INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36502, 22077, 28432, NULL, '2022-05-02 00:00:00.000', 'In Process', 'Email received from: ywyatt@humana.com  Subject: RE: Enrollment Query || Stephane Cyriaque & Shametria Tann || BHUCC || Tricare  Good Afternoon Alex,     We show both Providers are affiliated to this group tax id. You can check status by using the online Self Service Provider Portal. Highlighted below is the link to create a log in.              In order to serve our providers more efficiently, we have begun using Humana Military’s Provider Self-Service Portal.  The secure messaging feature through Provider Self Service increases the timeliness of responses to your questions.  If you are not currently registered on the Provider Self-Service Portal, please visit:  Provider Self-Service (humana-military.com)  To verify provider status, please utilize the NPI search tool in the Provider Self-Service Portal.  If the provider does not populate in this tool, then the provider is not TRICARE certified.     Thanks,  Yvonne W. Wyatt,  TRICARE Community Liaison II  Humana Military     502-318-5409 Telephone  502-322-8018 Fax  ywyatt@humana.com     HumanaMilitary.com  Additional Resources:  ** Provider claims, certification and other forms  ** Rates and reimbursements', NULL, NULL, '2022-04-25 13:20:10', '2022-04-25 13:20:10'),
(36503, 22077, 28432, NULL, '2022-05-02 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: 	Re: Enrollment Query || Stephane Cyriaque & Shametria Tann || BHUCC || Tricare  Hi,  I want to know the effective date for both providers,  Group Name	Best Health Urgent Care & Clinic Tax ID	84-4737737 Group NPI	1013540962 Primary & Billing Address	3003 TEXAS PKWY UNIT B MISSOURI CITY, TX 77489-5242 Provider Name	NPI Stephane Cyriaque	1780192633 Shametria Tann	1124615612  I am looking forward to your kind response.  Thanks & Regards. ', NULL, NULL, '2022-04-25 13:21:48', '2022-04-25 13:21:48'),
(36504, 1006, 28433, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36505, 1006, 28433, NULL, '2021-06-14 00:00:00.000', 'Initiated', 'Submitted group & provider enrollment request, it\'s attached for reference. ', NULL, NULL, '2021-06-07 09:44:03', '2021-06-07 09:44:03'),
(36506, 1006, 28433, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent following email to \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com;  Sub; RE: Become A Provider - Unsecured - Not Applicable - Texas  \"Hello,   I appreciate the update but the provider Shametria Tann needs to be set up as a PCP under our group, please let me know what is required to proceed with that request?  Thank you!\"', NULL, NULL, '2021-06-24 14:26:18', '2021-06-24 14:26:18'),
(36507, 11056, 28433, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email received from : ProspectiveProviderTX@wellcare.com  Sub : Become A Provider - Unsecured - Not Applicable - Texas  Good Afternoon,  We will send this over to Account Management for update.  Thanks.', NULL, NULL, '2021-07-13 13:48:39', '2021-07-13 13:48:39'),
(36508, 11056, 28433, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Process Update - BHUCC - Wellcare  Greetings,  Hope you are doing well. Any update on Shametria Tann enrollment to be set up as a PCP under our group mentioned below ?  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Provider : Provider Name: Tann, Shametria Provider  NPI # : 1124615612  If you need any information or documents please let me know . Waiting to hear from you soon.  Thank you! Have a great day! ', NULL, NULL, '2021-07-22 14:47:09', '2021-07-22 14:47:09'),
(36509, 11056, 28433, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Email received from : ProspectiveProviderTX@wellcare.com  Sub : Become A Provider - Unsecured - Not Applicable - Texas  Good Afternoon,  Update request was sent in we will let you know as soon as it is complete.  Thanks Network Development', NULL, NULL, '2021-07-26 09:34:32', '2021-07-26 09:34:32'),
(36510, 11056, 28433, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email received from : ProspectiveProviderTX@wellcare.com  Sub : Become A Provider - Unsecured - Not Applicable - Texas  Good Afternoon,   The request was sent 7.13.2021 to have the provider updated as PCP. It should not take much longer to be updated. I will let you know once the request is complete.   Thanks  Network Development', NULL, NULL, '2021-07-27 13:27:39', '2021-07-27 13:27:39'),
(36511, 11056, 28433, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Become A Provider - Unsecured - Not Applicable - Texas  Greetings,  Hope you are doing well. Any update on Shametria Tann enrollment to be set up as a PCP under our group mentioned below ? How much more time needed for the completion of enrollment or credentialing process take ?  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Provider : Provider Name: Tann, Shametria Provider  NPI # : 1124615612  If you need any information or documents please let me know . Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-07-27 13:37:55', '2021-07-27 13:37:55'),
(36512, 11056, 28433, NULL, '2021-08-06 00:00:00.000', 'Approved', '05/01/2021  Please see attachment.', NULL, NULL, '2021-07-29 14:16:25', '2021-07-29 14:16:25'),
(36513, 11056, 28433, NULL, '2021-08-06 00:00:00.000', 'Approved', 'Approval email received from : ProspectiveProviderTX@wellcare.com  Sub : Fwd: Become A Provider - Unsecured - Not Applicable - Texas  Good Afternoon,   Please see welcome letters and contract.   Let us know if you have any questions.   Thanks  Network Management – Texas | www.wellcare.com | www.superiorhealthplan.com  Shametria eff date is : 06/18/2021  STEPHANE eff date is : 05/01/2021  Please see the attachment', NULL, NULL, '2021-07-29 14:17:27', '2021-07-29 14:17:27'),
(36514, 1006, 28434, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36515, 1006, 28434, NULL, '2021-06-01 00:00:00.000', 'Initiated', 'Submitted enrollment request via PalmetoGBA website: \"Reference Number :	21145000578\"', NULL, NULL, '2021-05-25 11:40:07', '2021-05-25 11:40:07'),
(36516, 1006, 28434, NULL, '2021-06-08 00:00:00.000', 'Approved', 'Your active Railroad Medicare PTAN has been located and is shown here :  PROVIDER NAME	SHAMETRIA TANN NP PROVIDER PTAN	Q00076615 PROVIDER NPI	1124615612 EFFECTIVE DATE	02/05/2021 END DATE	 GROUP NAME	BEST HEALTH URGENT CARE & CL GROUP PTAN	DZ8560 BUSINESS STATE	TX EFFECTIVE DATE	02/25/2020 END DATE	  Approval confirmation is attached for reference. ', NULL, NULL, '2021-06-01 09:02:23', '2021-06-01 09:02:23'),
(36517, 1006, 28435, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36518, 1006, 28435, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'Florida only insurance, not eligible for enrollment in Texas. ', NULL, NULL, '2021-05-28 14:28:32', '2021-05-28 14:28:32'),
(36519, 1006, 28436, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36520, 1006, 28436, NULL, '2021-05-16 00:00:00.000', 'Initiated', 'Submitted Enrollment application: Enrollment Tracking Information Applicant Name: SHAMETRIA TANN  Tracking ID: T050620210001378  Reassignment Tracking ID: T050620210001430  Submitted Date: THU - MAY 06 2021 02:48:12 PM EST  Submitted By: Shametria Tann  Contact Email(s): S_TANN@YAHOO.COM BHUCC@CLAIMSMEDINC.COM Reason(s) for submission: A Medicare Part B practitioner is enrolling in the Medicare program for the first time to bill for Part B services. A reassignment of benefits may exist.', NULL, NULL, '2021-05-06 13:49:21', '2021-05-06 13:49:21'),
(36521, 1006, 28436, NULL, '2021-05-21 00:00:00.000', 'Approved', 'Application Tracking ID: T050620210001378   NPI ID: 1124615612   Medicare ID: 1P0365   Name: SHAMETRIA TANN  State: TX   Form Type: 855I  Date: 05/11/2021  Status: APPROVED', NULL, NULL, '2021-05-11 08:23:48', '2021-05-11 08:23:48'),
(36522, 1006, 28437, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36523, 1006, 28437, NULL, '2021-06-01 00:00:00.000', 'Initiated', 'Sent following enrollment request to Michelle Monroe mmonroe@ghn-mci.com:  Sub: Provider Enrollment - Shametria Tann - BHUCC  \"Hello Michelle,   I hope you\'re doing well, our group has a new provider and I wanted to know what is required to get her enrolled under it, the group and provider information are as follows:  Group Name: Best Health Urgent Care & Clinic NPI# 1013540962  Provider Name: Tann, Shametria NPI# 1124615612  Please get back to me as soon as you\'re able to.   Thank you.\"', NULL, NULL, '2021-05-25 11:21:18', '2021-05-25 11:21:18'),
(36524, 3040, 28437, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: mmonroe@ghn-mci.com  Subject: Enrollment Status || Best Health Urgent Care & Clinic || Tann, Shametria || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned provider in our group Best Health Urgent Care & Clinic under the below location.   Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID# 84-4737737 Practice NPI# 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242  Provider Details: Provider Name: Tann, Shametria Provider NPI# 1124615612  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-06-09 14:49:21', '2021-06-09 14:49:21'),
(36525, 1006, 28437, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from Michelle Monroe mmonroe@ghn-mci.com:  Sub; Enrollment Status || Best Health Urgent Care & Clinic || Tann, Shametria || Galaxy Health ||   \"Hello,  Please see the attached Agreement needed to enroll your provider. If you should have any questions, please feel free to contact me.  Thank you, Michelle   Michelle Monroe Contract Specialist / Client Relations Galaxy Health Network  2261 Brookhollow Plaza Drive Suite 106 Arlington, TX 76006 PO Box 201425 Arlington, TX 76006-1425 mmonroe@ghn-mci.com Phone (800) 975-3322 x1401 Fax directly (817)-394-2497 \"  Sent following reply:  \"Hello Michelle,   I wanted to verify if we had a group contract or are we still not eligible for one until we have two providers enrolled with Galaxy Health?  Thank you! \"', NULL, NULL, '2021-06-21 16:28:43', '2021-06-21 16:28:43'),
(36526, 1006, 28437, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following response from Michelle Monroe mmonroe@ghn-mci.com:  Sub: Enrollment Status || Best Health Urgent Care & Clinic || Tann, Shametria || Galaxy Health ||  \"Hi Brad,  I do apologize for the delay in getting back with you. You had asked on your voicemail, if you could fill this out as a group or individually. We would prefer the entire clinic of providers.  What we will need is One Agreement, and each provider would need to fill out their own application (Provider Data Record- attached with Agreement) or you are welcome to send in their CAQH in place of, along with all credentials that apply to each provider you are adding,  If you should have any questions, please feel free to reach out to me.  Thank you, Michelle  Michelle Monroe Contract Specialist / Client Relations Galaxy Health Network 2261 Brookhollow Plaza Drive Suite 106 Arlington, TX 76006 PO Box 201425 Arlington, TX 76006-1425 mmonroe@ghn-mci.com Phone (800) 975-3322 x1401 Fax directly (817)-394-2497\"  Replied with:  \"Hello Michelle,   I appreciate the reply and I apologize for the delay in responding back, please find the agreement, and here\'s the CAQH ID\'s for both providers:  Stephane Cyriaque:14189681 Shametria Tann: 15094779  I\'ve also attached all the required credentials for both providers for reference. Please let me know if anything else is required to proceed with this request.  Thank you. \"', NULL, NULL, '2021-07-08 13:00:38', '2021-07-08 13:00:38'),
(36527, 11056, 28437, NULL, '2021-07-26 00:00:00.000', 'In Process', 'Email sent to : mmonroe@ghn-mci.com  Sub :  Enrollment Status Query - Galaxy Health - BHUCC  Greetings,  Hope all is well. I wanted to inquire about the enrollment status and Galaxy participating agreement with the documents of the providers which we have submitted on 8th July,2021. Kindly update me with the enrollment status of the below mentioned providers and group.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice NPI # : 1013540962 Practice TIN # : 84-4737737 Practice Address : 3003 TEXAS PKWY UNIT B, MISSOURI CITY , TX 77489-5242  Provider: Provider Name : Stephane Cyriaque Provider  NPI # : 1780192633  Provider Name : Shametria Tann Provider  NPI # : 1124615612  If you need any information or documents feel free to reach out to us. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-07-19 12:48:44', '2021-07-19 12:48:44'),
(36528, 11056, 28437, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email received from : cguerue@ghn-mci.com  Sub : Enrollment Status || Best Health Urgent Care & Clinic || Tann, Shametria || Galaxy Health ||  Good Morning, The information for Best Health Urgent Care & Clinic has been processed, we don’t subscribe to CAQH, so I am unable to access the information, however, Stephane Cyriaque has already been previously credentialed, so no other information will be needed, but we will need a copy of Shametria Tann’s CAQH forwarded to complete her credentialing.  Please feel free to contact me with any questions…  Thank you!  Christine Guerue Credentialing Dept  cguerue@ghn-mci.com 800-975-3322 x1130 817-633-5729 fax Galaxy Health Network 2261 Brookhollow Plaza Dr, Ste 106 Arlington, TX 76006 PO Box 201425 Arlington, TX 76006-1425', NULL, NULL, '2021-07-27 13:54:14', '2021-07-27 13:54:14'),
(36529, 11056, 28437, NULL, '2021-08-05 00:00:00.000', 'Approved', 'Approval Email received from : cguerue@ghn-mci.com  Sub : Enrollment Status || Best Health Urgent Care & Clinic || Tann, Shametria || Galaxy Health ||  Thank you Ahmed, this works perfectly and I have now marked all paperwork complete, the new group’s eff date is 7/27/21, providers Tann and Cyriaque will be linked to the group eff 7/27/21 as well.  Also, I have attached a copy of the fully executed agreement for your files.     Please feel free to contact me with any questions…  Thank you and have a good day!   The agreement has been attached. Please see the attachment.', NULL, NULL, '2021-07-28 15:58:00', '2021-07-28 15:58:00'),
(36530, 1006, 28438, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36531, 1006, 28438, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We cannot proceed with this enrollment until Dr. Segun has been enrolled with Scott & White, as he is the supervising physician for the group. ', NULL, NULL, '2021-06-07 15:07:36', '2021-06-07 15:07:36'),
(36532, 1006, 28439, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36533, 1006, 28439, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Need to allow superior health enrollment to finish before submitting ambetter request, need to allow more time. ', NULL, NULL, '2021-06-07 09:15:52', '2021-06-07 09:15:52'),
(36534, 1006, 28440, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36535, 1006, 28440, NULL, '2021-06-04 00:00:00.000', 'Initiated', 'Sent following email @ trpndataentry@trpnppo.com & providerrelations@trpnppo.com:  Sub: Enrollment Request - BHUCC - TRPN  \"Hello,  We wish to enroll the following providers and group with TRPN, their information is as follows: Group Name: Best Health Urgent Care & ClinicNPI# 1013540962TIN# 84-4737737 Provider Name: Stephane Cyriaque NPI# 1780192633Enroll as: Specialist Provider Name: Shametria Tann NPI# 1124615612Enroll as: PCP Please let me know what else is required to process this request.  Thank you. \"', NULL, NULL, '2021-05-28 16:07:56', '2021-05-28 16:07:56'),
(36536, 3040, 28440, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email rcvd from: AVasquez@trpnppo.com  Subject: TRPN - Best Health Urgent Care & Clinic Hi Brad,   It was a pleasure speaking with you today.  Per our conversation, I am attaching a copy of our standard agreement for review and completion, please contact me directly with any questions and/or requests. I look forward to working with you.  Best regards,  Alex Vasquez Contract Coordinator 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 271-2708 Fax: (619) 271-2587 avasquez@trpnppo.com www.trpnppo.com ', NULL, NULL, '2021-06-09 16:08:21', '2021-06-09 16:08:21'),
(36537, 1006, 28440, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Replied to Alejandro with the agreement @ Alejandro Vasquez AVasquez@trpnppo.com:  Sub: FW: TRPN - Best Health Urgent Care & Clinic  \"Hello Alejandro,  Appreciate the reply, here\'s the filled-out agreement. Please let me know what else might be needed to proceed further with this process.  Thank you. \"  Agreement is attached in group task for reference as it is an ancillary contract request. ', NULL, NULL, '2021-06-09 16:25:04', '2021-06-09 16:25:04'),
(36538, 11056, 28440, NULL, '2021-07-05 00:00:00.000', 'In Process', 'Email received from : AVasquez@trpnppo.com  Sub : TRPN - Best Health Urgent Care & Clinic  Hi Brad,   I will have the agreement executed and a countersigned copy will be sent to you for your records, the time frame for completion is three to four weeks, but feel free to follow up with me at any time.   Thank you and have a great weekend!', NULL, NULL, '2021-06-28 12:58:57', '2021-06-28 12:58:57'),
