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:

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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/ New Providers, effective 10/1/ 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: 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 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) NEW Provider & Facility Electronic Directory: There is now an electronic directory available on ProHealth s website at 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 independent 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) Phone#: (317) Dwidgery@ecommunity.com Cboyd@ecommunity.com 1

2 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective October 1, 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 - CHE/CHN, CHV Foster LMHC, Ashley - Behavioral Health Kitchens MD, Anne C. - Endocrinology, Diabetes & Metabolism Diabetes & Endocrinology Care (Employed) - CHE/CHN, CHV, CHS Klepfer LCSW, Kourtney - Behavioral Health 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 Scholer MD, Aaron - Pediatrics Community Pediatric Hospitalists (Employed) - CHE/CHN Sievers LMFT, Shannon A. - Behavioral Health Singh MD, Manpreet - Nephrology Kidney & Hypertension Consultants, PC - CHE/CHN, CHV, CHS, CHR Sykes LMFT, Shannon A. - Behavioral Health 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 2

3 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective October 1, Hospital affiliations will be listed with each provider. 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 3

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 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 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 Kentucky 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 October 15, 2017 and runs through December 7, 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 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

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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 Manager Provider Relations: Jenny Bouck, Business Information Coordinator Hollie Putzback, Provider Relations Analysts: Carol Boyd, Dawn Widgery, Amanda Bobo, Governmental Programs Manager (Medicare): Lori White, Governmental Programs Manager (Medicaid): Salena Woodson, Supervisor Provider Credentialing: Jenna White, Credentialing Coordinators: Kim Tibbets, Julia Chumbley, Julie Starr, Aletha Burnett, April Woodruff, Adrianne Stocks, Provider Credentialing Assistants: Amy Walls, Denise Smith, Dianne Castillo, Sharon Harlan, Lori Jones, Melissa Scharfenberg, 7