Explore Participant and Provider Objects

Learning Objectives

After completing this unit, you’ll be able to:

• Explain how Provider Management stores participant information.
  
• Describe the types of data in provider objects.
  

Participants Data Model

It’s time to continue your Provider Management journey. First up, explore the objects you use to record useful information about the constituents your agency serves and your partnering service providers. As with other Public Sector Solutions apps, you can assign person accounts, business accounts, and contacts as participants to keep track of who’s associated with a particular record. You can add participants to providers, referrals, benefit assignments, benefit disbursements, and other records.

Set any of these objects as a participant on a record.

• Person account, which represents an individual constituent
  
• Business account, which represents a service provider
  
• Contact, which represents a member of a business account, such as a provider staff member
  

Individual practitioners and organizations are the two types of service providers. Some practitioners perform services for multiple provider organizations, forming more complex relationships. To track these relationships, you can associate a practitioner’s contact record to multiple business accounts and capture relationship details in the account contact relationship object. To learn more, see the Set Up Contacts to Multiple Accounts article in Salesforce Help.

Use additional objects to store useful information about participants.

• In the person employment object, record an individual’s work history, such as employers, positions held, employment status, and income.
  
• Use the party income object to track household income data.
  
• Use the person education object to store copies of the degrees and certifications that a constituent or practitioner has earned, which can be relevant information for certain benefits, such as job counseling.
  
• If a constituent discloses having a relevant disability, use the person disability object.
  

Public Sector Solutions includes several additional objects for capturing all the details about a person or group. To learn more, complete the Benefit Management Data Model in Public Sector Solutions Trailhead module.

Participant Referrals

Connor, a Cosville caseworker, coordinates with several individuals, groups, and businesses to connect constituents to the services they need. Today, Connor’s working on a case involving Steve Marshall, a constituent whose spouse recently passed away.

As part of Steve’s care plan, Connor wants to refer him to the Cosville Grief Counseling Center. There, Steve can receive weekly counseling from Ashley, a certified grief counselor.

Steve already has a person account, so Connor creates a referral record with Steve as a participant. Connor can also review Steve’s constituent details, as relevant to his case. This includes his household income on the Party Income object and whether he has a disability. Steve’s Person Disability Record documents his recent knee injury.

Cosville Grief Counseling Center has an associated Business Account that stores details about the organization. An Account Contact Relationship object connects Ashley’s contact record to the Grief Counseling Center business account. Connor reviews Ashley’s employment history in her Person Employment record to verify that she’s a suitable counselor for Steve.

Key Objects and Relationships

This diagram illustrates the relationship between person accounts, business accounts, contacts, and employment and income objects, which you’ll use to capture participant data for your own agency.

With this scenario in mind, review this table to learn more about the relationships between participant objects.

With these objects, caseworkers can share constituent information with providers to speed up referrals.

Healthcare Provider Objects

Several objects store data about partnering service providers. Providers enter this data through the online portal during onboarding, and you can use information from these records as search criteria to help caseworkers find the right provider during referrals.

A healthcare provider record represents an organization or individual practitioner in your network. This object contains fields to store information about the type of provider, employed practitioners, number of licensed beds, the electronic health record (EHR) systems that the provider uses, and more.

If you’re in the United States, your providers may follow the National Plan and Provider Enumeration (NPI) System. Use the healthcare provider NPI object to store the unique NPI identifier of each organization for electronic health information sharing.

To maintain an effective provider network and prevent poor constituent experiences, you should track when your providers fail to uphold standards or if they provide low-quality care. Use the healthcare provider adverse action object to record corrective measures, such as suspension or revocation of a license, or other regulatory penalties.

Area of specialization is another important factor for determining the correct provider for a constituent. Create records for each care specialty and connect them to a dedicated service provider with the healthcare provider specialty junction object.

Here’s a diagram that shows the connections between healthcare provider, account, and contact objects.

The Cosville Grief Counseling Center is a registered healthcare provider that specializes in bereavement therapy. In an isolated incident many years ago, regulators penalized the center for mishandling a few confidential patient documents. Connor can view all of this information on the healthcare provider record.

With access to detailed and up-to-date healthcare provider records, Connor is confident that his referral will mean positive results for Steve.

In this unit, you learned how the Provider Management data model enhances collaboration with objects that store information about people and organizations. In the next unit, you’ll explore how credentials and healthcare facility objects fit into the data model.

Resources

• Salesforce Help: Set Up Contacts to Multiple Accounts