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1 March 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 YourChoice - eff 1/1/ New Provider Credentialing 1 UnitedHealthcare Portal 2-3 New Providers, effective 4/1/ Termed Providers 5 VHG - Healthcare & Business Consulting 6 Provider Relations Staff Directory YourChoice Marketplace - effective 1/1/2017: *Please Note* YourChoice Marketplace is NOT a marketplace plan, but is a commercial basic PPO plan. ALL providers in the ProHealth network have been enrolled with this plan, effective 1/1/17. This plan pays on the ProHealth PPO fee schedule. Please call ProHealth Provider Relations at (317) with any further questions. Thank you! 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) Changes to UnitedHealthcare Link Portal - UnitedHealthcare recently rolled out a new elink (eligibility and benefits) in January and as a result the ability to check eligibility and benefits on UHCO has been removed. In addition, the eligibility and benefits app on the Link dashboard will also be removed later in In April we are also rolling out the new claimslink (claim status and claim reconsideration) and will be removing the ability to check claim status on UHCO. In addition, the claims management and claims reconsideration apps on the Link dashboard will also be removed later in Considering these changes are fairly significant, UnitedHealthcare wants to ensure Community is aware of where they might find training opportunities or QRGs to assist with performing tasks. **Please see the attachment slides that include pathways to specific documents and where you can register for training.** 1
2 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective March 1, 2017 Hospital affiliations will be listed with each provider. Prime SCP Ayoubi MD, Edris - Internal Medicine St. Francis Medical Group / IIMC - CHS Dale LMHC, Blair - Behavioral Health Fisher LCSW, Roger - Behavioral Health Fisher Counseling LLC Frank LCSW, Christopher - Behavioral Health Ibrahim MD, Saad - Diagnostic Radiology Summit Radiology, PC - CHA, CHRH, CHSH Sharp MD, Anne - Emergency Medicine EPCHA, PC - CHA Whiteman DO, Aaron - Addiction Psychiatry Community Behavioral Professionals Inpatient (Employed) - CHE/CHN, CHV Wiersema MD, Pieter - Pathology Indianapolis Gastroenterology & Hepatology, Inc. Prime PCP Prakash MD, Shimoga - Family Medicine St. Francis Medical Group / IIMC - CHS Prime SCP Advanced Practice Practitioner Cragen NP, Deborah - Nurse Practitioner Community South Hospitalists (Employed) Ditzler CNS, Cheryl - Certified Nurse Specialist Touchpoint Senior Living (Employed) 2
3 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective March 1, Hospital affiliations will be listed with each provider. Prime SCP Advanced Practice Practitioner Doyle NP, Marjo - Behavioral Health Community Howard Behavioral Professionals (Employed) Rance NP, Karen - Pediatric Nurse Practitioner Allergy Partners of Indiana Schilling CRNA, Sarah - Nurse Anesthetist Community Group CRNA (Employed) Stoelting-Gettelfinger NP, Wendy - Nurse Practitioner St. Francis Medical Group / IIMC Styer NP, Jennifer - Family Nurse Practitioner Community South Hospitalists (Employed) - CHS Walker NP, Cari - Family Nurse Practitioner Center for Pain Management Works NP, Esta - Nurse Practitoner Community Hospital Oncology Physicians (Employed) Prime OBG Advanced Practice Practitioner Winningham CNM, NP, Barbara - Certified Nurse Midwife OB/GYN Care Triage (Employed) 3
4 Termed Providers The following providers will no longer be participating with ProHealth: Agrawal MD, Arun - Internal Medicine, termed 3/31/2017 Community Howard Regional Health Hospitalists (Employed) Bakar MD, Ayla - Endocrinology, termed 3/31/2017 Howard Diabetes & Endocrinology (Employed) Blackwell MD, David M. - Family Medicine, termed 3/31/2017 Chatam Care PC Craft PA-C, Roberta E. - Physician Assistant, termed 3/31/2017 Goodman Campbell Brain and Spine Farmer NP, Laura K. - Nurse Practitioner, termed 3/31/2017 Goodman Campbell Brain and Spine Feldman MD, Chad M. - Cardiovascular Disease, termed 3/31/2017 St. Vincent Medical Group, Inc Frascella DO, Paul - Ophthalmology, termed 3/2/ Eye Physicians of Indiana Harrill MD, Connie D. - Radiology, termed 3/31/2017 Radiology of Indiana, PC Huynh NP, Maria - Nurse Practitioner, termed 3/31/2017 Urology of Indiana, LLC Lee MD, Philip C. - Cardiovascular Disease, termed 3/31/2017 St. Vincent Medical Group, Inc Linville LCSW, Laura M. - Licensed Clinical Social Worker, termed 3/31/2017 Mandel DO, Terry J. - Family Medicine, termed 3/31/2017 Community Physician Network, Family Medicine Care (Employed) Mehmood MD, Sajid - Family Medicine, termed 3/31/2017 St. Francis Medical Group / IIMC Nicholls MD, Chong H. - Anesthesiology, termed 3/31/2017 CPN Heart and Vascular (Employed) Rabadi NP, Andrea S. - Nurse Practitioner, termed 3/31/2017 Andrea Rabadi, NP Salyer NP, Annamarie L. - Nurse Practitioner, termed 3/31/2017 Commmunity Physician Network, Internal Medicine Care (Employed) Smith NP, Rebecca K. - Nurse Practitioner, termed 3/31/2017 Goodman Campbell Brain and Spine Valentin LMHC, Jamie J. - Licensed Mental Health Counselor, termed 3/31/2017 Vandivier NP, Brandi L. - Nurse Practitioner, termed 3/31/2017 Community Pediatric Hospitalists (Employed) Young LCSW, Janna L. - Licensed Clinical Social Worker, termed 3/31/2017 Community Behavioral Professionals Inpatient (Employed) / 4
5 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 Account Coordinator Ph#: (317) Fx#: (317) jschroth@ecommunity.com Tara Reiman Director Provider Operations, Practice Management Ph#: (317) trieman@ecommunity.com 5
6 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, Adrianne Stocks, Provider Enrollment Coordinators: Amy Walls, Denise Smith, Dianne Castillo, Sharon Harlan, Lori Jones, 6
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
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 :
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
September 2017 I N S I D E T H I S I S S U E : epower. Credentialing of New Providers: NEW Provider & Facility Electronic Directory:
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
November 2017 I N S I D E T H I S I S S U E : epower. Credentialing of New Providers:
November 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 2018 - New & Termed Payors 2 Updates on PA Requests
epower: *PLEASE NOTE*
January 2018 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 3D Mammograms in 2018 epower: ProHealth s epower (Provider
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