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 :
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1 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 (Provider Portal) is now available on our website at: provider-relations Providers may login and use epower to check claim status, eligibility and more. 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 June 1, 2017 Hospital affiliations will be listed with each provider. PPO Only Providers Faulkner MD, James - Internal Medicine Indiana Hemophilia & Thrombosis Center, Inc. Rainey MD, Sabrina - Internal Medicine Indiana Hemophilia & Thrombosis Center, Inc. Prime SCP Habib MD, Amir - Internal Medicine Community Howard Regional Health Hospitalists (Employed) - CHRH Balan DiBella LMFT, Kristen - Licensed Marriage and Family Therapist Brownlee LCSW, LCAC, Lisa M. - Licensed Clinical Social Worker Davis LMHC, Timothy R. - Licensed Mental Health Counselor Timothy Davis Counseling Services Jones PsyD, HSPP, Jessica - Psychologist Indiana Behavior Analysis Academy Maurice LCSW, Janet L. - Licensed Clinical Social Worker Miskulin MD, Judiann - General Surgery Community Physician Network, Endocrine Surgical Care (Employed) - CHS Smith DDS, Harold - Dentist Dental Sleep Medicine of Indiana - CHE/CHN, CHV Stringer LCAC, Eva - Licensed Clinical Addiction Counselor Thomas MD, Sarah - Rheumatology Community Physician Network, Rheumatology Care (Employed) - CHE/CHN, CHV Williams LMHC, Lindsey - Licensed Mental Health Counselor 2
3 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective June 1, Hospital affiliations will be listed with each provider. Prime SCP Advanced Practice Practitioners Apple PA, Drew W. - Physician Assistant Methodist Sports Medicine - CHE/CHN, CHV Bantz NP, Diana - Nurse Practitioner Bullard NP, Diana - Nurse Practitioner Casburn NP, Jenny - Nurse Practitioner Cunningham NP, Kelly - Nurse Practitioner Demeter PA, Jaclyn M. - Physician Assistant Indiana Spine Group - CHE/CHN, CHV DeRose NP, Barbara S. - Nurse Practitioner Gerber NP, Alexandra M. - Nurse Practitioner Goens PA, Ryan - Physician Assistant Grigsby NP, Jennifer - Nurse Practitioner Jackson NP, Michelle L. - Nurse Practitioner Johnson NP, Jenna - Nurse Practitioner Kellermeyer NP, William H. - Nurse Practitioner Lambdin NP, Cheryl - Nurse Practitioner Lawrence NP, Ashley - Nurse Practitioner Mason NP, Hannah E. - Nurse Practitioner St. Francis / IIMC 3
4 Contracting and Credentialing Corner Providers Joining ProHealth We would like to welcome the following providers to the ProHealth Network effective June 1, Hospital affiliations will be listed with each provider. Prime SCP Advanced Practice Practitioners (continued) Mechem NP, Anna - Nurse Practitioner McDaniel CRNA, LeeAnn - Certified Registered Nurse Anesthetist Community Hospital Anderson Anesthesia (Employed) Ross NP, Stacey - Nurse Practitioner Nikou PA, Erin M. - Physician Assistant Stesney NP, Christine - Nurse Practitioner Stevens NP, Kristene P. - Nurse Practitioner Stewart NP, Cary - Nurse Practitioner Thorington NP, Julia A. - Nurse Practitioner White NP, Lisa M. - Nurse Practitioner Radiation Oncology Care North (Employed) - CHE/CHN, CHV White NP, Tomekia S. - Nurse Practitioner Family Medicine & Internal Medicine Care, Southpointe (Employed) Wors NP, Carrie A. - Nurse Practitioner Young NP, Sharon R. - Nurse Practitioner 4
5 Termed Providers The following providers will no longer be participating with ProHealth: Aroutiounova MD, Inna - Rheumatology, termed 6/1/2017. Community Physicians of IN, Inc / Community Physician Network, Rheumatology Care (Employed) VHS Genesis Labs, Inc. - Laboratory, termed 6/1/
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
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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