(36539, 11056, 28440, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Email sent to : AVasquez@trpnppo.com  Sub : Enrollment Status Update - Best Health Urgent Care & Clinic - TRPN  Greetings,  Hope you are doing well. This is a follow-up email for the agreement which you were going to send us in 3-4 weeks but the time frame has been completed and we haven\'t got the agreement yet. Kindly respond to us soon. We are eagerly waiting for your response and agreement.   Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice NPI # : 1013540962 Practice TIN # : 84-4737737 Practice Address : 3003 TEXAS PKWY UNIT B, MISSOURI CITY , TX 77489-5242  Provider: Provider Name : Stephane Cyriaque Provider  NPI # : 1780192633  Provider Name : Shametria Tann Provider  NPI # : 1124615612  If you need any information or documents feel free to reach out to us. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-07-12 12:57:47', '2021-07-12 12:57:47'),
(36540, 11056, 28440, NULL, '2021-07-26 00:00:00.000', 'In Process', 'Email sent to : AVasquez@trpnppo.com  Sub : AGREEMENT DEMAND - BHUCC - TRPN  Greetings,  Hope you are doing well. This is a follow-up email for the agreement which you were going to send us in 4-5 weeks ago but the time frame has been completed and we haven\'t got the agreement yet. Kindly respond to us soon. We are eagerly waiting for your response and agreement.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice NPI # : 1013540962 Practice TIN # : 84-4737737 Practice Address : 3003 TEXAS PKWY UNIT B, MISSOURI CITY , TX 77489-5242  Provider: Provider Name : Stephane Cyriaque Provider  NPI # : 1780192633  Provider Name : Shametria Tann Provider  NPI # : 1124615612  If you need any information or documents feel free to reach out to us. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-07-19 10:47:32', '2021-07-19 10:47:32'),
(36541, 11056, 28440, NULL, '2021-08-06 00:00:00.000', 'In Process', 'Email received from : AVasquez@trpnppo.com via trpnppo.onmicrosoft.com   Sub : Automatic reply: AGREEMENT DEMAND - BHUCC - TRPN  I will be out of the office starting Mondy, July 19 and I will return all calls/emails upon my return on Wednesday, July 21. Thank you!', NULL, NULL, '2021-07-30 12:44:50', '2021-07-30 12:44:50'),
(36542, 11056, 28440, NULL, '2021-08-11 00:00:00.000', 'Approved', 'Approval Email received from : kfry@trpnppo.com  &  avasquez@trpnppo.com  Sub : Welcome to Three Rivers Provider Network.  Welcome to Three Rivers Provider Network.  Please see your attached welcome letter and executed agreement.  Please reach out if you need anything else.  Thank you  Kellyn Fry Data Entry Coordinator/Office Assistant 6970 O’ Bannon Drive Las Vegas, NV 89117 Phone:(619) 600-4808 Fax: (619) 271-2658 Primary Email: kfry@trpnppo.com', NULL, NULL, '2021-08-04 13:28:12', '2021-08-04 13:28:12'),
(36543, 1006, 28441, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36544, 1006, 28441, NULL, '2021-06-14 00:00:00.000', 'Not Eligible', 'Group does not fall under Driscoll\'s service area: \"From: Melinda.Lopez@dchstx.org Sub: Request for Contract Stephane Cyriaque FNP  Hello Samuel, I want to acknowledge receipt of the completed request for contract form submitted for Stephane Cyriaque FNP however cannot process due to Missouri City TX is not in our service area and we do not have any members that reside in this area.  The request for contract is being withdrawn due to not in our service area. Please refer to the map below of the 24 counties within our service area.\"', NULL, NULL, '2021-06-07 15:08:55', '2021-06-07 15:08:55'),
(36545, 1006, 28442, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36546, 1006, 28442, NULL, '2021-06-14 00:00:00.000', 'Initiated', 'Sent following enrollment initiation request @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Request - BHUCC - Christus Spohn   \"Hello, We wish to enroll the following group and providers with Christus Spohn, their information is as follows:  Group Name: Best Health Urgent Care & Clinic NPI# 1013540962 TIN# 84-4737737  Provider Name: Stephane Cyriaque NPI# 1780192633  Provider Name: Shametria Tann NPI# 1124615612  Please let me know what is required to proceed with this process.  Thank you. \"', NULL, NULL, '2021-06-07 10:47:25', '2021-06-07 10:47:25'),
(36547, 1006, 28442, NULL, '2021-07-01 00:00:00.000', 'Not Eligible', 'Christus Spohn service area does not cover Missouri City/Fort Bend County: https://www.christushealth.org/spohn/patient-resources/spohn-health-network/service-area', NULL, NULL, '2021-06-24 13:43:37', '2021-06-24 13:43:37'),
(36548, 1006, 28443, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36549, 1006, 28443, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Ancillary enrollment is in-process in the main group task, please check it for further information. ', NULL, NULL, '2021-06-07 14:14:18', '2021-06-07 14:14:18'),
(36550, 11056, 28443, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to : TXMAContracting@cigna.com  Sub : Enrollment Query - BHUCC - Cigna Healthspring  Good Evening,  Hope you are doing well. I wanted to get an update regarding the enrollment request we submitted for our group, please let me know what the current status is? Kindly respond to us soon.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B  MISSOURI CITY , TX 77489-5242  If you need any information or documents feel free to contact us. Waiting for your response.  Thank you!', NULL, NULL, '2021-07-12 14:44:40', '2021-07-12 14:44:40'),
(36551, 11056, 28443, NULL, '2021-07-20 00:00:00.000', 'On Hold', 'Ancillary enrollment is in-process in the main group task, please check it for further information. ', NULL, NULL, '2021-07-12 14:45:21', '2021-07-12 14:45:21'),
(36552, 1006, 28444, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36553, 1006, 28444, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'This is pending UHC enrollment, need to allow more time. ', NULL, NULL, '2021-06-07 09:24:22', '2021-06-07 09:24:22'),
(36554, 11056, 28444, NULL, '2021-07-20 00:00:00.000', 'Initiated', 'Greetings,  Hope you are doing well. I want to enroll the below mentioned provider and Group. Kindly guide me with the procedure how to enroll them.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   Provider Details: Provider Name : Tann, Shametria Provider NPI # : 1124615612   If you need any information please feel free to call or email me. Waiting for your response.    Thank you! Have a great day!', NULL, NULL, '2021-07-12 17:03:26', '2021-07-12 17:03:26'),
(36555, 11056, 28444, NULL, '2021-07-20 00:00:00.000', 'Initiated', 'Email sent to : networkhelp@uhc.com  Sub : ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Greetings,  Hope you are doing well. I want to enroll the below mentioned provider and Group. Kindly guide me with the procedure how to enroll them.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   Provider Details: Provider Name : Tann, Shametria Provider NPI # : 1124615612   If you need any information please feel free to call or email me. Waiting for your response.    Thank you! Have a great day!', NULL, NULL, '2021-07-12 17:04:52', '2021-07-12 17:04:52'),
(36556, 11056, 28444, NULL, '2021-07-23 00:00:00.000', 'In Process', 'Email received from : networkhelp@uhc.com  Sub : ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Hello,     Thank you for reaching out to UnitedHealth Care.  I’ll be happy to assist you today. I reviewed  TANN, SHAMETRIA  - 7674348 /TAX ID 844737737 regarding enrolling group and provider. Per your provider’s profile, I can confirm that group is enrolled, and the provider is linked to the group, waiting to be added to group contract. Open phycon add to group PR-5925454 being work on. Need more time to complete, 30 days.     Let us know if you need further assistance.  Please send all responses or questions pertaining to this email to networkhelp@uhc.com. Have a wonderful day!     Thank You,     Aldean Mosley  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-07-15 15:57:20', '2021-07-15 15:57:20'),
(36557, 11056, 28444, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email received from : aldean_mosley@uhc.com  & networkhelp@uhc.com  Sub : Secure Message from aldean_mosley@uhc.com  Hello,  Thank you for reaching back out to UnitedHealth Care.  I submitted an escalation today requesting that provider be added to group contract, load contract lines, ETA 10 days, there is nothing additional required of you other than following up in 10 days to check the contract status for the provider.     Let us know if you need further assistance.  Please send all responses or questions pertaining to this email to networkhelp@uhc.com. Have a wonderful day!  Thank You, Aldean Mosley UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-07-23 12:28:49', '2021-07-23 12:28:49'),
(36558, 11056, 28444, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email received from  : networkhelp@uhc.com  Sub : Secure Message from katherine_k_floyd@uhc.com  Good afternoon Ahmed,    SHAMETRIA TANN  has had two request for credentialing. Is this provider not a urgent care seeing walk-ins or seeing patients by appointment?  Walk-in providers do not require credentialing by appointment does.     Thank you.     Katherine Floyd  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-07-27 10:57:13', '2021-07-27 10:57:13'),
(36559, 11056, 28444, NULL, '2021-08-11 00:00:00.000', 'In Process', 'Email sent to : 	networkhelp@uhc.com  Sub :  ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Good morning!  Hope you are doing well. I want to know the enrollment status of the below mentioned provider and Group for UHC Plan (Texas Star Kids). Kindly provide me with the updates soon.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address : 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   Provider Details: Provider Name : Tann, Shametria Provider NPI # : 1124615612   If you need any information please feel free to call or email me. Waiting for your response.   Thank you! Have a great day!', NULL, NULL, '2021-08-04 08:35:02', '2021-08-04 08:35:02'),
(36560, 11056, 28444, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Email sent to : 	networkhelp@uhc.com  Sub :  ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Good morning!  Hope you are doing well. I want to know the enrollment status of the below mentioned provider and Group for UHC Plan (Texas Star Kids). Kindly provide me with the updates soon.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address : 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   Provider Details: Provider Name : Tann, Shametria Provider NPI # : 1124615612   If you need any information please feel free to call or email me. Waiting for your response.   Thank you! Have a great day!', NULL, NULL, '2021-08-10 14:40:03', '2021-08-10 14:40:03'),
(36561, 11056, 28444, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Approval Email received from : networkhelp@uhc.com  Sub : ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Hi Talha  Thank you for emailing Network help.  The Group and Provider has been updated with  UHC Plan (Texas Star Kids) plan.   Attached is the Product code list.   Thanks Pam  Pamela(Pam) Preece UnitedHealthcare Network Management Resource Team (NMRT)   Eff date is : 07/20/2021', NULL, NULL, '2021-08-16 14:22:04', '2021-08-16 14:22:04'),
(36562, 11056, 28444, NULL, '2021-08-24 00:00:00.000', 'Approved', 'Approval Email received from :   networkhelp@uhc.com  Sub : ENROLLMENT REQUEST - BHUCC - UHC Plan (Texas Star Kids)  Hi Talha  Thank you for emailing Network help.  The Group and Provider has been updated with  UHC Plan (Texas Star Kids) plan.   Attached is the Product code list.   Thanks Pam  Pamela(Pam) Preece UnitedHealthcare Network Management Resource Team (NMRT)   Eff date is : 07/20/2021', NULL, NULL, '2021-08-16 14:23:44', '2021-08-16 14:23:44'),
(36563, 1006, 28445, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36564, 1006, 28445, NULL, '2021-06-14 00:00:00.000', 'Initiated', 'Sent enrollment and f/u request @ credentialing@anci-care.com:  Sub: Enrollment Request/Status - BHUCC - Anci-Care  \"Hello,  I wanted to know what is required to get the following group and providers enrolled with Anci-Care, their information is as follows:  Group Name: Best Health Urgent Care & Clinic NPI# 1013540962 TIN# 84-4737737  Provider Name: Stephane Cyriaque NPI# 1780192633  Provider Name: Shametria Tann NPI# 1124615612  Please get back to me as soon as possible regarding this. Thank you. \"', NULL, NULL, '2021-06-07 10:31:01', '2021-06-07 10:31:01'),
(36565, 1006, 28445, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent following reply to Patti DavidsonACS pdavidson@anci-care.com:  Sub; New Provider Agreement - per request  \"Hello Patti,  Please find the attached information as requested, do let me know if anything else is required to proceed with this process.  Thank you!\"  Documents are attached for reference in main group task. ', NULL, NULL, '2021-06-24 13:40:44', '2021-06-24 13:40:44'),
(36566, 11056, 28445, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from :  pdavidson@anci-care.com  Sub : New Provider Agreement - per request  Hi.  Thank you!  I have submitted all documents on for credentialing approval.  Once approved you will receive a welcome letter and signed provider agreement from Jennifer Maligaya- Sr. PR Rep.  Thank you,  Patti Davidson | Manager, Network Development HealthSmart | Network Solutions Office: 972 388 3091 | Fax: 214 574 1121 patti.davidson@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-07-06 16:23:55', '2021-07-06 16:23:55'),
(36567, 11056, 28445, NULL, '2021-07-23 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub :  New Provider Agreement - per request  Good Afternoon Patti,    Hope you are doing well. I want to inquire about the enrollment status of the below mentioned providers and group in Anci care. When will you gonna provide the letter welcome letter and signed provider agreement.    Practice Details:  Practice Name: Best Health Urgent Care & Clinic Practice NPI# 1013540962  Practice TIN# 84-4737737     Providers:   Provider Name: Stephane Cyriaque NPI# 1780192633     Provider Name: Shametria Tann NPI# 1124615612     Please get back to me as soon as possible regarding this.Feel free to reach out to me if you have any questions.     Thank you!', NULL, NULL, '2021-07-15 14:06:03', '2021-07-15 14:06:03'),
(36568, 11056, 28445, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email received from : Jennifer.Maligaya@healthsmart.com  Sub : New Provider Agreement - per request  Good Morning,  BEST HEALTH URGENT CARE & CLINIC, TIN 844737737 is contracted with ACS. Please note, ACS credentials/recredentials the location, not individuals. Therefore, if the providers invoice with the same TIN, they are considered in network with ACS.  Best Regards,  Jennifer Maligaya | Sr. Provider Relations, ACS and MyDecision HealthSmart | Network Solutions Office: 405 241 4811 | Fax: 214 574 1121 Jennifer.maligaya@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-07-23 10:20:18', '2021-07-23 10:20:18'),
(36569, 11056, 28445, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Email sent to : Jennifer.Maligaya@healthsmart.com  Sub : New Provider Agreement - per request  Greetings,  Hope all is well. Yeah the provider invoice with the same TIN of the practice BEST HEALTH URGENT CARE & CLINIC. Thank you for the clarification.  Thank you! Have a great day!', NULL, NULL, '2021-07-26 11:30:58', '2021-07-26 11:30:58'),
(36570, 11056, 28445, NULL, '2021-08-05 00:00:00.000', 'Approved', '	 APPROVAL Email received from : 	\'Jennifer Maligaya\' via Best Health Urgent Care & Clinic, PLLC   Jennifer.Maligaya@healthsmart.com  Sub : Welcome to ACS, Best Health Urgent Care & Clinic  Good Afternoon,     Congratulations and welcome to the Ancillary Care Services (ACS) network. Please see the attachments. My name is Jennifer Maligaya and I am the Sr. Provider Relations Representative to the ACS Providers.     My contact information is listed below my signature. Please do not hesitate to reach out to me with any questions or concerns. Thank you!     Best Regards,     Jennifer Maligaya | Sr. Provider Relations Representative  HealthSmart | Network Solutions  Office: 405 241 4811 | Fax: 214 574 1121  Jennifer.maligaya@healthsmart.com | www.HealthSmart.com   The agreement is attached .Please see the attachment.', NULL, NULL, '2021-07-28 14:39:01', '2021-07-28 14:39:01'),
(36571, 1006, 28446, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:45:59', '2021-05-06 07:45:59'),
(36572, 1006, 28446, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Our request is in-process but we still haven\'t received a contract and it is based on the need for providers and the amount of VA patients in the area, we need to wait until we are eligible. Need to wait until we receive a contract from them to proceed with this application.  Ref# Kate 06/07/2021', NULL, NULL, '2021-06-07 11:41:56', '2021-06-07 11:41:56'),
