september 2017 prohealth provider relations update · community clinic at walgreens (employed)...
TRANSCRIPT
1
September 2017
P r o H e a l t h P r o v i d e r R e l a t i o n s
U p d a t e
I N S I D E T H I S I S S U E :
1 ePower
1 New Provider Credentialing
1 NEW Electronic Directory
1 PAs Medicaid Eligible 8/1/2017
2-3 New Providers, effective
10/1/2017
4 Termed Providers
4 CareSource Medicare Terming
5 VHG - Healthcare & Business
Consulting
6 Provider Relations Staff
Directory
ePower
ProHealth’s ePower (Provider Portal) is now available on our
website at:
https://www.ecommunity.com/community-prohealth/
provider-relations
Providers may login and use ePower to check claim status,
eligibility and more.
Credentialing of New Providers:
*PLEASE NOTE*
Credentialing through ProHealth for ALL new providers can take anywhere from 90-120 days from notification to completion.
The Credentialing fee has increased to $200 for ALL new providers wishing to join the Community/ProHealth network, effective 11/1/2016.
ProHealth Credentialing/Enrollment Supervisor:
Jenna White
Phone#: (317)621-9312
NEW Provider & Facility Electronic Directory:
There is now an electronic directory available on ProHealth’s website at https://www.ecommunity.com/
community-prohealth for Tier1 and Tier2 providers and facilities.
Physician Assistants Now Eligible for Medicaid:
*PLEASE NOTE*
Effective 8/1/2017, Physician Assistants (PAs) are now eligible to be enrolled in Indiana Medicaid. If you are an inde-
pendent provider who has signed a contract with Community ProHealth to be enrolled in CHNw MDwise (HIP &
HHW) and wish to have your PAs enrolled in these plans, please contact your ProHealth Provider Relations Analyst so
they can start the process.
Dawn Widgery, Provider Relations Analyst Carol Boyd, Provider Relations Analyst
Phone#: (317)621-7462 Phone#: (317)621-7923
2
Contract ing and Credentia l ing Corner Providers Joining ProHealth
We would like to welcome the following providers to the ProHealth Network effective October 1, 2017.
Hospital affiliations will be listed with each provider.
Prime SCP
Alder MD, Jason D. - Orthopedic Surgery-Spine
CPN, Orthopedic Specialty Care - Kokomo (Employed) - CHRH
Best MD, Amy R. - Otolaryngology
Ear, Nose & Throat Care - East (Employed) - CHE/CHN, CHV
Blumenkrants MD, Monica S. - Child & Adolescent Psychiatry
Gallahue Mental Health Services (Employed) - CHE/CHN, CHV
Foster LMHC, Ashley - Behavioral Health
Gallahue Mental Health Services (Employed)
Kitchens MD, Anne C. - Endocrinology, Diabetes & Metabolism
Diabetes & Endocrinology Care (Employed) - CHE/CHN, CHV, CHS
Klepfer LCSW, Kourtney - Behavioral Health
Gallahue Mental Health Services (Employed)
Leaming MD, Eric S. - Orthopedic Surgery
CPN, Orthopedic Specialty Care (Employed) - CHA
Patel MD, Ruchin G. - Facial Plastic & Reconstructive Surgery
Otolaryngology Associates, LLC - CHE/CHN, CHV, CHS, CSC-S
Payne MD, Michael - Anesthesiology
Southeast Anesthesiologists, PC - CHS
Sabau LCSW, Emily - Behavioral Health
Gallahue Mental Health Services (Employed)
Scholer MD, Aaron - Pediatrics
Community Pediatric Hospitalists (Employed) - CHE/CHN
