June 2017 I N S I D E T H I S I S S U E : epower. Credentialing of New Providers: BETTER DOCTOR, INC. VALIDATION - Employed Providers :
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1 June 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 2-4 New Providers, effective 7/1/2017 epower ProHealth s epower (Provider Portal) is now available on our website at: provider-relations Providers may login and use epower to check claim status, eligibility and more. 4-5 Termed Providers 6 VHG - Healthcare & Business Consulting 7 Provider Relations Staff Directory Credentialing of New Providers: *Please Note* Credentialing through ProHealth for ALL new providers can take anywhere from 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 jwhite2@ecommunity.com Phone#: (317) BETTER DOCTOR, INC. VALIDATION - Employed Providers : Many Community employed practices have received phone calls or faxes from a company by the name of Better Doctor, Inc. This organization is a third party vendor that seeks contracts with many of the Medicare Advantage (MA) plans to verify provider data on a quarterly basis. CMS has required all MA companies to verify data on a quarterly basis. Community Health Network has contracts in place with several of the MA companies. ProHealth transmits provider demographic data to these organizations on a bi-weekly basis. Please do not verify provider data either via fax or phone with Better Doctor, Inc. at the practice level. The provider data is shared by ProHealth to the MA companies bi-weekly on your behalf. We have reached out to the MA plans and Better Doctor, Inc. to assist in streamlining their process and ask that they do not contact our offices for this project. It has been communicated to Better Doctor, Inc. that we do not verify provider data at the practice level. If you have further questions or concerns, please contact Lori White, Medicare Program Manager, ProHealth Lwhite4@ecommunity.com or
2 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective July 1, 2017 Hospital affiliations will be listed with each provider. Prime SCP Bryan LMHC, Eric A. - Behavioral Health Galford PhD, HSPP, Susan - Psychology Evergreen Psychological Services, LLC Jones LCSW, Kimberly K. - Behavioral Health Community Physician Network, Behavioral Care (Employed) Kamatkar MD, Suyog - Pediatrics Community Pediatric Hospitalists (Employed) - CHE/CHN, CHV Kim MD, Sunghoon - Pediatric Surgery Pediatric Surgical Care (Employed) - CHE/CHN, CHV Lucchetti LCSW, Teresa - Behavioral Health Massela OD, Tiffany E. - Optometry Hancock Eye Associates, P.C. Meyer LMFT, Heather - Behavioral Health Morrison LCSW, A. Claire - Behavioral Health Norris LCSW, Shaunna M. - Behavioral Health Community Quick Care (Employed) Perez CNM, Jody - Certified Midwife OB/GYN Care Triage (Employed) - CHE/CHN Roark OD, Mark W. - Optometry Allisonville Eye Care Center, Inc. Scott OD, Elaine R. - Optometry Hancock Eye Associates, P.C. Summers OD, Kelly C. - Optometry Allisonville Eye Care Center, Inc. Torres MD, Manuel B. - Pediatric Surgery Pediatric Surgical Center (Employed) - CHE/CHN, CHV Walling OD, Christa L. - Optometry Hancock Eye Associates, P.C. Young PsyD, HSPP, Kelly C. - Psychology Evergreen Psychological Services, LLC 2
3 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective July 1, Hospital affiliations will be listed with each provider. Prime SCP Advanced Practice Practitioners Adamowicz PA, Jeremy - Physician Assistant Baer NP, Kimberly K. - Nurse Practitioner Buck NP, Maryellen - Nurse Practitioner Chambers NP, SanChitta - Nurse Practitioner DeWitt NP, Annette - Nurse Practitioner Frey NP, Megan M. - Nurse Practitioner Heart and Vascular Care (Employed) McKenzie NP, Brittany J. - Nurse Practitioner Community Hospital Oncology Physicians (Employed) Sterett PA, Lauren E. - Physician Assistant Pulmonary and Critical Care (Employed) 3