(36573, 1006, 28447, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:46:00', '2021-05-06 07:46:00'),
(36574, 1006, 28447, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment as per our discussion with the billing teams.', NULL, NULL, '2021-05-28 17:01:06', '2021-05-28 17:01:06'),
(36575, 1006, 28459, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:46:00', '2021-05-06 07:46:00'),
(36576, 1006, 28459, NULL, '2021-06-14 00:00:00.000', 'Not Eligible', 'Renaissance Physicians does not cover Missouri City for enrollment requests. We cannot move forward.', NULL, NULL, '2021-06-07 10:58:14', '2021-06-07 10:58:14'),
(36577, 1006, 28460, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:46:00', '2021-05-06 07:46:00'),
(36578, 1006, 28460, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'The request is in process in the main Molina task, need to allow more time. ', NULL, NULL, '2021-06-07 16:10:35', '2021-06-07 16:10:35'),
(36579, 11056, 28460, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to  : MHTContractrequest@molinahealthcare.com  Sub : Molina Provider Contracting - Shametria Tann  Good morning!     Hope this email finds you well. Please let me know about the procedure to link the following provider to the group & location mentioned below in the group contract. Group contract & roster has been attached. Please see the attachments.        Group Name  Best Health Urgent Care & Clinic  Tax ID  84-4737737  Group NPI  1013540962  Primary Location  3003 TEXAS PKWY UNIT B, MISSOURI CITY , TX 77489-5242  Provider Name  NPI  Shametria Tann  ( FNP )  1124615612    If you have any questions or require additional information or documents please let me know.      Thank you!  Have a great day!', NULL, NULL, '2021-11-10 16:59:58', '2021-11-10 16:59:58'),
(36580, 11056, 28460, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Email received from: MHTContractrequest@molinahealthcare.com  Sub:   Enrollment Query - BHUCC - MOLINA MARKETPLACE  Good Afternoon,     Happy Wednesday! - Thank you for your interest in becoming part of the Molina Healthcare network.  I have been assigned the intake of your request to contract with Molina Healthcare of Texas.         Please Note: In order for the contract process to start, we will need a copy of the W9 form.      Please send back both forms to this email once completed.     Also, please advise if the group is an Urgent Care or a Group of Providers.     Thank you in advance!        Best Regards,     Provider Contract Coordination Department | JG   Molina Healthcare of Texas, Inc.    Form has been submitted.', NULL, NULL, '2021-11-29 09:20:30', '2021-11-29 09:20:30'),
(36581, 11056, 28460, NULL, '2021-12-21 00:00:00.000', 'Approved', 'Approval email received from : MHTContractrequest@molinahealthcare.com  Sub : Enrollment Request - BHUCC - Molina  Good morning,  Happy Tuesday!!  Thank you for your interest in joining Molina healthcare network.  I have received your contract request form, however, I noticed pay to NPI number belongs to urgent care.  Molina does not contract individual providers to urgent care.  Molina contract urgent care itself.  I also show facility is already contracted with Molina healthcare effective date 10/1/2020.  Thank you  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'  (888) 562-5442 ext 200249    Received Urgent Care Contract for the practice effective 10/01/2020. Placed on the server and uploaded on EMRBS. As the facility is now contracted as and Urgent Care with molina so all the practicing providers will be considered in-network.', NULL, NULL, '2021-12-14 16:50:17', '2021-12-14 16:50:17'),
(36582, 1006, 28461, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 07:46:00', '2021-05-06 07:46:00'),
(36583, 1006, 28461, NULL, '2021-06-14 00:00:00.000', 'Initiated', 'Sent enrollment request @ \"Simms, Michal\" michal.simms@christushealth.org:  Sub: Enrollment Request - BHUCC - Christus Health  \"Hello Michal, I hope you\'re doing well, we wish to enroll the following group and providers with Christus Health, their information is as follows:  Group Name: Best Health Urgent Care & Clinic NPI# 1013540962 TIN# 84-4737737  Provider Name: Stephane Cyriaque NPI# 1780192633  Provider Name: Shametria Tann NPI# 1124615612  Please let me know what is required to proceed with this request.  Thank you. \"', NULL, NULL, '2021-06-07 10:49:35', '2021-06-07 10:49:35'),
(36584, 1006, 28461, NULL, '2021-06-22 00:00:00.000', 'In Process', 'We received the following reply from Hunter Barrett hunter.barrett@christushealth.org:  Sub: Enrollment Request - BHUCC - Christus Health  \"Brad,  Does the urgent care bill on a professional level, billing with the individuals NPI or as the group NPI?  Thanks,\"  Gave them the following reply: \"Good morning Hunter,   The urgent care bills with individual NPI\'s. Also, we want one of the providers to be listed as a PCP, is that possible?  Thank you.\"', NULL, NULL, '2021-06-15 08:06:06', '2021-06-15 08:06:06'),
(36585, 1006, 28461, NULL, '2021-07-12 00:00:00.000', 'In Process', 'We received the following reply hunter.barrett@christushealth.org:  Sub: Enrollment Request - BHUCC - Christus Health  \"Does the provider have a separate office?  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org\"  Replied with:   \"Hello Hunter,  I apologize for the delay, but no the provider will be working in the same office. Please let me know if there\'s any way to enroll her as a PCP.  Thank you. \"', NULL, NULL, '2021-07-05 16:54:38', '2021-07-05 16:54:38'),
(36586, 11056, 28461, NULL, '2021-07-26 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enrollment Request - BHUCC - Christus Health  Brad,   After talking with my manager, we cannot contract with an Urgent Care Center with a group contract, the only way the center can become in network is with an Ancillary contract and only the group NPI will show up as in network and can only bill as the group NPI.   Thanks, Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org', NULL, NULL, '2021-07-19 10:37:56', '2021-07-19 10:37:56'),
(36587, 11056, 28461, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub : Enrollment Request - BHUCC - Christus Health  Good Afternoon!  Hope you are doing well. Ok, then kindly inform me with Ancillary contract procedure and guide me with that properly soon. What steps do I have to take and which documents you required for enrollment in the Ancillary contract?  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242  Provider Details: Provider 1: Provider Name : Tann, Shametria Provider NPI # : 1124615612  Provider 2: Provider Name : Cyriaque, Stephane Provider NPI # : 1780192633  If you need any details please let me know. Waiting for your response, eagerly.  Thank you! Have a Great Day!', NULL, NULL, '2021-07-26 15:48:31', '2021-07-26 15:48:31'),
(36588, 11056, 28461, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub : Enrollment Request - BHUCC - Christus Health  Good Afternoon!  Hope you are doing well. Ok, then kindly inform me with Ancillary contract procedure and guide me with that properly soon. What steps do I have to take and which documents you required for enrollment in the Ancillary contract?  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242  Provider Details: Provider 1: Provider Name : Tann, Shametria Provider NPI # : 1124615612  Provider 2: Provider Name : Cyriaque, Stephane Provider NPI # : 1780192633  If you need any details please let me know. Waiting for your response, eagerly.  Thank you! Have a Great Day!', NULL, NULL, '2021-07-26 15:48:31', '2021-07-26 15:48:31'),
(36589, 11056, 28461, NULL, '2021-08-06 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : RE: Enrollment Request - BHUCC - Christus Health  Ahmed,  I apologize, I thought I sent the documents. Here is the contract and application needed.  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan  CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org', NULL, NULL, '2021-07-29 17:06:22', '2021-07-29 17:06:22'),
(36590, 11056, 28461, NULL, '2021-08-11 00:00:00.000', 'In Process', '	 Email sent to : hunter.barrett@christushealth.org  Sub : RE: Enrollment Request - BHUCC - Christus Health  Good afternoon Hunter!  Hope you are doing well. Here is the filled contract/agreement and application forms for the providers and practice mentioned below. Please see the attachment.   Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242  Provider Details: Provider 1: Provider Name : Tann, Shametria Provider NPI # : 1124615612  Provider 2: Provider Name : Cyriaque, Stephane Provider NPI # : 1780192633  If you have questions or need documents or information feel free to reach out to me. Waiting for your response, eagerly.  Thank you! Have a Great Day!', NULL, NULL, '2021-08-03 15:18:58', '2021-08-03 15:18:58'),
(36591, 11056, 28461, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : RE: Enrollment Request - BHUCC - Christus Health  Ahmed,   Do you have a copy of the W9?   Thanks,   Hunter Barrett Network Contracting CHRISTUS Health Plan  CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113', NULL, NULL, '2021-08-10 08:31:54', '2021-08-10 08:31:54'),
(36592, 11056, 28461, NULL, '2021-09-02 00:00:00.000', 'In Process', 'The request will take 6 months because their credentialing team is packed with some old providers and work, it will take 6 months to enroll new providers..', NULL, NULL, '2021-08-25 17:03:11', '2021-08-25 17:03:11'),
(36593, 11056, 28461, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Email sent to : christus.hp.credentialing@christushealth.org  Sub : RE: Enrollment Request - BHUCC - Christus Health  Good afternoon Hunter!  Hope this email finds you well. It\'s been a long time sir, that you haven\'t responded to my emails. Please inform me about the enrollment status of the mentioned below providers and Practice.  Practice Details: Practice Name : Best Health Urgent Care & Clinic Practice Tax ID # : 84-4737737 Practice NPI # : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242  Provider Details: Provider 1: Provider Name : Tann, Shametria Provider NPI # : 1124615612  Provider 2: Provider Name : Cyriaque, Stephane Provider NPI # : 1780192633  If you have questions or need documents or information feel free to reach out to me. Waiting for your response, eagerly.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-31 16:21:26', '2021-08-31 16:21:26'),
(36594, 11056, 28461, NULL, '2021-10-04 00:00:00.000', 'On Hold', 'Email received from : hunter.barrett@christushealth.org  &  CHRISTUS.HP.Credentialing@christushealth.org  Sub : RE: Enrollment Request - BHUCC - Christus Health   I have been on Vacation. Contract was sent to credentialing at the beginning of August. They hast to give them 6 months to process new applications.', NULL, NULL, '2021-09-27 08:26:53', '2021-09-27 08:26:53'),
(36595, 1006, 28462, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 12:05:35', '2021-05-06 12:05:35'),
(36596, 1006, 28462, NULL, '2021-05-16 00:00:00.000', 'Initiated', 'Ancillary enrollment request is in process for the group. ', NULL, NULL, '2021-05-06 13:30:39', '2021-05-06 13:30:39'),
(36597, 1006, 28462, NULL, '2021-05-21 00:00:00.000', 'In Process', 'Sent a f/u email @ Michelle Bangert mbangert@wellmed.net:  Sub: Re: Missing Documents -WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic  \"Hello Michelle,   I hope you\'re doing well, I wanted to verify if there\'s anything else that\'s required and how long will enrollment take?  Thank you.\"', NULL, NULL, '2021-05-11 07:19:27', '2021-05-11 07:19:27'),
(36598, 1006, 28462, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received the following reply from Michelle Bangert mbangert@wellmed.net:  Sub: WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  \"Good Morning,  Can you please resend the ancillary application using the name exactly as it appears on the W9? My corporate office will not be able to process the group’s contract without the correction listed below. My apologies for any inconvenience.  Thank you\"  Replied with:  \"Hello Michelle,  I hope you\'re doing well, I had already sent you an updated copy with the corrected W9 on May 18th. Did that not suffice?  Thank you.\"  ', NULL, NULL, '2021-05-28 11:18:02', '2021-05-28 11:18:02');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36599, 3040, 28462, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: mbangert@wellmed.net  Subject: WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  Hello Michelle,   I just wanted to check in with you again regarding this, could you please let me know how we should proceed?  Thank you', NULL, NULL, '2021-06-09 16:15:34', '2021-06-09 16:15:34'),
(36600, 11056, 28462, NULL, '2021-07-05 00:00:00.000', 'In Process', 'Email sent to :    mbangert@wellmed.net  Sub : WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  Good morning!  Hope you are doing well. Please see the attachment. If you need any further information please let me know.  Have a great day!', NULL, NULL, '2021-06-28 10:50:18', '2021-06-28 10:50:18'),
(36601, 11056, 28462, NULL, '2021-07-21 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good evening!  Hope you are doing well. Kindly update me on the enrollment status of the following providers and Group. Kindly inform me regarding the Ancillary Applications which i had submitted to you 2 weeks ago. Kindly respond to this email, eagerly waiting for your response.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633   If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!', NULL, NULL, '2021-07-13 16:40:37', '2021-07-13 16:40:37'),
(36602, 11056, 28462, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email received from : bcole1@wellmed.net  Sub : Credentialing for Best Health Urgent Care & Clinic  Good Morning,  I’m reaching out because we are currently processing the credentialing file for Best Health Urgent Care & Clinic, and we require some additional information before we can complete the credentialing process. Please provide or clarify the following items:  • The liability insurance that was provided with the application is for an individual provider. Please provide a copy of the liability insurance for the facility.  If you have any questions regarding the requested information above, please contact Cody Dodgen at: cododgen@wellmed.net or (210) 951-3092. I appreciate your assistance.  My Regards, Bianca Cole Sr. Provider Service & Experience Manager WellMed Medical Management, Inc. O +1 (832) 973-8154', NULL, NULL, '2021-07-20 10:44:35', '2021-07-20 10:44:35'),
(36603, 1006, 28462, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Replied with the requested information @ cododgen@wellmed.net & bcole1@wellmed.net:  \"Hello Cody,   Please find the attached COI, it covers both the provider and the facility. Do let me know if this is sufficient.  Thank you. \"', NULL, NULL, '2021-07-26 08:20:00', '2021-07-26 08:20:00'),
(36604, 11056, 28462, NULL, '2021-08-11 00:00:00.000', 'In Process', 'Email sent to : 	cododgen@wellmed.net    &   bcole1@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Bianca!  Hope you are doing well. Please accept my apology for the last email. Here is the copy of the liability insurance for the facility you requested for. Kindly see the attachment.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID# 84-4737737 Practice NPI# : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   If you need any additional information or documents please feel free to reach out to me soon. Waiting for your response.  Thank you! Have a Great week ahead!', NULL, NULL, '2021-08-04 08:46:22', '2021-08-04 08:46:22'),
(36605, 11056, 28462, NULL, '2021-08-22 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Morning,     Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-10 14:46:57', '2021-08-10 14:46:57'),
(36606, 11056, 28462, NULL, '2021-08-23 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Michelle!  Hope all is well. I wanted to inquire about the enrollment status of the provider and group. Kindly update me with the enrollment status of the below mentioned provider and group soon.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!  I have tried to reach out through call but she is working from home. And recorder just allowed me to left out the voice message for her about the issue.', NULL, NULL, '2021-08-16 11:35:19', '2021-08-16 11:35:19'),
(36607, 11056, 28462, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good afternoon. As of 8/16 the group is still in credentialing. Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you for your continued patience.     Thank you,  Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-23 14:25:42', '2021-08-23 14:25:42'),
