Last Update: February 23, 2026
Audience: County System Administrators, Supervisors, Billing Staff, and Clinical Leads
Attachment: Streamline Healthcare – Active vs. Inactive Provider Formal Standard Guidance
Purpose
This memo provides CalMHSA’s standardized guidance for managing direct service staff user accounts in SmartCare when a provider leaves a county organization. It supplements Streamline Healthcare’s formal technical guidance with recommended operational practices to support consistent and safe implementation across all counties.
Counties have reported receiving conflicting guidance on this topic in the past; this memo supersedes all prior informal guidance and represents the current standard.
Caveats
Counties are not always made aware of staff departures until after providers leave. However, when possible, before clinical staff leave the organization, do the following:
- Ensure departing staff complete all documentation, including progress notes. Progress notes that are in progress cannot be completed by another clinician without changing the name of the provider completing the service.
- Transfer the staff member’s caseload to another active provider before departure to avoid disruptions in client care.
Overview of the Deactivation Process
When a direct service staff member departs, counties should follow a structured process to ensure continuity of billing, clinical documentation, state reporting, and prescribing workflows before fully deactivating the account.
The process has three phases.
Phase 1: Remove Login Access (Immediately Upon Departure)
This should be done on the staff person’s last day or as soon as the county is aware of the departure.
Configuration:
- Keep user Active (checkbox remains checked)
- Select Can’t Login in the Access Rights section
This configuration:
- Blocks the provider’s access to SmartCare
- Keeps the provider visible in staff dropdowns across Billing, Clinical, and eRx screens so remaining work can be completed under their name
Additional steps:
- Add a comment in the Comments text box noting the departure date
- Billing License/Degree and NPI Configuration (Important)
When a provider leaves the organization, counties should also:- End date the provider’s billing license/degree to the provider’s last day of service.
This helps prevent services or charges from being successfully completed for dates of service after the provider’s departure. It is particularly helpful for counties using Batch Service Upload for contractors who do not log directly into SmartCare, as their user accounts may already be set to “Can’t Login.” When a billing license/degree is end-dated:
-
- Services entered for dates after the end date may generate service or charge errors, helping prevent inappropriate billing under the departed provider.
Important:
Counties should not end date the provider’s NPI. If an end date is added to the NPI:
-
- The NPI may no longer populate onto claims
- This can result in claim denials
The NPI should remain active to support proper processing of historical claims and adjustments.
- Remove EPCS permissions for prescribers using SmartCare MedicationRx
- Modify the User Code (e.g., add “DONOTRESTORE”)
- Enter Employment End Date in the Demographic/Professional tab
Immediate operational actions:
- Notify billing staff that the provider is departing
- Begin transitioning patients to an active prescriber (if applicable)
- Notify supervisors to review outstanding documentation via the Supervision Documents screen
Phase 2: Complete Cleanup Activities
Settings remain: Active = Y + Can’t Login
This phase focuses on operational resolution. No additional setting changes are needed.
Checklist:
Caseload Reassignment
- Transfer all clients, cases, and assignments to active staff
Supervision Documents
- Supervisors confirm all outstanding documents are completed, reassigned, or resolved
Scheduled Services
- Review the Services list page for services in Scheduled status and reassign/reschedule as needed
In-Progress Clinical Documentation
- Identify documentation still in progress and reassign for completion
Billing/Charges
- Confirm no remaining billing tasks require the provider’s name in dropdowns
- Process any final claims
Client Orders
- Ensure active lab orders have resulted into client charts
Prescribing (SmartCare RX)
- Transition all patients to an active prescriber
- Resolve pending medication orders and queued prescriptions
- Confirm no EPCS workflows remain outstanding
Cleanup should be completed within 90 days whenever possible.
Phase 3: Deactivate the Account
Settings: Active = N + Can’t Login
Once cleanup is confirmed complete across clinical, billing, and supervisory workflows, uncheck the Active box.
