workstations in common areas such as the eyewear center should only be locked for brief periods to protect work in progress. If you are away from your station for periods of more than a few minutes these stations should be logged off. In some cases UC Eye Clinic computers have an automatic screen saver that, after 10 minutes, will secure the computer and requires a password to access the computer.
- Passwords need to be kept confidential and changed regularly. Since passwords allow access to private files, they will not be shared. Certain systems will prompt a password change on a regular basis, but staff can initiate a change at any time. Staff are not to attempt to use a computer account to which they have no authorization. Strong passwords of a minimum of 8 characters, and containing a combination of letters, numbers, and other characters, shall be used to access UC Eye Clinic computing resources.
- The UC Eye Clinic Network may not be used to gain unauthorized access to any computer systems.
- Staff should not attempt to mask the identity of an account or machine.
- All UC Eye Clinic staff members are required to sign a Statement of Confidentiality when hired. It is the responsibility of all UC Eye Clinic staff to protect the confidentiality of UC Eye Clinic data and access to the UC Eye Clinic network. Most data security breaches occur when staff give others access to their files or passwords.
- Staff shall not encrypt UC Eye Clinic data with a private encryption key. Encryption keys should be obtained from the UC Eye Clinic Systems Administrator.
Software Licensing and Installation
- All software programs and applications, including public domain freeware or shareware software will be installed by UC Eye Clinic Systems Administrative staff. Limiting the installation of software to the UC Eye Clinic Systems Administrative staff allows them to ensure that all software running on the network servers and local computers are compatible, working efficiently, and free of computer viruses.
- UC Eye Clinic units must submit any desired purchases of software or technology services (such as third party web hosting or contract technology staff) to the UC Eye Clinic Systems Administrator to ensure that licensing and contracting issues are addressed. This includes appropriate volume licensing agreements, regulatory compliance including HIPAA (Health Insurance Portability and Accountability Act), and UC contract requirements.
- All software must be properly licensed to the University of California and/or the UCBSO Eye Clinics. No illegal duplicate copies of software may be made or used.
- No software will be installed on UC Eye Clinic computers, without the explicit permission of a UC Eye Clinic Systems Administrator. Unauthorized software includes but is not limited to software brought in from home, and software downloaded from the Internet. Some examples might be yahoo messenger, yahoo toolbars, and media players.
- Staff must always answer “No” to on-screen prompts to download software, “plug-ins,” or upgrade to newer versions of a software package (other than Microsoft Windows XP updates). If this compromises your ability to perform UC Eye Clinic activities, please contact the UC Eye Clinic Systems Administrator. Updates must be tested by UC Eye Clinic Systems staff to ensure compatibility with other software packages prior to deployment.
- The UC Eye Clinic Systems Administrator automatically does daily backups of all files stored on the network. Since it is not possible for the UC Eye Clinic Systems Administrator to back up data files that are not stored on the network, users will not store files on removable media or on the local hard drive of their desktops without the express permission of their supervisor and the UC Eye Clinic Systems Administrator. The UC Eye Clinic Systems Administrator will not be responsible for the recovery of any data stored in an unauthorized way.
- UC Eye Clinic staff will not store data containing confidential data or protected health information on removable media, including but not limited to floppy disks, compact disks, data tapes, or removable storage drives and cards, without prior approval from the UC Eye Clinic Systems Administrator. Appropriate security measures, including secure physical storage of the media and encryption of the data will be taken to protect data and patient confidentiality.
- Protected health information will NOT be stored on portable computing devices, including but not limited to laptops, tablet PCs, and personal digital assistants (Pads), without the permission of the UC Eye Clinic Systems Administrator. If there is a valid business need, the use may be allowed but the data and device must be protected by data encryption and additional security measures to protect confidential data in the case of device loss or theft.
- All files are automatically scanned for viruses when accessed at a UC Eye Clinic computer. Staff should report any computer virus incident immediately to the UC Eye Clinic Systems Administrator so that action may be taken to stop the virus from spreading. UC Eye Clinic staff should not disable virus scanning software on their desktop computer at any time.
- UC Eye Clinic Systems staff will scan all software applications that are approved for installation on a UC Eye Clinic computer, including commercially purchased or shrink wrapped software.
- No staff shall deliberately place on the network a program that compromises network security or places excessive load on the network. This includes, but is not limited to, programs such as instant messaging programs, peer-to-peer programs, file sharing programs, online games, and streaming media/video players. If you believe you have a valid business use for these programs, please contact the UC Eye Clinic Systems Administrator for assistance and approval for software installation.
- Staff should protect their computers and data from damage by keeping equipment clean and away from magnets, liquids and food.