(36608, 11056, 28462, NULL, '2021-09-07 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Hey Michelle!  Hope this email finds you well. You have already informed me about this about 60-90 days for credentialing on 14 of July,2021. Now you are saying the same.  Please provide me with the latest updates soon. And inform me with the exact time frame for the process.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-08-31 11:04:20', '2021-08-31 11:04:20'),
(36609, 11056, 28462, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Afternoon.     As of 8/25 the group is still in process. WellMed loading and credentialing commenced 6/8/2021and can take 60-90 days for completion. The Best Health UC is not presently loaded in WellMed’s system for UC services under the WellMed agreement as of today.     The completion time may vary based on volume of contracts in the processing queue and may vary if any unforeseen items occur in the credentialing process.     The group is presently in the usual and customary time frame and no further updates will become available until after 9/8/2021. However the group may be contacted directly by WellMed Contracting and Credentialing Department for any missing information that may delay the loading process.     Thank you for your continued patience.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-09-08 14:47:46', '2021-09-08 14:47:46'),
(36610, 11056, 28462, NULL, '2021-09-16 00:00:00.000', 'Approved', 'Approval Email received from : mbangert@wellmed.net  Sub  : RE: [EXTERNAL] Re: Enrollment Request Application - BHUCC - WellMed - effective WM PAR 9/1/2021  The Group BHUCC is WellMed PAR and effective for Houston as of 09/01/2021.  Ancillary providers are not loaded individually. The group TIN has been confirmed PAR.', NULL, NULL, '2021-09-09 16:22:21', '2021-09-09 16:22:21'),
(36611, 1006, 28463, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 12:05:35', '2021-05-06 12:05:35'),
(36612, 1006, 28463, NULL, '2021-05-16 00:00:00.000', 'Initiated', 'Ancillary enrollment request is in process for the group. ', NULL, NULL, '2021-05-06 13:31:04', '2021-05-06 13:31:04'),
(36613, 3040, 28463, NULL, '2021-06-16 00:00:00.000', 'On Hold', 'Ancillary enrollment request is in process for the group.  ', NULL, NULL, '2021-06-09 15:56:29', '2021-06-09 15:56:29'),
(36614, 11056, 28463, NULL, '2021-07-05 00:00:00.000', 'In Process', 'Email sent to :    mbangert@wellmed.net  Sub : WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  Good morning!  Hope you are doing well. Please see the attachment. If you need any further information please let me know.  Have a great day!', NULL, NULL, '2021-06-28 10:49:47', '2021-06-28 10:49:47'),
(36615, 11056, 28463, NULL, '2021-07-21 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good evening!  Hope you are doing well. Kindly update me on the enrollment status of the following providers and Group. Kindly inform me regarding the Ancillary Applications which i had submitted to you 2 weeks ago. Kindly respond to this email, eagerly waiting for your response.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633   If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!', NULL, NULL, '2021-07-13 16:41:03', '2021-07-13 16:41:03'),
(36616, 11056, 28463, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email received from : bcole1@wellmed.net  Sub : Credentialing for Best Health Urgent Care & Clinic  Good Morning,  I’m reaching out because we are currently processing the credentialing file for Best Health Urgent Care & Clinic, and we require some additional information before we can complete the credentialing process. Please provide or clarify the following items:  • The liability insurance that was provided with the application is for an individual provider. Please provide a copy of the liability insurance for the facility.  If you have any questions regarding the requested information above, please contact Cody Dodgen at: cododgen@wellmed.net or (210) 951-3092. I appreciate your assistance.  My Regards, Bianca Cole Sr. Provider Service & Experience Manager WellMed Medical Management, Inc. O +1 (832) 973-8154', NULL, NULL, '2021-07-20 10:44:26', '2021-07-20 10:44:26'),
(36617, 1006, 28463, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Replied with the requested information @ cododgen@wellmed.net & bcole1@wellmed.net:  \"Hello Cody,   Please find the attached COI, it covers both the provider and the facility. Do let me know if this is sufficient.  Thank you. \"', NULL, NULL, '2021-07-26 08:19:57', '2021-07-26 08:19:57'),
(36618, 11056, 28463, NULL, '2021-08-11 00:00:00.000', 'In Process', 'Email sent to : 	cododgen@wellmed.net    &   bcole1@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Bianca!  Hope you are doing well. Please accept my apology for the last email. Here is the copy of the liability insurance for the facility you requested for. Kindly see the attachment.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID# 84-4737737 Practice NPI# : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   If you need any additional information or documents please feel free to reach out to me soon. Waiting for your response.  Thank you! Have a Great week ahead!', NULL, NULL, '2021-08-04 08:46:13', '2021-08-04 08:46:13'),
(36619, 11056, 28463, NULL, '2021-08-22 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Morning,     Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-10 14:46:39', '2021-08-10 14:46:39'),
(36620, 11056, 28463, NULL, '2021-08-23 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Michelle!  Hope all is well. I wanted to inquire about the enrollment status of the provider and group. Kindly update me with the enrollment status of the below mentioned provider and group soon.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!  I have tried to reach out through call but she is working from home. And recorder just allowed me to left out the voice message for her about the issue.', NULL, NULL, '2021-08-16 11:35:13', '2021-08-16 11:35:13'),
(36621, 11056, 28463, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good afternoon. As of 8/16 the group is still in credentialing. Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you for your continued patience.     Thank you,  Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-23 14:25:35', '2021-08-23 14:25:35'),
(36622, 11056, 28463, NULL, '2021-09-07 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Hey Michelle!  Hope this email finds you well. You have already informed me about this about 60-90 days for credentialing on 14 of July,2021. Now you are saying the same.  Please provide me with the latest updates soon. And inform me with the exact time frame for the process.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-08-31 11:04:14', '2021-08-31 11:04:14'),
(36623, 11056, 28463, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Afternoon.     As of 8/25 the group is still in process. WellMed loading and credentialing commenced 6/8/2021and can take 60-90 days for completion. The Best Health UC is not presently loaded in WellMed’s system for UC services under the WellMed agreement as of today.     The completion time may vary based on volume of contracts in the processing queue and may vary if any unforeseen items occur in the credentialing process.     The group is presently in the usual and customary time frame and no further updates will become available until after 9/8/2021. However the group may be contacted directly by WellMed Contracting and Credentialing Department for any missing information that may delay the loading process.     Thank you for your continued patience.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-09-08 14:47:36', '2021-09-08 14:47:36'),
(36624, 11056, 28463, NULL, '2021-09-16 00:00:00.000', 'Approved', 'Approval Email received from : mbangert@wellmed.net  Sub  : RE: [EXTERNAL] Re: Enrollment Request Application - BHUCC - WellMed - effective WM PAR 9/1/2021  The Group BHUCC is WellMed PAR and effective for Houston as of 09/01/2021.  Ancillary providers are not loaded individually. The group TIN has been confirmed PAR.', NULL, NULL, '2021-09-09 16:22:05', '2021-09-09 16:22:05'),
(36625, 1006, 28464, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 12:05:39', '2021-05-06 12:05:39'),
(36626, 1006, 28464, NULL, '2021-05-16 00:00:00.000', 'Initiated', 'Received the following email from Michelle Bangert mbangert@wellmed.net:  Sub: Re: Missing Documents -WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic  \"Hi Brad,  WellMed is missing the supporting documentation for the ancillary application. Please complete and return the ancillary application and include all supporting documentation for processing. Thank you for your attention to this matter.  Thank you,  Michelle Bangert, Sr. Contract Consultant Manager Ph.: 1-813-767-5236| MBangert@WellMed.net\"  Ancillary application submitted to rep.', NULL, NULL, '2021-05-06 13:29:36', '2021-05-06 13:29:36'),
(36627, 1006, 28464, NULL, '2021-05-21 00:00:00.000', 'In Process', 'Sent a f/u email @ Michelle Bangert mbangert@wellmed.net:  Sub: Re: Missing Documents -WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic  \"Hello Michelle,   I hope you\'re doing well, I wanted to verify if there\'s anything else that\'s required and how long will enrollment take?  Thank you.\"', NULL, NULL, '2021-05-11 07:19:57', '2021-05-11 07:19:57'),
(36628, 1006, 28464, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received the following reply from Michelle Bangert mbangert@wellmed.net:  Sub: WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  \"Good Morning,  Can you please resend the ancillary application using the name exactly as it appears on the W9? My corporate office will not be able to process the group’s contract without the correction listed below. My apologies for any inconvenience.  Thank you\"  Replied with:  \"Hello Michelle,  I hope you\'re doing well, I had already sent you an updated copy with the corrected W9 on May 18th. Did that not suffice?  Thank you.\"  ', NULL, NULL, '2021-05-28 11:17:38', '2021-05-28 11:17:38'),
(36629, 3040, 28464, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: mbangert@wellmed.net  Subject: WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  Hello Michelle,   I just wanted to check in with you again regarding this, could you please let me know how we should proceed?  Thank you', NULL, NULL, '2021-06-09 16:15:38', '2021-06-09 16:15:38'),
(36630, 11056, 28464, NULL, '2021-07-05 00:00:00.000', 'In Process', 'Email sent to :    mbangert@wellmed.net  Sub : WellMed - Stephanie Cyriaque dba Best Health Urgent Care & Clinic - missing/incomplete - requested 5/28  Good morning!  Hope you are doing well. Please see the attachment. If you need any further information please let me know.  Have a great day!', NULL, NULL, '2021-06-28 10:50:35', '2021-06-28 10:50:35'),
(36631, 11056, 28464, NULL, '2021-07-21 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good evening!  Hope you are doing well. Kindly update me on the enrollment status of the following providers and Group. Kindly inform me regarding the Ancillary Applications which i had submitted to you 2 weeks ago. Kindly respond to this email, eagerly waiting for your response.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633   If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!', NULL, NULL, '2021-07-13 16:41:10', '2021-07-13 16:41:10'),
(36632, 11056, 28464, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email received from : bcole1@wellmed.net  Sub : Credentialing for Best Health Urgent Care & Clinic  Good Morning,  I’m reaching out because we are currently processing the credentialing file for Best Health Urgent Care & Clinic, and we require some additional information before we can complete the credentialing process. Please provide or clarify the following items:  • The liability insurance that was provided with the application is for an individual provider. Please provide a copy of the liability insurance for the facility.  If you have any questions regarding the requested information above, please contact Cody Dodgen at: cododgen@wellmed.net or (210) 951-3092. I appreciate your assistance.  My Regards, Bianca Cole Sr. Provider Service & Experience Manager WellMed Medical Management, Inc. O +1 (832) 973-8154', NULL, NULL, '2021-07-20 10:44:06', '2021-07-20 10:44:06'),
(36633, 1006, 28464, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Replied with the requested information @ cododgen@wellmed.net & bcole1@wellmed.net:  \"Hello Cody,   Please find the attached COI, it covers both the provider and the facility. Do let me know if this is sufficient.  Thank you. \"', NULL, NULL, '2021-07-26 08:19:52', '2021-07-26 08:19:52'),
(36634, 11056, 28464, NULL, '2021-08-11 00:00:00.000', 'In Process', 'Email sent to : 	cododgen@wellmed.net    &   bcole1@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Bianca!  Hope you are doing well. Please accept my apology for the last email. Here is the copy of the liability insurance for the facility you requested for. Kindly see the attachment.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID# 84-4737737 Practice NPI# : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   If you need any additional information or documents please feel free to reach out to me soon. Waiting for your response.  Thank you! Have a Great week ahead!', NULL, NULL, '2021-08-04 08:45:18', '2021-08-04 08:45:18'),
(36635, 11056, 28464, NULL, '2021-08-11 00:00:00.000', 'In Process', 'Email sent to : 	cododgen@wellmed.net    &   bcole1@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Bianca!  Hope you are doing well. Please accept my apology for the last email. Here is the copy of the liability insurance for the facility you requested for. Kindly see the attachment.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice Tax ID# 84-4737737 Practice NPI# : 1013540962 Practice Address: 3003 TEXAS PKWY UNIT B MISSOURI CITY , TX 77489-5242   If you need any additional information or documents please feel free to reach out to me soon. Waiting for your response.  Thank you! Have a Great week ahead!', NULL, NULL, '2021-08-04 08:45:19', '2021-08-04 08:45:19'),
(36636, 11056, 28464, NULL, '2021-08-22 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Morning,     Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-10 14:46:10', '2021-08-10 14:46:10'),
(36637, 11056, 28464, NULL, '2021-08-23 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good morning Michelle!  Hope all is well. I wanted to inquire about the enrollment status of the provider and group. Kindly update me with the enrollment status of the below mentioned provider and group soon.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a nice day!  I have tried to reach out through call but she is working from home. And recorder just allowed me to left out the voice message for her about the issue.', NULL, NULL, '2021-08-16 11:34:23', '2021-08-16 11:34:23'),
(36638, 11056, 28464, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good afternoon. As of 8/16 the group is still in credentialing. Group Tax ID is in process with credentialing. WellMed credentialing commenced 6/8/2021. All updates will be provided when credentialing is completed. Please allow 60-90 days for credentialing. You may be contacted directly by WellMed Contracting and Credentialing for any missing information that may delay the process.     Thank you for your continued patience.     Thank you,  Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-08-23 14:25:15', '2021-08-23 14:25:15'),
(36639, 11056, 28464, NULL, '2021-09-07 00:00:00.000', 'In Process', 'Email sent to : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Hey Michelle!  Hope this email finds you well. You have already informed me about this about 60-90 days for credentialing on 14 of July,2021. Now you are saying the same.  Please provide me with the latest updates soon. And inform me with the exact time frame for the process.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Providers: Provider Name: Tann, Shametria Provider  NPI # : 1124615612  Provider Name : Cyriaque, Stephane Provider NPI# : 1780192633  If you need any further information please let me know. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-08-31 11:03:44', '2021-08-31 11:03:44'),
(36640, 11056, 28464, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email received from : mbangert@wellmed.net  Sub : Enrollment Request Application - BHUCC - Wellmed  Good Afternoon.     As of 8/25 the group is still in process. WellMed loading and credentialing commenced 6/8/2021and can take 60-90 days for completion. The Best Health UC is not presently loaded in WellMed’s system for UC services under the WellMed agreement as of today.     The completion time may vary based on volume of contracts in the processing queue and may vary if any unforeseen items occur in the credentialing process.     The group is presently in the usual and customary time frame and no further updates will become available until after 9/8/2021. However the group may be contacted directly by WellMed Contracting and Credentialing Department for any missing information that may delay the loading process.     Thank you for your continued patience.     Thank you,     Michelle Bangert, Sr. Contract Consultant Manager  Ph.: 1-813-767-5236| MBangert@WellMed.net', NULL, NULL, '2021-09-08 14:47:05', '2021-09-08 14:47:05'),