Sievers LMFT, Shannon A. - Behavioral Health
Gallahue Mental Health Services (Employed)
Singh MD, Manpreet - Nephrology
Kidney & Hypertension Consultants, PC - CHE/CHN, CHV, CHS, CHR
Sykes LMFT, Shannon A. - Behavioral Health
Gallahue Mental Health Services (Employed)
Wood MD, Megan W. - Otolaryngology
Otolaryngology Associates, LLC - CHE/CHN, CHV
Woodland MD, Connor - Internal Medicine
Pulmonary and Critical Care (Employed) - CHE/CHN, CHV
Prime OB/GYN Advanced Practice Practitioners
Zambrano MD, Nabila - Obstetrics and Gynecology
3
Prime SCP Advanced Practice Practitioners
Arms PA, Jimmy - Physician Assistant
Greenwood Orthopaedics PC
Belk PA, Abby L. - Physician Assistant
MedCheck (Employed)
Brown NP, Gwendolyn - Nurse Practitioner
Community Physician Network, CHS Hospitalist (Employed)
Hunt NP, Hilari - Nurse Practitioner
Community Spine Center (Employed)
Koch PA, Jennifer - Physician Assistant
Pulmonary and Critical Care (Employed)
Langsford NP, Sarah S. - Nurse Practitioner
Community Spine Center (Employed)
Matthews NP, Kelly - Nurse Practitioner
Community Clinic at Walgreens (Employed)
Pixley NP, Melissa A. - Nurse Practitioner
Diabetes & Endocrinology Care - Kokomo (Employed) - CHRH
Stidd PA, Heather - Physician Assistant
Central Indiana Orthopedics
Yarman PA, Emily - Physician Assistant
MedCheck (Employed)
Prime PCP
Gawa MD, Yochana R. - Family Medicine
CPN, Family Medicine Care (Employed) - CHA
Lang MD, William K. - Family Medicine
CPN, Family Medicine Care (Employed) - CHE/CHN, CHV
Lauck DO, David - Internal Medicine
CPN, Internal Medicine Care (Employed) - CHE/CHN, CHV
Musa MD, Collin - Family Medicine
MedCheck (Employed)
Newsom MD, Allison - Pediatrics
Excell for Life Family Care and Pediatrics - CHE/CHN, CHV
Rifai MD, Dima - Pediatrics
Pediatric Care, Anderson (Employed) - CHA
Tomlinson MD, Natasha - Hospice & Palliative Medicine
Community Physician Network, Palliative Care Services (Employed) - CHE/CHN, CHV
Winternheimer MD, Louis - Family Medicine
CPN, Family Medicine Care (Employed) - CHE/CHN, CHV
Prime PCP Advanced Practice Practitioners
Waller NP, Kensie - Nurse Practitioner
Advanced Healthcare Associates, LLP
Contract ing and Credentia l ing Corner Providers Joining ProHealth
We would like to welcome the following providers to the ProHealth Network effective October 1, 2017.
Hospital affiliations will be listed with each provider.
4
Termed Providers The following providers will no longer be participating with ProHealth:
Anderson MD, Kimberland S. - Family Medicine, termed 9/30/2017
Community Physician Network, Family Medicine Care (Employed)
Camara LCSW, Angela - Licensed Clinical Social Worker, termed 9/30/2017
Gallahue Mental Health Services (Employed)
Chase MD, John D. - Neurology, termed 9/30/2017
American Health Network of IN, LLC
Coats LCSW, Britney N. - Licensed Clinical Social Worker, termed 9/30/2017
Gallahue Mental Health Services (Employed)
Corbito PA, Laura K. - Physician Assistant, termed 9/30/2017
Community Physicians of IN, Inc / Gastroenterology Associates (Employed)
Dobbs DO, Glenn L. - Obstetrics and Gynecology, termed 9/30/2017
Southside OB-GYN, P.C.