- Staff should not move or relocate any computer hardware equipment. To move or relocate hardware, users should submit a service request to the UC Eye Clinic Systems Administrator. UC Eye Clinic Systems staff will ensure that the appropriate cables and data connections are made to continue network use. The UC Eye Clinic Systems Administrator is also responsible for inventory management and ensuring that the equipment inventory is accurate and up to date.
E-Mail Privacy and Security
- In general, the nature of electronic mail makes it less private than a user may anticipate. Please note the following:
- Electronic mail may constitute a University record, and so may be subject to disclosure under the California Public Records Act. Please note, however, that the University does not automatically comply with all requests for disclosure, but evaluates such requests relative to provisions of the Act or other applicable law. UC Eye Clinic’s regular data backup procedures mean that an e-mail message, even after being deleted by the user, may exist in a manner in which it may be subject to disclosure. See the campus e-mail policy for more information.
- UC Eye Clinic Systems staff, in the everyday performance of their duties, may inadvertently see the contents of e-mail messages. In general, they are bound to maintain the confidentiality of such messages. See the campus e-mail policy for more information.
- In general, the nature of electronic mail makes it less private than a user may anticipate. Please note the following:
Appropriateness of Use of E-Mail
- Note that when using e-mail outside of UC Eye Clinic and especially across the Internet, there is absolutely no guarantee of confidentiality of the contents of the e-mail message. Please bear this in mind when exchanging e-mail with clients, consultants, outside vendors and/or medical personnel. Never discuss any information which is to be protected by patient confidentiality guidelines in e-mail exchanged via the Internet. E-mail should be free of all ePHI.
- UC Eye Clinic e-mail users, however, are strongly encouraged to use the same personal and professional courtesies in electronic mail as they would in other forms of communications.
- UC Eye Clinic e-mail services may be used for incidental personal communications provided that this does not interfere with UC Eye Clinic computing facilities or the staff member’s employment. Note, however, that a personal e-mail is subject to the same confidentiality and disclosure issues as all other electronic mail communications.
- As outlined in the Campus e-mail policy “…University Electronic mail services may not be used for: unlawful activities; commercial purposes not under the auspices of the University; personal financial gain (except as permitted by academic policies); personal use inconsistent with Section VI, A.8 (of the Campus E-mail Policy); or uses that violate other University policies or guidelines. The latter include, but are not limited to, policies and guidelines regarding intellectual property, or regarding sexual or other forms of harassment.”
Termination of Services
- Upon termination of a volunteer or staff member’s affiliation with UC Eye Clinic, the supervisor of the terminated volunteer or staff member shall immediately notify the UC Eye Clinic Systems Administrator. Human resources will also notify the UC Eye Clinic Systems Administrator when they receive notice of termination. Arrangements for the disposition of the files of the terminated user can be made between the Supervisor and the UC Eye Clinic Systems Administrator. The user’s access to the UC Eye Clinic network will be disabled immediately.
Philip Weekly, Computer Support, UCBSO
Please sign and date the Computer Use Policy Acknowledgement Form and submit to Clinic Administration.
OBTAINING YOUR CALNET ID and bMAIL EMAIL ADDRESS
ENVIRONMENTAL HEALTH AND SAFETY TRAININGS
ACCESS TO MINOR BUILDING
Access to exterior building doors and faculty areas for after hours or during work hours would need to be requested on your behalf. Please send a copy of the front and back of your Cal1 Card to Dr. Vikki Yu at firstname.lastname@example.org and Elizabeth Doty at email@example.com and indicate what areas you would like access to. You will need to have completed the EH&S trainings 207 and 502 before a request for access can be submitted.
One way to improve safety and hygiene is for staff, faculty, residents, interns and optical staff to wear scrubs at Minor Hall Addition. So why require scrubs? Most people wear clinic jackets, ties and other work related attire multiple times before laundering it and because of this, we know that this clothing can be a source of microorganisms. While there have been no definite cases of clothing transmitting COVID19, the fact is, every day we’re learning more. While we know that COVID19 is highly transmissible and can linger on surfaces, the good news is that killing the virus is pretty easy. Wiping down surfaces with disinfectants and washing with simple soap and water does an excellent job of killing the virus. Thus, by having people wear scrubs that are laundered daily, we all are reducing a possible source of transmission and yet, presenting a consistent and professional image to our patients.
For uniformity with the interns, all staff, clinic faculty, and PreClinic Faculty will also be required to wear scrubs.
The changes in attire have been updated in Professional Appearance policy, https://optohub.berkeley.edu/professional-appearance-and-conduct-clinic. For the reasons mentioned above, due to the need for daily laundering, white coats and ties should no longer be worn in PreClinic or Clinic.