What happens:
- No new items can be created for the provider across Billing, Clinical, and Rx modules
- Provider no longer appears in system dropdowns
- Refill requests stop for prescribers
- Historical data, signed documentation, and existing charges remain accessible
Quarterly Account Review Process
To prevent accounts from remaining indefinitely in transitional status:
Frequency
- At minimum: quarterly (90 days)
- Monthly for high-turnover counties (optional)
Review Steps
Generate a list of all accounts set to:
- Active = Y + Can’t Login
For each account verify:
- No services remain in Scheduled status
- No in-progress clinical documentation remains
- Caseload reassignment is complete
- Supervisory review is complete
- Prescriber transitions are complete
Deactivate accounts where cleanup is confirmed complete.
Maintain a log of each review cycle for accountability and audit readiness.
Important Information for Billing Staff
Claims can still be billed, worked, rebilled, and processed for providers who have been set to Active = N. Historical billing is not impacted by deactivation.
However:
Once a provider is deactivated, their name will no longer appear in the Clinician Search field on the Charges/Claims list page.
Workaround: Locate charges using:
- Client name
- Date of service
- Program
- Payer
- Other available filters
Billing teams should be informed of this workflow change prior to deactivation.
License/Degree Expiration and Billing – System Behavior Clarification
License/degree expiration does not directly block claim generation. However, license/degree validity and billing eligibility can affect service completion, charge creation, and billing outcomes at multiple points in the workflow.
Key system behavior:
Service Entry
- A clinician may be selected during service entry.
- If no valid license/degree exists for the date of service (and marked for billing), the service may fail to complete with an error such as “unable to find a matching rate.”
Charge Creation
- If Procedures/Rates are configured to allow “ANY” license/degree, a charge may still generate even if license/degree validation is weak.
- If license/degree dates are corrected before billing, the system may then generate a charge error.
Claim Creation
- Billing code validation occurs when calculating billing codes and units.
- If a valid billing license/degree is not in effect for the date of service, the system may generate errors such as “missing billing code.”
Timing Risk
If license/degree end dates are updated only after billing occurs:
- Claims may need to be voided and corrected.
Configuration Considerations
Some Procedures/Rates and Plan-level Billing Codes are intentionally not license/degree-specific based on DHCS’s Service Table and Fee Schedule design. Because of this:
- Enforcement may occur later in the workflow rather than at service entry.
- Counties should ensure license/degree start/end dates and billing flags are maintained accurately and promptly.
Impact on Provider Counts
|
Setting |
Counted in AMA Provider Counts? |
Counted in Rx Provider Counts? |
|
Active = Y + Can Login + Valid NPI/SPI |
Yes |
Yes |
|
Active = Y + Can’t Login |
No |
No |
|
Active = N |
No |
No |
The transitional state does not inflate provider counts.
Impact on State Reporting
NACT 274
The Active checkbox no longer determines whether a provider is included in 274 reporting. Reporting status is controlled through designated staff custom field settings.
CalOMS
Records generated by signed documentation remain available for batching and processing after deactivation.
If corrections are required:
- A new edited version can be created
- The new version will reflect the new author
Summary – Quick Reference
|
When |
Action |
Settings |
|
Provider’s last day |
Remove login access |
Active = Y + Can’t Login |
|
Following 1–90 days |
Complete cleanup activities |
Active = Y + Can’t Login |
|
After cleanup confirmed complete |
Deactivate account |
Active = N + Can’t Login |
|
Every 90 days |
Run quarterly review |
— |
Open Items (Pending Final Confirmation)
The following areas remain under review and are not yet part of this standard:
- eRx/EPCS workflow behavior during provider deactivation.
- Handling of queued or pending prescriptions at the time of deactivation.
- Error handling for in-flight prescriptions when a prescriber is deactivated.
Updates will be distributed when available.
Questions
For questions about this guidance, please contact your Account Manager.
Streamline Guide – Inactive vs Active Provider Formal Standard Guidance