(36641, 11056, 28464, NULL, '2021-09-16 00:00:00.000', 'Approved', 'Approval Email received from : mbangert@wellmed.net  Sub  : RE: [EXTERNAL] Re: Enrollment Request Application - BHUCC - WellMed - effective WM PAR 9/1/2021  Good Afternoon,     The Group BHUCC is WellMed PAR and effective for Houston as of 09/01/2021.     A screenshot of the internal WellMed load is provided for your records.    Please see the attachment.', NULL, NULL, '2021-09-09 16:20:03', '2021-09-09 16:20:03'),
(36642, 3040, 28465, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36643, 3040, 28465, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:31', '2021-05-06 16:05:31'),
(36644, 3040, 28465, NULL, '2021-05-13 00:00:00.000', 'Rejected', 'Provider is no longer working with VMUC. ', NULL, NULL, '2021-05-06 16:10:11', '2021-05-06 16:10:11'),
(36645, 3040, 28466, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36646, 3040, 28466, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:36', '2021-05-06 16:05:36'),
(36647, 3040, 28466, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:13:59', '2021-05-31 10:13:59'),
(36648, 3040, 28467, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36649, 3040, 28467, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:40', '2021-05-06 16:05:40'),
(36650, 3040, 28467, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:14:11', '2021-05-31 10:14:11'),
(36651, 3040, 28468, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36652, 3040, 28468, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:43', '2021-05-06 16:05:43'),
(36653, 3040, 28468, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:14:23', '2021-05-31 10:14:23'),
(36654, 3040, 28469, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36655, 3040, 28469, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:47', '2021-05-06 16:05:47'),
(36656, 3040, 28469, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:14:36', '2021-05-31 10:14:36'),
(36657, 3040, 28470, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36658, 3040, 28470, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:51', '2021-05-06 16:05:51'),
(36659, 3040, 28470, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:14:40', '2021-05-31 10:14:40'),
(36660, 3040, 28471, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36661, 3040, 28471, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:05:56', '2021-05-06 16:05:56'),
(36662, 3040, 28471, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:14:53', '2021-05-31 10:14:53'),
(36663, 3040, 28472, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36664, 3040, 28472, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:00', '2021-05-06 16:06:00'),
(36665, 3040, 28472, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:15:05', '2021-05-31 10:15:05'),
(36666, 3040, 28473, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36667, 3040, 28473, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:03', '2021-05-06 16:06:03'),
(36668, 3040, 28473, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:15:16', '2021-05-31 10:15:16'),
(36669, 3040, 28474, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36670, 3040, 28474, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:08', '2021-05-06 16:06:08'),
(36671, 3040, 28474, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:15:26', '2021-05-31 10:15:26'),
(36672, 3040, 28475, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36673, 3040, 28475, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:11', '2021-05-06 16:06:11'),
(36674, 3040, 28475, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:15:35', '2021-05-31 10:15:35'),
(36675, 3040, 28476, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 15:59:55', '2021-05-06 15:59:55'),
(36676, 3040, 28476, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:15', '2021-05-06 16:06:15'),
(36677, 3040, 28476, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:15:45', '2021-05-31 10:15:45'),
(36678, 3040, 28477, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:01:28', '2021-05-06 16:01:28'),
(36679, 3040, 28477, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:19', '2021-05-06 16:06:19'),
(36680, 3040, 28477, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email sent to: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Hello Anderson,  Thank you so much for your prompt response. Can you please send me the copy of the facility agreement? Also can you please confirm that all the three locations are updated in your system?  Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-10 15:26:07', '2021-05-10 15:26:07'),
(36681, 3040, 28477, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email rcvd from: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Good Morning,  Our Expedite team asked me to assist.  You are currently contracted under a facility agreement so we do not add or credential providers under this contract type.  We can assist If you are wanting to add additional locations.  Please advise.  Kindly,  Velann Anderson', NULL, NULL, '2021-05-10 15:27:22', '2021-05-10 15:27:22'),
(36682, 3040, 28477, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Good Morning,  Our Expedite team asked me to assist.  You are currently contracted under a facility agreement so we do not add or credential providers under this contract type.  We can assist If you are wanting to add additional locations.   Please advise.  Kindly,  Velann Anderson Provider Relations Manager, Network Management FirstCare Health Plans—part of Baylor Scott & White Health 806-403-9637 Fax Velann.Anderson@BSWHealth.org', NULL, NULL, '2021-05-31 10:13:07', '2021-05-31 10:13:07'),
(36683, 3040, 28478, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:01:36', '2021-05-06 16:01:36'),
(36684, 3040, 28478, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:06:55', '2021-05-06 16:06:55'),
(36685, 3040, 28478, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email sent to: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Hello Anderson,  Thank you so much for your prompt response. Can you please send me the copy of the facility agreement? Also can you please confirm that all the three locations are updated in your system?  Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-10 15:26:20', '2021-05-10 15:26:20'),
(36686, 3040, 28478, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email rcvd from: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Good Morning,  Our Expedite team asked me to assist.  You are currently contracted under a facility agreement so we do not add or credential providers under this contract type.  We can assist If you are wanting to add additional locations.  Please advise.  Kindly,  Velann Anderson', NULL, NULL, '2021-05-10 15:27:27', '2021-05-10 15:27:27'),
(36687, 3040, 28478, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Good Morning,  Our Expedite team asked me to assist.  You are currently contracted under a facility agreement so we do not add or credential providers under this contract type.  We can assist If you are wanting to add additional locations.   Please advise.  Kindly,  Velann Anderson Provider Relations Manager, Network Management FirstCare Health Plans—part of Baylor Scott & White Health 806-403-9637 Fax Velann.Anderson@BSWHealth.org', NULL, NULL, '2021-05-31 10:13:18', '2021-05-31 10:13:18'),
(36688, 3040, 28479, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:01:41', '2021-05-06 16:01:41'),
(36689, 3040, 28479, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:32', '2021-05-06 16:08:32'),
(36690, 3040, 28479, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email sent to: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Hello Anderson,  Thank you so much for your prompt response. Can you please send me the copy of the facility agreement? Also can you please confirm that all the three locations are updated in your system?  Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-10 15:26:32', '2021-05-10 15:26:32'),
(36691, 3040, 28479, NULL, '2021-05-17 00:00:00.000', 'In Process', 'Email rcvd from: Velann.Anderson@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Good Morning,  Our Expedite team asked me to assist.  You are currently contracted under a facility agreement so we do not add or credential providers under this contract type.  We can assist If you are wanting to add additional locations.  Please advise.  Kindly,  Velann Anderson', NULL, NULL, '2021-05-10 15:27:32', '2021-05-10 15:27:32'),
(36692, 3040, 28479, NULL, '2021-05-18 00:00:00.000', 'In Process', ' Form submitted online for additional location.  Thank you again for your interest in becoming a Scott and White Health Plan contracted provider.  Please allow 30-45 days before checking on status.  Your form submission identifier is: 857ed844-51bd-445e-98be-5f510c3505b1', NULL, NULL, '2021-05-11 09:03:09', '2021-05-11 09:03:09'),
(36693, 3040, 28479, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Email sent to: SWHPPROVSERVICES@bswhealth.org  Subject: Re: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,   Hope you are doing well. I wanted to know the status for an additional location in our group Valley Med Urgent Care PLLC. Below are mentioned the additional location details:   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Additional Location: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-05-31 10:24:12', '2021-05-31 10:24:12'),
(36694, 3040, 28479, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Email rcvd from: SWHPPROVSERVICES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Good afternoon,  This demographic update request was submitted on 5/11/2021 and is still in process.  Requests can take approximately 30-45 days to process.  Please allow 30 days before checking the status of any address change request.   Thank you so much,  Lacey b', NULL, NULL, '2021-06-17 12:05:37', '2021-06-17 12:05:37'),
(36695, 3040, 28479, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email sent to: SWHPPROVSERVICES@bswhealth.org  Subject: Re: Re: Re: Re: Re: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Hello,   Hope you are doing well. I wanted to know the status for an additional location in our group Valley Med Urgent Care PLLC. Below are mentioned the additional location details:   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Additional Location: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your response.    Thank you ', NULL, NULL, '2021-07-05 14:24:56', '2021-07-05 14:24:56'),
(36696, 3040, 28479, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Email rcvd from: SWHPPROVSERVICES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Good evening,  The address change request was completed on 06/03/2021.  Thank you so much,  Lacey B', NULL, NULL, '2021-07-06 08:26:54', '2021-07-06 08:26:54'),
(36697, 3040, 28480, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36698, 3040, 28480, NULL, '2021-05-13 00:00:00.000', 'Rejected', 'Provider is no longer working with VMUC ', NULL, NULL, '2021-05-06 16:07:28', '2021-05-06 16:07:28'),
(36699, 3040, 28481, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36700, 3040, 28481, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:34', '2021-05-06 16:07:34'),
(36701, 3040, 28481, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:16:26', '2021-05-31 10:16:26'),
(36702, 3040, 28482, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36703, 3040, 28482, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:38', '2021-05-06 16:07:38'),
(36704, 3040, 28482, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:16:42', '2021-05-31 10:16:42'),
(36705, 3040, 28483, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36706, 3040, 28483, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:42', '2021-05-06 16:07:42'),
(36707, 3040, 28483, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:16:51', '2021-05-31 10:16:51'),
(36708, 3040, 28484, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36709, 3040, 28484, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:46', '2021-05-06 16:07:46'),
(36710, 3040, 28484, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:00', '2021-05-31 10:17:00'),
(36711, 3040, 28485, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36712, 3040, 28485, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:49', '2021-05-06 16:07:49'),
(36713, 3040, 28485, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:10', '2021-05-31 10:17:10'),
(36714, 3040, 28486, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36715, 3040, 28486, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:53', '2021-05-06 16:07:53'),
(36716, 3040, 28486, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:18', '2021-05-31 10:17:18'),
(36717, 3040, 28487, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36718, 3040, 28487, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:07:57', '2021-05-06 16:07:57'),
(36719, 3040, 28487, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:28', '2021-05-31 10:17:28'),
(36720, 3040, 28488, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36721, 3040, 28488, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:01', '2021-05-06 16:08:01'),
(36722, 3040, 28488, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:41', '2021-05-31 10:17:41'),
(36723, 3040, 28489, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36724, 3040, 28489, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:04', '2021-05-06 16:08:04'),
(36725, 3040, 28489, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:17:53', '2021-05-31 10:17:53'),
(36726, 3040, 28490, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36727, 3040, 28490, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:08', '2021-05-06 16:08:08'),
(36728, 3040, 28490, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:18:04', '2021-05-31 10:18:04'),
(36729, 3040, 28490, NULL, '2021-06-24 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-06-17 12:03:06', '2021-06-17 12:03:06'),
(36730, 3040, 28491, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:38', '2021-05-06 16:03:38'),
(36731, 3040, 28491, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:13', '2021-05-06 16:08:13'),
(36732, 3040, 28491, NULL, '2021-06-07 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task. ', NULL, NULL, '2021-05-31 10:18:14', '2021-05-31 10:18:14'),
(36733, 3040, 28492, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36734, 3040, 28492, NULL, '2021-05-13 00:00:00.000', 'Rejected', 'Provider is no longer with VMUC. ', NULL, NULL, '2021-05-06 16:08:50', '2021-05-06 16:08:50'),
(36735, 3040, 28493, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36736, 3040, 28493, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:08:57', '2021-05-06 16:08:57'),
(36737, 3040, 28493, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:26:43', '2021-05-31 10:26:43'),
(36738, 3040, 28493, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:05:54', '2021-06-17 12:05:54'),
(36739, 3040, 28493, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:27:52', '2021-07-06 08:27:52'),
(36740, 3040, 28494, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36741, 3040, 28494, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:01', '2021-05-06 16:09:01'),
(36742, 3040, 28494, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:26:48', '2021-05-31 10:26:48'),
(36743, 3040, 28494, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:05:59', '2021-06-17 12:05:59'),
(36744, 3040, 28494, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:27:57', '2021-07-06 08:27:57'),
(36745, 3040, 28495, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36746, 3040, 28495, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:05', '2021-05-06 16:09:05'),
(36747, 3040, 28495, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:26:51', '2021-05-31 10:26:51'),
(36748, 3040, 28495, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:09', '2021-06-17 12:06:09'),
(36749, 3040, 28495, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:02', '2021-07-06 08:28:02'),
(36750, 3040, 28496, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36751, 3040, 28496, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:11', '2021-05-06 16:09:11'),
(36752, 3040, 28496, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:26:55', '2021-05-31 10:26:55'),
(36753, 3040, 28496, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:14', '2021-06-17 12:06:14'),
(36754, 3040, 28496, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:10', '2021-07-06 08:28:10'),
(36755, 3040, 28497, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36756, 3040, 28497, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:15', '2021-05-06 16:09:15'),
(36757, 3040, 28497, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:26:58', '2021-05-31 10:26:58'),