In order to have consistency of appearance and colors, we are ordering our scrubs from the company, Uniform Advantage (see below for links). We have investigated several companies for competitive pricing and Uniform Advantage has agreed to provide a 10% discount code ( S237UC10 ) that can be entered upon checkout. In order to receive our scrubs quickly, each individual must purchase their own scrubs. The 10% discount is on top of any sales they have, and includes free shipping on orders $99.00 or more. Please note, you need to order at least two pairs (top and bottom, and optional jacket) of scrubs. This is required in case of COVID exposure. As a tip, it is recommended that you stick with the same manufacturer for both the top and bottoms of scrubs since there will be better color consistency over time when laundering them.
Please order your scrubs in Navy Blue (color 830)
Please choose scrubs from the following styles from Uniform Advantage:
For Women (please note, you can order in petite/tall sizes):
UA36C – Elastic Waist
UA47C – Flared Pant
Cherokee Revolution: The fabric content is 78/20/2 poly/rayon/spandex twill
834 UA Best Buy Scrubs Round Neck Scrub Jacket
PC86C Butter-Soft Scrubs by UA™ Ladies Button Front Warm-Up Jacket
CK340 Cherokee Workwear Professionals Women’s Snap Front Scrub Jacket
Long-sleeve, solid color, same color as scrubs preferred however, a neutral color such as white, gray or black would be acceptable.
UA71C – Top
UA31C – Bottom
UA Flex2 Pants
UA Flex2 Top
Long sleeve top:
Long-sleeve, solid color, same color as scrubs preferred however, a neutral color such as white, gray or black would be acceptable.
The clinic will reimburse you up to $100 for the purchase of scrubs. Please contact Erika Racklin at firstname.lastname@example.org for instructions on how to get reimbursed.
There are a number of insurance plans which the Optometry Clinic is a provider for. As part of the credentialing process, you will need to become a provider for the various insurances that the Clinic works with. The insurance application process may take many months to complete and requires completion of many documents. We would recommend that you sign up with CAQH to help expedite the application process. Patrick Richards (email@example.com) can assist you with the credentialing process.
Upon initial application, you must be licensed and in good standing and that your authorization to practice is without restrictions or limitations. You must also be in good standing with all insurance paneling and if not, must disclose the limitations currently in effect. You must disclose any unresolved State Board of Optometry complaints and previous or current malpractice claims against you.
Currently-employed clinical faculty and residents must disclose any malpractice claims or a mandated revocation or limitation of credentialing or licensure outside the Berkeley Optometry system to the Associate Dean for Clinical Affairs or designee within 48 hours.
PECOS: On-Line Medicare Application
Medicare enrollment is done online via the PECOS enrollment system at https://pecos.cms.hhs.gov/pecos/login.do.
You should grant Patrick access to your account by providing her with your NPPES (PECOS) user ID and password and she will enter in the clinic information for you.
The following information will be required for processing enrollment:
- NPPES (PECOS) user id & password
- NPI number
- Copy of driver’s license
- Copy of Optometric license
- Optometry school attended & graduation date
- Home address
Once you have applied to Medicare, you will receive a Welcome Letter with a tracking number or an application email from Medicare. Please retain a copy of this welcome letter as you will need it to sign up to be a VSP provider.
Check to see if you are a Medi-Cal provider, by going to https://www.medi-cal.ca.gov/ORPEnroll/ORPEnroll.aspx. Enter in your NPI number and today’s date. If you are not a provider, then click on the blue icon with the work Provider underneath it. You will then see a link to Provider Enrollment. Please click on that. https://files.medi-cal.ca.gov/pubsdoco/prov_enroll.aspx to work on the application process.
Once you have applied to Medi-Cal, you will receive a Welcome Letter from them. Please retain a copy of this welcome letter as you will need it to sign up to be a VSP provider.
CAQH (Council for Affordable Quality Healthcare)
CAQH is a universal provider datasource. Signing up with CAQH streamlines the credentialing process of the many insurances that a faculty member will have to apply for. The initial process of setting up a CAQH account can be lengthy; however, once it is set up, it takes minimal effort to periodically update your information. You can sign up for CAQH at http://www.caqh.org/. You may be asked for the following information:
Practice Location Information:
UC Berkeley School of Optometry
230 Minor Hall, MC-2020
Berkeley, CA 94720-2020
(510) 642-2020; FAX (510) 642-8012
Tax ID: 94-6002123 and it is for a corporation in the name of “Regents of the University of California”.
Primary Credentialing Contact and Office Manager:
Patrick Richards at firstname.lastname@example.org
(510) 642-0609 Fax (510) 642-8012
Billing Contact: Jacqueline Tang, 200 Minor Hall, Berkeley, CA 94720
(510) 642-1399 Fax (510) 642-8012, email@example.com
Payment and Remittance:
Checks should be made payable to : UC Berkeley School of Optometry/UC Regents
200 Minor Hall, Berkeley, CA 94720-0001
Monday through Friday 8:30 a.m. to 5:00 p.m.
