American Family Children's Hospital
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Graduating Residents

Required Address Updates

 

Change of Address

 

A resident/fellow needs to change their home address before their last day of training. This can be done by going to Employee Self Service. A current address will be necessary for receipt a of the W-2 form in January of the next year. U-Connect access will be revoked after training ends.

 

Wisconsin Medical Licensure

 

Complete the Change of Address for your Wisconsin medical license on the Wisconsin Department of Safety & Professional Services website

 

NPI - National Provider Identification Number

 

It is crucial that NPI information is updated when beginning employment at a new institution. This must be updated within 30 days of the effective date of the change. It is the health care providers' responsibility to keep their NPI information up to date.

 

Information to change:

  • Provider Business MAILING Address
    • New practice location
    • New program location - If going to a new training program outside UW Hospital and Clinics contact the new program coordinator for the address.
    • If transitioning to UW School of Medicine and Public Health Faculty - contact the UW Medical Foundation Provider Enrollment at (608) 829-5485.
    • If transitioning to Williams S. Middleton VA Hospital Faculty contact Medical Affairs Office at (608) 280-7239.
  • Provider Business PRACTICE Address (in many cases this is different from the Provider Business (office) address - pharmacies use this address to directly contact providers on prescription questions.
  • DO NOT use home address or personal mobile phone number
  • Update Provider Taxonomy and State licensure
  • Update designation of an alternate person (can be the practitioner)
  • Review carefully that all of the information has been updated

https://nppes.cms.hhs.gov/NPPES/LoginPage.do?userType=PROVIDER

 

DEA

 

If applicable, complete the address change request on the DEA website after acquiring an approved state license at the new practice location. These changes will become effective immediately upon DEA verifying the new state license. The change of address will also ensure that DEA renewal notices are sent to the correct address.

 

DEA Diversion Website - Address Change Form

  

Additional Updates

 

Change of Bank

 

If the last paycheck should be deposited into a new bank account complete the UW Hospital and Clinics Direct Deposit Authorization Form (pdf) and submit no later than three weeks prior to program completion to UW Hospital and Clinics Payroll Department, (608) 262-0399 (fax).

 

Last Paycheck

 

To determine the date of your last paycheck, review the UWHC 2015 Bi-Weekly Payroll calendar located on U-Connect, or contact Payroll at uwhcpayroll@uwhealth.org or (608) 262-4559.

 

Medical School payrolled trainees should check with their Department Payroll Personnel.

 

Items to be Returned

 

Return the following items to Program Coordinator:

  1. UW Hospitals and Clinics photo ID
  2. UW Hospitals and Clinics pager
  3. GME forwarding address form (if not already submitted to the GME Office)
  4. UW parking permit/hangtag (if applicable)
  5. Meal card (if applicable)
  6. VA photo ID (if applicable)
  7. Meriter Hospital ID (refund received when ID returned to Meriter Hospital Transportation Department)
  8. Keys (if applicable)

Wisconsin Patients Compensation Fund (PCF)

 

Graduating residents/fellows employed by UW Hospital and Clinics are responsible for the status changes with the Wisconsin Injured Patients and Families Compensation Fund (PCF). UWHC paid for residents/fellows PCF assessment (excess coverage) during training.

 

With the completion of training, and after changing the address with Wisconsin Medical license, the PCF will send a letter indicating that the resident/fellow no longer has a valid certificate of professional liability on file with the PCF. It is the responsibility of the individual to respond to this letter. Review the attached directions on how to correctly complete the PCF form.

 

Professional Liability Insurance

 

While employed by UW Hospital and Clinics, residents/fellows were covered under UW Hospital and Clinics' professional liability insurance and UWHC paid for the primary insurance during the training period. Any coverage for moonlighting activities would have been paid by the moonlighting employer.

 

Liability Coverage/Claims History Request: Information regarding liability coverage and claims history is required for new employment; residents should complete the Request for Liability Coverage/Claims History Form (pdf) to obtain a report. Any questions on coverage or claims, contact the Risk Management Department at (608) 261-1327.

 

E-mail and Electronic File Storage

 

Outlook e-mail accounts will terminate on the last day of training. Forward any e-mails from Outlook account to your personal account. Be sure that you are not transferring any PHI to an outside account. Also, transfer any files that have been saved on your Resident Desktop.