(36758, 3040, 28497, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:20', '2021-06-17 12:06:20'),
(36759, 3040, 28497, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:15', '2021-07-06 08:28:15'),
(36760, 3040, 28498, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36761, 3040, 28498, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:19', '2021-05-06 16:09:19'),
(36762, 3040, 28498, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:03', '2021-05-31 10:27:03'),
(36763, 3040, 28498, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:24', '2021-06-17 12:06:24'),
(36764, 3040, 28498, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:20', '2021-07-06 08:28:20'),
(36765, 3040, 28499, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36766, 3040, 28499, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:23', '2021-05-06 16:09:23'),
(36767, 3040, 28499, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:07', '2021-05-31 10:27:07'),
(36768, 3040, 28499, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:29', '2021-06-17 12:06:29'),
(36769, 3040, 28499, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:24', '2021-07-06 08:28:24'),
(36770, 3040, 28500, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36771, 3040, 28500, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:29', '2021-05-06 16:09:29'),
(36772, 3040, 28500, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:10', '2021-05-31 10:27:10'),
(36773, 3040, 28500, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:36', '2021-06-17 12:06:36'),
(36774, 3040, 28500, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:29', '2021-07-06 08:28:29'),
(36775, 3040, 28501, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36776, 3040, 28501, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:34', '2021-05-06 16:09:34'),
(36777, 3040, 28501, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:14', '2021-05-31 10:27:14'),
(36778, 3040, 28501, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:41', '2021-06-17 12:06:41'),
(36779, 3040, 28501, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:34', '2021-07-06 08:28:34'),
(36780, 3040, 28502, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36781, 3040, 28502, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:38', '2021-05-06 16:09:38'),
(36782, 3040, 28502, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:18', '2021-05-31 10:27:18'),
(36783, 3040, 28502, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:46', '2021-06-17 12:06:46'),
(36784, 3040, 28502, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:39', '2021-07-06 08:28:39'),
(36785, 3040, 28503, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-06 16:03:45', '2021-05-06 16:03:45'),
(36786, 3040, 28503, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: SWHPEXPEDITES@bswhealth.org  Subject: Group & Providers || Valley Med Urgent Care PLLC || Group & Providers || Scott & White ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Scott & White for our group Valley Med Urgent Care PLLC under all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997  Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553  Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800  Provider 4: Provider Name: Garcia, Homero Provider NPI# 1730564857  Provider 5: Provider Name: Lira, Arturo Alejandro Provider NPI# 1245789502  Provider 6: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125  Provider 7: Provider Name: Potter, Deborah Provider NPI# 1861914053  Provider 8: Provider Name: Saavedra, Teresa Provider NPI# 1255676151  Provider 9: Provider Name: Wright, Larry Donald Provider NPI# 1033769765  Provider 10: Provider Name: Wert, Jeniece K Provider NPI# 1659919702  Provider 11: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-06 16:09:43', '2021-05-06 16:09:43'),
(36787, 3040, 28503, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-05-31 10:27:22', '2021-05-31 10:27:22'),
(36788, 3040, 28503, NULL, '2021-06-24 00:00:00.000', 'On Hold', 'Group has an ancillary contract. No need to add individual provides. Location addition request was sent out its still in process. Once location added under the group we will approved the providers task. For details please see group task.  ', NULL, NULL, '2021-06-17 12:06:53', '2021-06-17 12:06:53'),
(36789, 3040, 28503, NULL, '2021-07-13 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. For more details please see group task.  ', NULL, NULL, '2021-07-06 08:28:44', '2021-07-06 08:28:44'),
(36790, 3040, 29267, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 07:13:50', '2021-05-10 07:13:50'),
(36791, 3040, 29267, NULL, '2021-06-07 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Group & Providers || Columbus Urgent Care PA || Group & Providers || Anci Care ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned practice and providers in Ancicare under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA  Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: Rauf., Abdur Provider NPI# 1497726202   Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3: Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 4: Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 5: Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 6: Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 7: Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 8: Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 9: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 10: Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 11: Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12: Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 13: Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 14: Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 15: Provider Name: PAUL, SIGI Provider NPI# 1033623616  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-31 16:44:26', '2021-05-31 16:44:26'),
(36792, 1006, 29267, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Sent f/u email @ Jennifer Maligaya Jennifer.Maligaya@healthsmart.com:  Sub: Enrollment Status - CUCC - Anci-Care  \"Hello Jennifer, I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following group and providers with Anci-Care:  Group Name: Columbus Urgent Care PA NPI# 1215330501TIN# 47-1914151 Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-01 11:19:25', '2021-06-01 11:19:25'),
(36793, 3040, 29267, NULL, '2021-06-25 00:00:00.000', 'Approved', 'Group has an ancillary contract. No need to add individual providers. ', NULL, NULL, '2021-06-18 17:00:32', '2021-06-18 17:00:32'),
(36794, 1006, 29268, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:00', '2021-05-10 12:25:00'),
(36795, 9057, 29268, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'Nueces Count is not covered by the Community Health Choice.  https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/ Please find attached link for the reference. ', NULL, NULL, '2021-05-27 15:31:47', '2021-05-27 15:31:47'),
(36796, 1006, 29269, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:00', '2021-05-10 12:25:00'),
(36797, 9057, 29269, NULL, '2021-06-05 00:00:00.000', 'In Process', 'We sent an email to TXMAContracting@Cigna.com Sub: Enrollment Request - BAQC - Cigna Healthspring   Hello, We wish to enroll our group and providers, please find the attached forms.  Waiting for your response.  Thank you', NULL, NULL, '2021-05-28 17:22:02', '2021-05-28 17:22:02'),
(36798, 1006, 29269, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@Cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I want to get an update regarding the status of enrollment for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 12:02:43', '2021-06-16 12:02:43'),
(36799, 1006, 29269, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  Did you recently submit a letter of interest form for this group to be credentialed?  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092\"  Sent following reply:   \"Hello Jennifer,   We filled out and submitted a facility network interest form to TXMAContracting@cigna.com back on the 28th of May, I just wanted to confirm if that had been received and was being worked on?  Thank you!\"', NULL, NULL, '2021-06-16 16:28:46', '2021-06-16 16:28:46'),
(36800, 1006, 29269, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:40', '2021-06-21 13:36:40'),
(36801, 11056, 29269, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Enrollment Status - BAQC - Cigna Healthspring  Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-07-06 15:58:22', '2021-07-06 15:58:22'),
(36802, 1006, 29269, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:07:00', '2021-07-08 13:07:00'),
(36803, 1006, 29269, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following update from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hi Brad,  I sent an updated denial letter for Right Steps Medical Center on behalf of the network committee, however we will be extending a contract for Bay Area Quick Care. I will work on this contract and send it to you once it’s been approved.\"', NULL, NULL, '2021-07-12 10:15:53', '2021-07-12 10:15:53'),
(36804, 1006, 29269, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:42:33', '2021-07-27 16:42:33'),
(36805, 1006, 29269, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,   Is there any update regarding the enrollment status for Bay Area Quick Care for either Cigna Healthspring or Renaissance Physicians?  Thanks. \"', NULL, NULL, '2021-08-10 13:54:42', '2021-08-10 13:54:42'),
(36806, 11056, 29269, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:57:14', '2021-08-20 10:57:14'),
(36807, 11056, 29269, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com  & TXGQProviderRelations@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Cigna Healthspring. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:49:33', '2021-08-30 10:49:33'),
(36808, 11056, 29269, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com, TX.AncillaryContracting@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope all is well with you. We still have not received any updates regarding the status of enrollment process of the below mentioned providers and practice with Cigna Healthspring. Please let me know how long it will take to just get an update from your side regarding the credentialing process.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    In the meantime, please do not hesitate to reach out if you have any questions or concerns. Eagerly, Waiting to hear from you soon.  Thank you! Have a great day!  Also have left out voice mails at 877-653-0331& 956-364-3331 for the enrollment updates.', NULL, NULL, '2021-09-24 10:08:18', '2021-09-24 10:08:18'),
(36809, 11056, 29269, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092   Confirm  from Rep : Oscar S & Banjie N COntact no. :  877-653-0331 ', NULL, NULL, '2021-10-11 09:49:43', '2021-10-11 09:49:43'),
(36810, 1006, 29270, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:00', '2021-05-10 12:25:00'),
(36811, 9057, 29270, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', ' Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-27 16:36:00', '2021-05-27 16:36:00'),
(36812, 1006, 29276, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:00', '2021-05-10 12:25:00'),
(36813, 9057, 29276, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: providerservices@renaissancefamily.com Sub: Requisition of Enrollment - BAQC - Renaissance Physicians Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you ', NULL, NULL, '2021-06-01 08:52:18', '2021-06-01 08:52:18'),
(36814, 11056, 29276, NULL, '2021-06-28 00:00:00.000', 'In Process', '	 Email sent to : providerservices@renaissancefamily.com  Sub : Requisition of Enrollment - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-06-21 12:38:50', '2021-06-21 12:38:50'),
(36815, 11056, 29276, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to : 	providerservices@renaissancefamily.com  Sub :  Enrollment Requisition - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-07-06 16:14:29', '2021-07-06 16:14:29'),
(36816, 1006, 29276, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email at corrected email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!\"', NULL, NULL, '2021-07-23 16:32:08', '2021-07-23 16:32:08'),
(36817, 1006, 29276, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"HI Brad,  I will be sending this contract this week, they’ve been approved to be submitted for credentialing. May you send me a roster in a word/PDF document with their Name, NPI,  and Specialty.  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092  cid:image002.png@01D6F326.EEB674D0 Confidential, unpublished property of Cigna Do not duplicate or distribute Use and distribution limited solely to authorized personnel.\"  Replied with roster: \"Hello Jennifer,   I appreciate the update, please find the attached roster. Do let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-07-26 10:52:12', '2021-07-26 10:52:12'),
(36818, 1006, 29276, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you for the clarification. The letter of interest you previously sent, was for Cigna-Medicare through our independent network. However If you wish to be a part of Renaissance Physicians, you will need to fill out a different form as they have their own network. The renaissance physician process is similar, as they will review your form and decide if there is a network need for your group.  Please let me which network you are seeking and I will lead you to the next step.\"  Replied:  \"Hello Jennifer,   I apologize for the delay but as stated before, we want to enroll under both insurances. Here\'s the form for all of the providers.   Please let me know if anything else is required. \"', NULL, NULL, '2021-08-02 14:18:47', '2021-08-02 14:18:47'),
(36819, 1006, 29276, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Sent a f/u email @ TXGQProviderRelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:   Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-08-12 16:19:07', '2021-08-12 16:19:07'),
(36820, 11056, 29276, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com  Sub  : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Details: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:53:19', '2021-08-20 10:53:19'),
(36821, 11056, 29276, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : 	TXGQProviderRelations@healthspring.com, providerservices@renaissancefamily.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Renaissance Physicians. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:57:48', '2021-08-30 10:57:48'),
(36822, 11056, 29276, NULL, '2021-09-06 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  1st time : Renaissance is not in the Corpus Christi area.     Thank you for your interest.     Cresta Smith   For confirmation:   Renaissance physicians organization is not in corpus Christi, we don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.     I responded with this information last week.     Thanks,  Cresta', NULL, NULL, '2021-08-30 12:21:23', '2021-08-30 12:21:23'),
(36823, 1006, 29277, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:00', '2021-05-10 12:25:00'),
(36824, 9057, 29277, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: Juliana.Mata@molinahealthcare.com  Sub: Requisition for Enrollment - BAQC - Molina Health Care  Hello, Hope you are doing well, We wish to enroll our below mentioned providers, under the following group. Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 10:41:37', '2021-06-01 10:41:37'),
(36825, 11056, 29277, NULL, '2021-06-28 00:00:00.000', 'On Hold', 'Request is in process in main Molina Task.', NULL, NULL, '2021-06-21 12:15:00', '2021-06-21 12:15:00'),
(36826, 1006, 29277, NULL, '2021-08-25 00:00:00.000', 'Approved', 'Approval email received from @ Mata, Juliana Juliana.Mata@molinahealthcare.com:  Sub: Enrollment Status - BAQC - Molina  \"Good morning,  Happy Friday!!  Hope you are doing well.  per information on our system, facility Bay Area Quick Care is loaded into network billing system with effective date 9/1/2020, Molina does not contract individual providers to urgent care, Molina contracts facility itself.  Thank you  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'(888) 562-5442 ext 200249\" ', NULL, NULL, '2021-08-18 11:08:06', '2021-08-18 11:08:06'),
(36827, 1006, 29278, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36828, 9057, 29278, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'Nueces Count is not covered by the Community Health Choice.  https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/ Please find attached link for the reference. ', NULL, NULL, '2021-05-27 15:32:24', '2021-05-27 15:32:24'),
(36829, 1006, 29279, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36830, 9057, 29279, NULL, '2021-06-05 00:00:00.000', 'In Process', 'We sent an email to TXMAContracting@Cigna.com Sub: Enrollment Request - BAQC - Cigna Healthspring   Hello, We wish to enroll our group and providers, please find the attached forms.  Waiting for your response.  Thank you', NULL, NULL, '2021-05-28 17:21:26', '2021-05-28 17:21:26'),