4 Termed Providers The following providers will no longer be participating with ProHealth: Aroutiounova MD, Inna - Rheumatology, termed 6/1/2017 Community Physician Network, Rheumatology Care (Employed) Berry MD, Earnest - Family Medicine, termed 6/30/2017 Blanchet NP, Mary P. - Nurse Practitioner, termed 6/30/2017 Community Quick Care (Employed) Bockstahler LCSW, Jennifer S. - Licensed Clinical Social Worker, termed 6/30/2017 Browne LCSW, Patricia - Licensed Clinical Social Worker, termed 6/30/2017 Deveaux MD, Teykia E. - Pediatrics, termed 6/30/2017 Jane Pauley Community Health Center Flamme MD, Paul A. - Neurology, termed 6/30/2017 Josephson Wallack Munshower Neurology, P.C. Franke LCSW, Christopher J. - Licensed Clinical Social Worker, termed 6/30/2017 Gage-White MD, Linda - Otolaryngology, termed 6/30/2017 Ear, Nose, and Throat Care East (Employed) Genesis Labs, Inc. - Laboratory, termed 6/1/2017 Giordano MD, Dennis E. - Radiology-Neuroradiology, termed 6/30/2017 Radiology of Indiana, PC Gullion LCSW, Dorothy L. - Licensed Clinical Social Worker, termed 6/30/2017 Imel LMHC, Tamara L. - Licensed Mental Health Counselor, termed 6/30/2017\ / CPN, Behavioral Health (Employed) Khan MD, Israa - Pediatrics, termed 6/30/2017 Community Pediatric Hospitalists (Employed) Kyle NP, Terri L. - Nurse Practitioner, termed 6/30/2017 4
5 Termed Providers The following providers will no longer be participating with ProHealth: Leipzig MD, Thomas J. - Neurosurgery, termed 6/30/2017 Goodman Campbell Brain and Spine Manley LCSW, Patricia J. - Licensed Clinical Social Worker, termed 6/30/2017 Miller NP, Emily Jo - Nurse Practitioner, termed 6/30/2017 Miller Smith NP, Amy M. - Nurse Practitioner, termed 6/30/2017 CPN, Internal Medicine Care (Employed) Moura-Souchet NP, Francisca - Nurse Practitioner, termed 6/30/2017 Niazi MD, Sultan - Pulmonary Disease, termed 6/30/2017 Pulmonary & Critical Care (Employed) Ofstein LMHC, Dovid C. - Licensed Mental Health Counselor, termed 6/30/2017 Indianapolis Treatment Center / Absolutions Counseling Enterprises, LLC Schulbaum LCSW, Dara L. - Licensed Clinical Social Worker, termed 6/30/2017 Thyen PA, Sarah J. - Physician Assistant, termed 6/30/2017 Pulmonary & Critical Care (Employed) 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 consulting 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) jareed@ecommunity.com Anita Huse, RN, CAPPM Business Consultant Physician Services Ph#: (317) ahuse@ecommunity.com Jamie L. McAllister, MA Business Consultant Ph#: (317) Fx#: (317) jschroth@ecommunity.com Tara Rieman Director Provider Operations Ph#: (317) trieman@ecommunity.com 6
7 Provider Relations Department 6626 E. 75th St, #500 Indianapolis, IN Phone: Department Staff Jenny Bouck, Provider Relations Manager Business Information Coordinator Hollie Putzback, Provider Relations Coordinators: Carol Boyd, Dawn Widgery, Amanda Bobo, Medicaid Program Manager: Salena Woodson, Medicare Program Manager: Lori White, Credentialing/Enrollment Supervisor: Jenna White, Credentialing Coordinators: Kim Tibbets, Julia Chumbley, Julie Starr, Aletha Burnett, April Woodruff, Adrianne Stocks, Provider Enrollment Coordinators: Amy Walls, Denise Smith, Dianne Castillo, Sharon Harlan, Lori Jones, Melissa Scharfenberg, 7
May 2017 I N S I D E T H I S I S S U E : epower. Credentialing of New Providers: BETTER DOCTOR, INC. VALIDATION - Employed Providers :
May 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 2-4 New Providers, effective 6/1/2017 epower ProHealth s epower
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