 

Health Insurance and Other Benefits

 

Please review the Health Insurance Coverage Information (pdf). Contact the Human Resources Service Center at uwhcbenefits@uwhealth.org or (608) 265-8204 with specific questions.

  

Long-Term Disability Insurance - Northwestern Group LTD Insurance

 

The long-term disability insurance, underwritten by the Northwestern Mutual Life Insurance Company through Shulla Financial Services, ends on the last day of training. If a resident/fellow wishes to apply for conversion coverage, this needs to be requested prior to the last day of employment at UW Hospital and Clinics. Information will be sent by Shulla Financial Services to the home address. Contact Andrew P. Shulla, CLU, at (608) 836-2094 with any questions. If interested in converting group long-term disability coverage to conversion insurance, complete the Long-Term Disability Conversion Request Form (pdf) and return to the address indicated on the form.

 

International Medical Graduates

 

As a resident/fellow completes training at UW Hospital and Clinics, the following documentation will need to be completed depending on the situation. These materials can be sent directly to ECFMG.

 

If transferring to another program, contact the Training Program Liaison at the new institution for assistance with J-1 continuation sponsorship.

 

If seeking an extension to sit for a Board exam, there is an application and instruction materials available on the ECFMG website.

 

If returning to home country, ECFMG need to be notified that sponsorship will no longer be required. Complete the Notification of Termination as an ECFMG Exchange Visitor

 

Med Hub Access

 

Access to MedHub terminates 30 days after the program end date. Please work with the program coordinator to ensure all necessary training documentation has been completed (e.g. evaluations, procedures, duty hours, etc.) and any personal information wished to be kept for a resident/fellow's records has been exported. Please note, if the resident/fellow wishes to have any MedHub communication sent via e-mail during this 30-day window that a personal e-mail must be provided as the UW Health e-mail account will no longer be active.

 

Certificates

 

UW Hospital and Clinics-GME certificate policy:

  • The certificate of completion is a valuable legal document
  • Each graduating trainee is entitled to one completion certificate per program completed
  • The name on the certificate is the name under which the resident/fellow trained
  • There is no replacement for lost or stolen certificates and name changes
  • A damaged certificate may be replaced only if the original certificate is returned to the GME Office to destroy

Scrubs

 

All scrubs must be returned to their respective assigned machines. You will be charged a fee of $25/set that will be deducted from your last paycheck. Do NOT turn in VA, Meriter or St. Mary's scrubs to UWHC machines.

 

Training Verifications

 

Training verifications can be completed by the training program.

 

Medicare Provider Enrollment

 

Note: Residents/fellows working as attending physicians (outside of UWHC training) were likely already enrolled through another healthcare facility as billable service providers for Medicare and Wisconsin Medicaid. These enrollments also covered the requirement for the enrollment types described above while training at UWHC. (Also, only one type of enrollment is allowed at a time.)

 

If the resident/fellow is continuing training elsewhere, the current enrollment (as an ordering and referring provider) will still apply. However, the resident/fellow should update his/her contact information by submitting another CMS – 885O Medicare application (pdf), unless it has already been covered by the new training institution.

 

A few instructions for completing/submitting the updated Medicare CMS – 885O application:

  1. Indicate reason as an update in Section 1, A and complete remaining required sections 
  2. Sign and date in blue ink
  3. Make a copy
  4. Mail the application to:

National Government Services, Inc.

P.O. Box 6475

Indianapolis, IN 46206-6475

 

Wisconsin Medicaid Provider Enrollment

 

If continuing training in Wisconsin, the current Wisconsin Medicaid enrollment will still apply. However, the resident/fellow should update his/her contact information. Unless the update also has already been covered by the new training institution, the resident/fellow should contact the ForwardHealth Help Desk at 1-800-947-9627, where a customer service rep will assist with establishing online portal access for making changes to contact information. The resident/fellow's NPI and Social Security number are likely needed to make updates through the portal. The resident/fellow should have a record of his/her NPI. If not, the NPI can be found on MedHub or through the program coordinator.

 

If continuing training in another state, the resident/fellow should contact the GME office at the new training institution to inquire about enrollment that may be required by the state.