Saturday 8:30 a.m. to 4:00 p.m.
Sunday 9:00 a.m. to 4:00 p.m.
Professional Liability Insurance Carrier:
University of California
131 University Hall
Berkeley, CA 94720
Amount of Coverage per occurrence: $1 million
Amount of Coverage aggregate: $3 million
Type of practice: Multi-Specialty
Associate Doctors – it is not necessary to list all the partners/associates at this location.
Electronic Billing – Yes, we do have electronic billing capabilities.
Vision Service Plan (VSP)
In order to start the VCP enrollment process, you must:
- Have started the Medicare application process and have received a welcome letter or application received email.
- Have started the Med-cal application process and have received a welcome letter.
- Make sure you CAQH is up to date with a professional liability from the University uploaded.
Once you have started your Medicare application, then you can start the application process for VSP. Generally, you must be a Medicare provider before you can be a VSP To begin the online process, please type in https://www.vspproviderhub.com/working-with-vsp/be-a-vsp-doctor.htmlwww.vspglobal.com in your browser. YOu will be proceeding as an employee of a VSP Network Provider which is the Regents of the University of California. Click on the blue “Apply Now” button.” Complete and submit the brief template. In a few days, a VSP representative will be contacting you (preferred) or Patrick Richards (Director of Clinic Financial Planning and Analysis), firstname.lastname@example.org, to further assist the process.
Here is information you will need to enter into the online form:
First Name: please enter
Last Name: please enter
Degree: indicate as appropriate
Practice Name: UC Berkeley School of Optometry
Contact Name: Your Name or Patrick Richards
Address: 200 Minor Hall, Berkeley, CA 94720
Phone: Your contact phone or Patrick Richard’s phone: (510) 664-4632
Email: Your email or Patrick Richard’s email: email@example.com
Are you currently employed? Yes, at UC Berkeley School of Optometry
Are You? Please click “Employed by an existing doctor?” icon
If this is a current VSP practice, who is the current owner? UC Berkeley
Are you enrolled with Medicare or have you started the enrollment process? Indicate yes or no (hopefully it is yes)
Do you have your own professional liability insurance of at least $1 million per occurrence/$3 million aggregate? Indicate Yes or No if you have your own, not UC’s. (I will clarify with VSP later about UC’s self-insurance.)
Are you registered with CAQH? Hopefully yes and enter in your CAQH number. You should be current with your CAQH credentialing.
March Vision Care
This is the process for applying for March Vision Care which is as simple as possible to expedite the process. There are two documents for the March Vision Provider Enrollment Application (march_visioncare_application):
- Provider Demographics (march_visioncare_application) please complete all the areas highlighted in yellow.
- Disclosure of Ownership and Controlled Interest Statement – please complete the items highlighted in yellow. You must address and answer all questions in “Section V” which the doctor him/herself must answer. The form is invalid if it is not fully completed. (march_visioncare_application)
Please return your completed and signed documents to Patrick Richards who will help with the enrollment. It is preferred that you return signed originals. Alternately, you can scan and email them to her at firstname.lastname@example.org. If you have questions, please send an email to Patrick.
Please visit this website for EyeMed Credentialing: www.eyemedinfocus.com/join/
Please complete the application that appears and follow these steps for each section:
a. Provider Contact Information – please enter information as appropriate. Please indicate Patrick Richards as the contact person. His email is email@example.com and his phone is (510) 664-4632.
b. W-9 – please upload the attached W-9
c. Location 1:
Office Name: Regents of the University of California
230 Minor Hall
Berkeley, CA 94720
TAX ID (used for reimbursement): 946002123
NPI Type 2: 1306908058
d. Click Submit Form. You and/or Patrick Richards may be contacted by an EyeMed associate if they have additional questions.
Blue Shield is the underwriter so you will be signing up with Blue Shield.
Please enter the following information on the Blue Shield Credentialing Application:
14. Primary Location: 200 Minor Hall, Berkeley, CA 94720
Office Phone: (510) 642-2020
Office Fax No. (510) 642-8012
Name of Office Manager or Credentialing Contact Person: Patrick Richards, firstname.lastname@example.org
16. Mailing Information: 200 Minor Hall, Berkeley, CA 94720
Page 7: Sign, date, print name and provide license number.
Please enter the following information on the Blue Shield PIN Application:
Physical Location Address: 200 Minor Hall, Berkeley, CA 94720
Billing Reimbursement Information: 200 Minor Hall, Berkeley, CA 94720
Sign and date the application.