Hamidi DO, Ramin E. - Radiology-Neuroradiology, termed 9/30/2017
Radiology of Indiana, PC
Inayatullah MD, Saqib - Nephrology, termed 9/30/2017
Kidney and Hypertension Consultants
McKenzie NP, Brittany J. - Nurse Practitioner, termed 9/30/2017
Community Hospital Oncology Physicians (Employed)
Munro MD, Jonathan L.T. - Anesthesiology, termed 9/30/2017
Community Anesthesia Associates, PC (Employed)
Patel MD, Anand - Internal Medicine, termed 9/30/2017
Post Acute Care Specialists, LLC
Stewart Porter PA, Natasha E. - Physician Assistant, termed 9/30/2017
Community Hospital Oncology Physicians (Employed)
Yager LCSW, Marie L. - Licensed Clinical Social Worker, termed 9/30/2017
Community Howard Behavioral Health (Employed)
Attention Community-Employed Practices: CareSource Medicare Termination Announced:
Effective January 1, 2018, CareSource Medicare Advantage product will no longer be sold in Indiana and Ken-
tucky areas. The CareSource Medicare plan has mailed letters to their members as well as providers impacted by this
change. Community Health Network employed practices, please remember: Medicare open enrollment starts Octo-
ber 15, 2017 and runs through December 7, 2017. During open enrollment, CareSource Medicare patients will have the
opportunity to choose another plan for the January 2018 coverage year. These members will maintain their CareSource
Medicare coverage until 12/31/17. Please direct all member questions to CareSource Medicare at 1-855-202-0557.
Community Health Network is contracted with various Medicare Advantage plans. For a list of those plans or questions
of what plans do we accept, please call ProHealth Provider Relations at 317-621-7581.
5
6
Visionary Health Group veicorp.com/consulting Are you an independent practice that needs consulting/financial help? ...
Integrated physician consulting services
A division of VEI since 1987, Visionary Health Group (VHG), formerly known as Indianapolis Medical Management
(IMM), has provided physician practice management and consulting services for more than 20 years. VHG prides itself
in providing comprehensive, tailor-made services that meet and exceed the needs of its physician clients. VHG’s con-
sulting and evaluation services have been designed to objectively evaluate every aspect of a medical practice and to
provide realistic solutions to the challenges faced by physicians today. VHG offers a diverse team of skilled individuals
to assist you with your various practice needs.
*Complimentary business assessment available upon request*
Consulting and practice operations
Business healthcare consulting
Revenue cycle management
Documentation and coding experts
Financial consulting and reporting
Payer credentialing and enrollment Practice/business start-up
Full suite of human resource services
OSHA/HIPAA compliance
Project management
Process improvement
Development of policy and procedures
Please Contact: Joni A. Reed, MBA, BSBA, ASB, CMA Business Consultant Physician Services Ph#: (317)621-1539 [email protected] Anita Huse, RN, CAPPM Business Consultant Physician Services Ph#: (317)621-4090 [email protected] Jamie L. McAllister, MA Business Consultant Ph#: (317)621-7521 Fx#: (317)957-2794 [email protected] Tara Rieman Director Provider Operations Ph#: (317)621-7066 [email protected]
7
Department Staff
Manager Provider Relations:
Jenny Bouck, [email protected]
Business Information Coordinator
Hollie Putzback, [email protected]
Provider Relations Analysts:
Carol Boyd, [email protected]
Dawn Widgery, [email protected]
Amanda Bobo, [email protected]
Governmental Programs Manager (Medicare):
Lori White, [email protected]
Governmental Programs Manager (Medicaid): Salena Woodson, [email protected]
Supervisor Provider Credentialing: Jenna White, [email protected]
Credentialing Coordinators:
Kim Tibbets, [email protected]
Julia Chumbley, [email protected]
Julie Starr, [email protected]
Aletha Burnett, [email protected]
April Woodruff, [email protected]
Adrianne Stocks, [email protected]
Provider Credentialing Assistants:
Amy Walls, [email protected]
Denise Smith, [email protected]
Dianne Castillo, [email protected]
Sharon Harlan, [email protected]
Lori Jones, [email protected]
Melissa Scharfenberg, [email protected]
Provider Relations Department
6626 E. 75th St, #500
Indianapolis, IN 46250
Phone: 317-621-7581
www.ecommunity.com/prohealth