(36831, 1006, 29279, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@Cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I want to get an update regarding the status of enrollment for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 12:02:39', '2021-06-16 12:02:39'),
(36832, 1006, 29279, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  Did you recently submit a letter of interest form for this group to be credentialed?  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092\"  Sent following reply:   \"Hello Jennifer,   We filled out and submitted a facility network interest form to TXMAContracting@cigna.com back on the 28th of May, I just wanted to confirm if that had been received and was being worked on?  Thank you!\"', NULL, NULL, '2021-06-16 16:28:42', '2021-06-16 16:28:42'),
(36833, 1006, 29279, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:36', '2021-06-21 13:36:36'),
(36834, 11056, 29279, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Enrollment Status - BAQC - Cigna Healthspring  Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-07-06 15:58:15', '2021-07-06 15:58:15');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36835, 1006, 29279, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:57', '2021-07-08 13:06:57'),
(36836, 1006, 29279, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following update from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hi Brad,  I sent an updated denial letter for Right Steps Medical Center on behalf of the network committee, however we will be extending a contract for Bay Area Quick Care. I will work on this contract and send it to you once it’s been approved.\"', NULL, NULL, '2021-07-12 10:15:50', '2021-07-12 10:15:50'),
(36837, 1006, 29279, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:42:29', '2021-07-27 16:42:29'),
(36838, 1006, 29279, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,   Is there any update regarding the enrollment status for Bay Area Quick Care for either Cigna Healthspring or Renaissance Physicians?  Thanks. \"', NULL, NULL, '2021-08-10 13:54:38', '2021-08-10 13:54:38'),
(36839, 11056, 29279, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:57:06', '2021-08-20 10:57:06'),
(36840, 11056, 29279, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com  & TXGQProviderRelations@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Cigna Healthspring. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:49:27', '2021-08-30 10:49:27'),
(36841, 11056, 29279, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com, TX.AncillaryContracting@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope all is well with you. We still have not received any updates regarding the status of enrollment process of the below mentioned providers and practice with Cigna Healthspring. Please let me know how long it will take to just get an update from your side regarding the credentialing process.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    In the meantime, please do not hesitate to reach out if you have any questions or concerns. Eagerly, Waiting to hear from you soon.  Thank you! Have a great day!  Also have left out voice mails at 877-653-0331& 956-364-3331 for the enrollment updates.', NULL, NULL, '2021-09-24 10:08:04', '2021-09-24 10:08:04'),
(36842, 11056, 29279, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092   Confirm  from Rep : Oscar S & Banjie N COntact no. :  877-653-0331 ', NULL, NULL, '2021-10-11 09:49:37', '2021-10-11 09:49:37'),
(36843, 1006, 29280, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36844, 9057, 29280, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', ' Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-27 16:35:33', '2021-05-27 16:35:33'),
(36845, 1006, 29286, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36846, 9057, 29286, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: providerservices@renaissancefamily.com Sub: Requisition of Enrollment - BAQC - Renaissance Physicians Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you ', NULL, NULL, '2021-06-01 08:52:06', '2021-06-01 08:52:06'),
(36847, 11056, 29286, NULL, '2021-06-28 00:00:00.000', 'In Process', '	 Email sent to : providerservices@renaissancefamily.com  Sub : Requisition of Enrollment - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-06-21 12:38:38', '2021-06-21 12:38:38'),
(36848, 11056, 29286, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to : 	providerservices@renaissancefamily.com  Sub :  Enrollment Requisition - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-07-06 16:14:23', '2021-07-06 16:14:23'),
(36849, 1006, 29286, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email at corrected email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!\"', NULL, NULL, '2021-07-23 16:32:05', '2021-07-23 16:32:05'),
(36850, 1006, 29286, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"HI Brad,  I will be sending this contract this week, they’ve been approved to be submitted for credentialing. May you send me a roster in a word/PDF document with their Name, NPI,  and Specialty.  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092  cid:image002.png@01D6F326.EEB674D0 Confidential, unpublished property of Cigna Do not duplicate or distribute Use and distribution limited solely to authorized personnel.\"  Replied with roster: \"Hello Jennifer,   I appreciate the update, please find the attached roster. Do let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-07-26 10:52:08', '2021-07-26 10:52:08'),
(36851, 1006, 29286, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you for the clarification. The letter of interest you previously sent, was for Cigna-Medicare through our independent network. However If you wish to be a part of Renaissance Physicians, you will need to fill out a different form as they have their own network. The renaissance physician process is similar, as they will review your form and decide if there is a network need for your group.  Please let me which network you are seeking and I will lead you to the next step.\"  Replied:  \"Hello Jennifer,   I apologize for the delay but as stated before, we want to enroll under both insurances. Here\'s the form for all of the providers.   Please let me know if anything else is required. \"', NULL, NULL, '2021-08-02 14:18:44', '2021-08-02 14:18:44'),
(36852, 1006, 29286, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Sent a f/u email @ TXGQProviderRelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:   Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-08-12 16:18:53', '2021-08-12 16:18:53'),
(36853, 11056, 29286, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com  Sub  : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Details: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:53:12', '2021-08-20 10:53:12'),
(36854, 11056, 29286, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : 	TXGQProviderRelations@healthspring.com, providerservices@renaissancefamily.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Renaissance Physicians. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:57:43', '2021-08-30 10:57:43'),
(36855, 11056, 29286, NULL, '2021-09-06 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  1st time : Renaissance is not in the Corpus Christi area.     Thank you for your interest.     Cresta Smith   For confirmation:   Renaissance physicians organization is not in corpus Christi, we don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.     I responded with this information last week.     Thanks,  Cresta', NULL, NULL, '2021-08-30 12:21:17', '2021-08-30 12:21:17'),
(36856, 1006, 29287, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36857, 9057, 29287, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: Juliana.Mata@molinahealthcare.com  Sub: Requisition for Enrollment - BAQC - Molina Health Care  Hello, Hope you are doing well, We wish to enroll our below mentioned providers, under the following group. Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 10:41:24', '2021-06-01 10:41:24'),
(36858, 11056, 29287, NULL, '2021-06-28 00:00:00.000', 'On Hold', 'Request is in process in main Molina Task.', NULL, NULL, '2021-06-21 12:13:00', '2021-06-21 12:13:00'),
(36859, 1006, 29287, NULL, '2021-08-25 00:00:00.000', 'Approved', 'Approval email received from @ Mata, Juliana Juliana.Mata@molinahealthcare.com:  Sub: Enrollment Status - BAQC - Molina  \"Good morning,  Happy Friday!!  Hope you are doing well.  per information on our system, facility Bay Area Quick Care is loaded into network billing system with effective date 9/1/2020, Molina does not contract individual providers to urgent care, Molina contracts facility itself.  Thank you  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'(888) 562-5442 ext 200249\" ', NULL, NULL, '2021-08-18 11:08:03', '2021-08-18 11:08:03'),
(36860, 1006, 29288, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36861, 9057, 29288, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'Nueces Count is not covered by the Community Health Choice.  https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/ Please find attached link for the reference. ', NULL, NULL, '2021-05-27 15:32:58', '2021-05-27 15:32:58'),
(36862, 1006, 29289, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36863, 9057, 29289, NULL, '2021-06-05 00:00:00.000', 'New/Not Initiated', 'We sent an email to TXMAContracting@Cigna.com Sub: Enrollment Request - BAQC - Cigna Healthspring   Hello, We wish to enroll our group and providers, please find the attached forms.  Waiting for your response.  Thank you', NULL, NULL, '2021-05-28 17:17:15', '2021-05-28 17:17:15'),
(36864, 9057, 29289, NULL, '2021-06-05 00:00:00.000', 'In Process', '', NULL, NULL, '2021-05-28 17:18:11', '2021-05-28 17:18:11'),
(36865, 1006, 29289, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@Cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I want to get an update regarding the status of enrollment for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 12:02:35', '2021-06-16 12:02:35'),
(36866, 1006, 29289, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  Did you recently submit a letter of interest form for this group to be credentialed?  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092\"  Sent following reply:   \"Hello Jennifer,   We filled out and submitted a facility network interest form to TXMAContracting@cigna.com back on the 28th of May, I just wanted to confirm if that had been received and was being worked on?  Thank you!\"', NULL, NULL, '2021-06-16 16:28:39', '2021-06-16 16:28:39'),
(36867, 1006, 29289, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:32', '2021-06-21 13:36:32'),
(36868, 11056, 29289, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Enrollment Status - BAQC - Cigna Healthspring  Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-07-06 15:58:05', '2021-07-06 15:58:05'),
(36869, 1006, 29289, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:53', '2021-07-08 13:06:53'),
(36870, 1006, 29289, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following update from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hi Brad,  I sent an updated denial letter for Right Steps Medical Center on behalf of the network committee, however we will be extending a contract for Bay Area Quick Care. I will work on this contract and send it to you once it’s been approved.\"', NULL, NULL, '2021-07-12 10:15:45', '2021-07-12 10:15:45'),
(36871, 1006, 29289, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:42:22', '2021-07-27 16:42:22'),
(36872, 1006, 29289, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,   Is there any update regarding the enrollment status for Bay Area Quick Care for either Cigna Healthspring or Renaissance Physicians?  Thanks. \"', NULL, NULL, '2021-08-10 13:54:36', '2021-08-10 13:54:36'),
(36873, 11056, 29289, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:56:54', '2021-08-20 10:56:54'),
(36874, 11056, 29289, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:56:54', '2021-08-20 10:56:54'),
(36875, 11056, 29289, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com  & TXGQProviderRelations@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Cigna Healthspring. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:49:09', '2021-08-30 10:49:09'),
(36876, 11056, 29289, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com, TX.AncillaryContracting@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope all is well with you. We still have not received any updates regarding the status of enrollment process of the below mentioned providers and practice with Cigna Healthspring. Please let me know how long it will take to just get an update from your side regarding the credentialing process.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    In the meantime, please do not hesitate to reach out if you have any questions or concerns. Eagerly, Waiting to hear from you soon.  Thank you! Have a great day!  Also have left out voice mails at 877-653-0331& 956-364-3331 for the enrollment updates.', NULL, NULL, '2021-09-24 10:07:57', '2021-09-24 10:07:57'),
(36877, 11056, 29289, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092   Confirm  from Rep : Oscar S & Banjie N COntact no. :  877-653-0331 ', NULL, NULL, '2021-10-11 09:49:30', '2021-10-11 09:49:30'),
(36878, 1006, 29290, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:01', '2021-05-10 12:25:01'),
(36879, 9057, 29290, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', ' Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-27 16:34:30', '2021-05-27 16:34:30'),
(36880, 1006, 29296, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36881, 9057, 29296, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: providerservices@renaissancefamily.com Sub: Requisition of Enrollment - BAQC - Renaissance Physicians Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you ', NULL, NULL, '2021-06-01 08:51:46', '2021-06-01 08:51:46'),
(36882, 11056, 29296, NULL, '2021-06-28 00:00:00.000', 'In Process', '	 Email sent to : providerservices@renaissancefamily.com  Sub : Requisition of Enrollment - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-06-21 12:38:21', '2021-06-21 12:38:21'),
(36883, 11056, 29296, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to : 	providerservices@renaissancefamily.com  Sub :  Enrollment Requisition - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-07-06 16:14:18', '2021-07-06 16:14:18'),
(36884, 1006, 29296, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email at corrected email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!\"', NULL, NULL, '2021-07-23 16:32:02', '2021-07-23 16:32:02'),
(36885, 1006, 29296, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"HI Brad,  I will be sending this contract this week, they’ve been approved to be submitted for credentialing. May you send me a roster in a word/PDF document with their Name, NPI,  and Specialty.  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092  cid:image002.png@01D6F326.EEB674D0 Confidential, unpublished property of Cigna Do not duplicate or distribute Use and distribution limited solely to authorized personnel.\"  Replied with roster: \"Hello Jennifer,   I appreciate the update, please find the attached roster. Do let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-07-26 10:52:04', '2021-07-26 10:52:04'),
(36886, 1006, 29296, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you for the clarification. The letter of interest you previously sent, was for Cigna-Medicare through our independent network. However If you wish to be a part of Renaissance Physicians, you will need to fill out a different form as they have their own network. The renaissance physician process is similar, as they will review your form and decide if there is a network need for your group.  Please let me which network you are seeking and I will lead you to the next step.\"  Replied:  \"Hello Jennifer,   I apologize for the delay but as stated before, we want to enroll under both insurances. Here\'s the form for all of the providers.   Please let me know if anything else is required. \"', NULL, NULL, '2021-08-02 14:18:41', '2021-08-02 14:18:41'),
(36887, 1006, 29296, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Sent a f/u email @ TXGQProviderRelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:   Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-08-12 16:18:16', '2021-08-12 16:18:16'),
(36888, 11056, 29296, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com  Sub  : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Details: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:53:04', '2021-08-20 10:53:04'),
