IWeb User Guide |
Tennessee providers can register online for access to the Tennessee IWeb application by clicking the Online Provider Registration Request link on the home page. Clicking this link opens the TennIIS Provider Enrollment Application page, which the new provider can fill out and submit to request access.
Enter the information in the fields (see table below) and click Save and Continue to Page 2.
Field | Description |
Full Access |
Select whether the provider is requesting full access (default) or read-only (view-only) access to the application. |
Practice Name |
Enter the name of the practice. This field is required. |
Address |
|
Street Address |
Enter the first line of the street address. This field is required. |
Street Address 2 |
Enter the second line of the street address, if necessary. |
City |
Enter the city name. This field is required. |
State |
TN is the default state, otherwise select the state from the drop-down list. This field is required. |
County |
Select the county from the drop-down list. This field is required. |
Zip Code |
Enter the zip code. This field is required. |
Phone |
Enter the phone number. An error message will appear if a phone number with repeating digits is entered (e.g., 111-1111). This field is required. |
Phone Extension |
Enter the extension number associated with the phone number. |
Fax |
Enter the fax number. An error message will appear if a phone number with repeating digits is entered (e.g., 111-1111). |
Office Manager |
Enter the name of the office manager or contact person. |
Email Address |
Enter the email address for the provider, office manager, or other contact person. This field is required. |
Mailing Address (if different from above) |
|
Street Address |
Enter or modify the first line of the mailing street address. |
Street Address 2 |
Enter the second line of the mailing street address, if necessary. |
City |
Enter the city name. (Enter the zip code first to pre-populate the city field.) |
State |
TN is the default state, otherwise select the state from the drop-down list. |
County |
Select the county from the drop-down list. (Enter the zip code first to pre-populate the county field.) |
Zip Code |
Enter the mailing zip code. |
Facility Type |
Select the Facility type from the drop-down list. If Other is selected, enter a description in the Facility Type Comments field. |
Facility Type Comments (if Other) |
Enter a description of the Facility Type, if Other was selected from the Facility Type drop-down list. |
Facility Type |
|
Does this practice see adults, children, or both? |
Select Adult, Pediatric, or Both from the drop-down list. This field is required. |
Does this practice provide obstetric care? |
Select Yes or No from the drop-down list. This field is required. |
Does this practice primarily provide inpatient care, outpatient care, or pharmacy services? |
Select Pharmacy, Primarily Inpatient, or Primarily Outpatient from the drop-down list. This field is required. |
Is this a multi-specialty group practice? |
This question appears if the answer to the previous question is Primary Outpatient. Select Yes or No from the drop-down list. This field is required if it appears on the page. |
Select the specialty that best describes this Primarily Outpatient practice. |
This displays only if Outpatient is selected. Select a specialty from the drop-down list. This field is required if it appears on the page. |
Select the sub-specialty that best describes this ______ practice. |
This displays for certain specialties and is a required field if it appears on the page. Select a sub-specialty from the drop-down list. |
Has this practice registered for TennIIS access in the past? |
Select one of these options (this field is required):
|
Current Computer Hardware Setup |
|
Internet Access Type |
Select the provider office's Internet access type from the drop-down list. Examples:
|
After clicking Save and Continue to Page 2, the User Agreement page opens. (If there is an error on the first page, it will appear in red at the top of the page. Correct the error and click the button again to continue.)
The second page is the TennIIS User Agreement Form page. Enter the relevant information and click Submit when finished.
Field | Description |
Primary Method of Report |
Select the primary reporting method from the drop-down list:
|
PMS Name |
Enter the provider's PMS name. |
Name of Vendor/Company |
Enter the vendor or company name. |
Staff: |
For each staff member from the provider's office that needs access to the IWeb application, enter their last name, first name, phone number, and email address, and select whether they are to have View Privileges or Edit Privileges. Each field is required for each staff member to have access to the application. |
Add More Staff Members |
Select this option if you need more rows for additional staff members. |
Provider: |
For each authorized immunization provider, enter their last name, first name, specialty, email address, phone number, and medical license number. Each field is required for each authorized immunization provider to have access to the application. |
Primary Contact |
|
Type |
Select the primary contact type from the drop-down list. Examples:
|
First Name, Middle Initial, Last Name |
Enter the first name, middle initial, and last name of the primary contact person. |
Phone Number |
Enter the primary contact person's phone number. |
Phone Number Extension |
If applicable, enter the primary contact person's phone number extension. |
Fax Number |
Enter the primary contact person's fax number. |
Email Address |
Enter the primary contact person's email address. |
Toward the bottom of the page, in the Pandemic Influenza Vaccine Provider Network section, read the information and select one of the three options:
After clicking Submit at the bottom of the second page, the submission thank you page opens. On the submission thank you page, click Print to print the provider enrollment application for your records, or click Done to close the page.
For information about viewing and updating provider enrollment applications, see the Provider IWeb Enrollment Applications topic.