(36889, 11056, 29296, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : 	TXGQProviderRelations@healthspring.com, providerservices@renaissancefamily.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Renaissance Physicians. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:57:36', '2021-08-30 10:57:36'),
(36890, 11056, 29296, NULL, '2021-09-06 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  1st time : Renaissance is not in the Corpus Christi area.     Thank you for your interest.     Cresta Smith   For confirmation:   Renaissance physicians organization is not in corpus Christi, we don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.     I responded with this information last week.     Thanks,  Cresta', NULL, NULL, '2021-08-30 12:21:08', '2021-08-30 12:21:08'),
(36891, 1006, 29297, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36892, 9057, 29297, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: Juliana.Mata@molinahealthcare.com  Sub: Requisition for Enrollment - BAQC - Molina Health Care  Hello, Hope you are doing well, We wish to enroll our below mentioned providers, under the following group. Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 10:41:03', '2021-06-01 10:41:03'),
(36893, 11056, 29297, NULL, '2021-06-28 00:00:00.000', 'On Hold', 'Request is in process in main Molina Task.', NULL, NULL, '2021-06-21 12:12:43', '2021-06-21 12:12:43'),
(36894, 1006, 29297, NULL, '2021-08-25 00:00:00.000', 'Approved', 'Approval email received from @ Mata, Juliana Juliana.Mata@molinahealthcare.com:  Sub: Enrollment Status - BAQC - Molina  \"Good morning,  Happy Friday!!  Hope you are doing well.  per information on our system, facility Bay Area Quick Care is loaded into network billing system with effective date 9/1/2020, Molina does not contract individual providers to urgent care, Molina contracts facility itself.  Thank you  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'(888) 562-5442 ext 200249\" ', NULL, NULL, '2021-08-18 11:08:00', '2021-08-18 11:08:00'),
(36895, 1006, 29298, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36896, 9057, 29298, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', 'Nueces Count is not covered by the Community Health Choice.  https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/ Please find attached link for the reference. ', NULL, NULL, '2021-05-27 15:33:28', '2021-05-27 15:33:28'),
(36897, 1006, 29299, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36898, 9057, 29299, NULL, '2021-06-05 00:00:00.000', 'In Process', 'We sent an email to TXMAContracting@Cigna.com Sub: Enrollment Request - BAQC - Cigna Healthspring   Hello, We wish to enroll our group and providers, please find the attached forms.  Waiting for your response.  Thank you', NULL, NULL, '2021-05-28 17:20:43', '2021-05-28 17:20:43'),
(36899, 1006, 29299, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@Cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I want to get an update regarding the status of enrollment for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 12:02:30', '2021-06-16 12:02:30'),
(36900, 1006, 29299, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  Did you recently submit a letter of interest form for this group to be credentialed?  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092\"  Sent following reply:   \"Hello Jennifer,   We filled out and submitted a facility network interest form to TXMAContracting@cigna.com back on the 28th of May, I just wanted to confirm if that had been received and was being worked on?  Thank you!\"', NULL, NULL, '2021-06-16 16:28:35', '2021-06-16 16:28:35'),
(36901, 1006, 29299, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:29', '2021-06-21 13:36:29'),
(36902, 11056, 29299, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Enrollment Status - BAQC - Cigna Healthspring  Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-07-06 15:58:28', '2021-07-06 15:58:28'),
(36903, 1006, 29299, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:49', '2021-07-08 13:06:49'),
(36904, 1006, 29299, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following update from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hi Brad,  I sent an updated denial letter for Right Steps Medical Center on behalf of the network committee, however we will be extending a contract for Bay Area Quick Care. I will work on this contract and send it to you once it’s been approved.\"', NULL, NULL, '2021-07-12 10:15:40', '2021-07-12 10:15:40'),
(36905, 1006, 29299, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:42:17', '2021-07-27 16:42:17'),
(36906, 1006, 29299, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,   Is there any update regarding the enrollment status for Bay Area Quick Care for either Cigna Healthspring or Renaissance Physicians?  Thanks. \"', NULL, NULL, '2021-08-10 13:54:32', '2021-08-10 13:54:32'),
(36907, 11056, 29299, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:56:44', '2021-08-20 10:56:44'),
(36908, 11056, 29299, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com  & TXGQProviderRelations@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Cigna Healthspring. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:48:59', '2021-08-30 10:48:59'),
(36909, 11056, 29299, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com, TX.AncillaryContracting@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope all is well with you. We still have not received any updates regarding the status of enrollment process of the below mentioned providers and practice with Cigna Healthspring. Please let me know how long it will take to just get an update from your side regarding the credentialing process.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    In the meantime, please do not hesitate to reach out if you have any questions or concerns. Eagerly, Waiting to hear from you soon.  Thank you! Have a great day!  Also have left out voice mails at 877-653-0331& 956-364-3331 for the enrollment updates.', NULL, NULL, '2021-09-24 10:07:52', '2021-09-24 10:07:52'),
(36910, 11056, 29299, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-10-11 09:47:43', '2021-10-11 09:47:43'),
(36911, 11056, 29299, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092   Confirm  from Rep : Oscar S & Banjie N COntact no. :  877-653-0331 ', NULL, NULL, '2021-10-11 09:49:23', '2021-10-11 09:49:23'),
(36912, 1006, 29300, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36913, 9057, 29300, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', ' Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-27 16:34:59', '2021-05-27 16:34:59'),
(36914, 1006, 29306, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36915, 9057, 29306, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: providerservices@renaissancefamily.com Sub: Requisition of Enrollment - BAQC - Renaissance Physicians Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you ', NULL, NULL, '2021-06-01 08:51:44', '2021-06-01 08:51:44'),
(36916, 11056, 29306, NULL, '2021-06-28 00:00:00.000', 'In Process', '	 Email sent to : providerservices@renaissancefamily.com  Sub : Requisition of Enrollment - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-06-21 12:38:05', '2021-06-21 12:38:05');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36917, 11056, 29306, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to : 	providerservices@renaissancefamily.com  Sub :  Enrollment Requisition - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-07-06 16:14:10', '2021-07-06 16:14:10'),
(36918, 1006, 29306, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email at corrected email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!\"', NULL, NULL, '2021-07-23 16:31:57', '2021-07-23 16:31:57'),
(36919, 1006, 29306, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"HI Brad,  I will be sending this contract this week, they’ve been approved to be submitted for credentialing. May you send me a roster in a word/PDF document with their Name, NPI,  and Specialty.  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092  cid:image002.png@01D6F326.EEB674D0 Confidential, unpublished property of Cigna Do not duplicate or distribute Use and distribution limited solely to authorized personnel.\"  Replied with roster: \"Hello Jennifer,   I appreciate the update, please find the attached roster. Do let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-07-26 10:52:01', '2021-07-26 10:52:01'),
(36920, 1006, 29306, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you for the clarification. The letter of interest you previously sent, was for Cigna-Medicare through our independent network. However If you wish to be a part of Renaissance Physicians, you will need to fill out a different form as they have their own network. The renaissance physician process is similar, as they will review your form and decide if there is a network need for your group.  Please let me which network you are seeking and I will lead you to the next step.\"  Replied:  \"Hello Jennifer,   I apologize for the delay but as stated before, we want to enroll under both insurances. Here\'s the form for all of the providers.   Please let me know if anything else is required. \"', NULL, NULL, '2021-08-02 14:18:37', '2021-08-02 14:18:37'),
(36921, 1006, 29306, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Sent a f/u email @ TXGQProviderRelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:   Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-08-12 16:18:10', '2021-08-12 16:18:10'),
(36922, 11056, 29306, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com  Sub  : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Details: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:52:57', '2021-08-20 10:52:57'),
(36923, 11056, 29306, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : 	TXGQProviderRelations@healthspring.com, providerservices@renaissancefamily.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Renaissance Physicians. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:57:28', '2021-08-30 10:57:28'),
(36924, 11056, 29306, NULL, '2021-09-06 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  1st time : Renaissance is not in the Corpus Christi area.     Thank you for your interest.     Cresta Smith   For confirmation:   Renaissance physicians organization is not in corpus Christi, we don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.     I responded with this information last week.     Thanks,  Cresta', NULL, NULL, '2021-08-30 12:21:01', '2021-08-30 12:21:01'),
(36925, 1006, 29307, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:02', '2021-05-10 12:25:02'),
(36926, 9057, 29307, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: Juliana.Mata@molinahealthcare.com  Sub: Requisition for Enrollment - BAQC - Molina Health Care  Hello, Hope you are doing well, We wish to enroll our below mentioned providers, under the following group. Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 10:41:13', '2021-06-01 10:41:13'),
(36927, 11056, 29307, NULL, '2021-06-28 00:00:00.000', 'On Hold', 'Request is in process in main Molina Task.', NULL, NULL, '2021-06-21 12:12:07', '2021-06-21 12:12:07'),
(36928, 1006, 29307, NULL, '2021-08-25 00:00:00.000', 'Approved', 'Approval email received from @ Mata, Juliana Juliana.Mata@molinahealthcare.com:  Sub: Enrollment Status - BAQC - Molina  \"Good morning,  Happy Friday!!  Hope you are doing well.  per information on our system, facility Bay Area Quick Care is loaded into network billing system with effective date 9/1/2020, Molina does not contract individual providers to urgent care, Molina contracts facility itself.  Thank you  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'(888) 562-5442 ext 200249\" ', NULL, NULL, '2021-08-18 11:07:56', '2021-08-18 11:07:56'),
(36929, 1006, 29308, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:06', '2021-05-10 12:25:06'),
(36930, 9057, 29308, NULL, '2021-06-04 00:00:00.000', 'On Hold', 'Nueces Count is not covered by the Community Health Choice.  https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/ Please find attached link for the reference. ', NULL, NULL, '2021-05-27 15:30:15', '2021-05-27 15:30:15'),
(36931, 9057, 29308, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', '', NULL, NULL, '2021-05-27 15:30:58', '2021-05-27 15:30:58'),
(36932, 1006, 29309, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:06', '2021-05-10 12:25:06'),
(36933, 9057, 29309, NULL, '2021-06-05 00:00:00.000', 'In Process', 'We sent an email to TXMAContracting@Cigna.com Sub: Enrollment Request - BAQC - Cigna Healthspring   Hello, We wish to enroll our group and providers, please find the attached forms.  Waiting for your response.  Thank you', NULL, NULL, '2021-05-28 17:22:42', '2021-05-28 17:22:42'),
(36934, 1006, 29309, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@Cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I want to get an update regarding the status of enrollment for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 12:00:03', '2021-06-16 12:00:03'),
(36935, 1006, 29309, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  Did you recently submit a letter of interest form for this group to be credentialed?  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092\"  Sent following reply:   \"Hello Jennifer,   We filled out and submitted a facility network interest form to TXMAContracting@cigna.com back on the 28th of May, I just wanted to confirm if that had been received and was being worked on?  Thank you!\"', NULL, NULL, '2021-06-16 16:28:28', '2021-06-16 16:28:28'),
(36936, 1006, 29309, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:06', '2021-06-21 13:36:06'),
(36937, 11056, 29309, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Enrollment Status - BAQC - Cigna Healthspring  Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.  Thank you,  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-07-06 15:57:18', '2021-07-06 15:57:18'),
(36938, 1006, 29309, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:42', '2021-07-08 13:06:42'),
(36939, 1006, 29309, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following update from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hi Brad,  I sent an updated denial letter for Right Steps Medical Center on behalf of the network committee, however we will be extending a contract for Bay Area Quick Care. I will work on this contract and send it to you once it’s been approved.\"', NULL, NULL, '2021-07-12 10:15:34', '2021-07-12 10:15:34'),
(36940, 1006, 29309, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:41:50', '2021-07-27 16:41:50'),
(36941, 1006, 29309, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,  I hope you\'re doing well, can you please let me know if there have been any updates on this request?  Thank you.\"', NULL, NULL, '2021-07-27 16:42:05', '2021-07-27 16:42:05'),
(36942, 1006, 29309, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello Jennifer,   Is there any update regarding the enrollment status for Bay Area Quick Care for either Cigna Healthspring or Renaissance Physicians?  Thanks. \"', NULL, NULL, '2021-08-10 13:54:29', '2021-08-10 13:54:29'),
(36943, 11056, 29309, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hi Brad,        May you please email TXGQProviderRelations@healthspring.com for a status update with Renaissance Physicians in the title of the email. The correct representative will reach out to you and will be able to assist you further.', NULL, NULL, '2021-08-20 10:55:36', '2021-08-20 10:55:36'),
(36944, 11056, 29309, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com  & TXGQProviderRelations@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Cigna Healthspring. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:48:33', '2021-08-30 10:48:33'),
(36945, 11056, 29309, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com, TX.AncillaryContracting@healthspring.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Good morning!  Hope all is well with you. We still have not received any updates regarding the status of enrollment process of the below mentioned providers and practice with Cigna Healthspring. Please let me know how long it will take to just get an update from your side regarding the credentialing process.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    In the meantime, please do not hesitate to reach out if you have any questions or concerns. Eagerly, Waiting to hear from you soon.  Thank you! Have a great day!  Also have left out voice mails at 877-653-0331& 956-364-3331 for the enrollment updates.', NULL, NULL, '2021-09-24 10:07:33', '2021-09-24 10:07:33'),
(36946, 11056, 29309, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092', NULL, NULL, '2021-10-11 09:47:22', '2021-10-11 09:47:22'),
(36947, 11056, 29309, NULL, '2021-10-18 00:00:00.000', 'Not Eligible', 'Email received from : JENNIFER.PEREZ@cigna.com & cresta.smith@careallies.com  Sub : Fwd: [External] Enrollment Status - BAQC - Cigna Healthspring  Hey Ahmed,  Thanks for following up! Based on Crestas previous email, they are currently not in the Corpus area.   Crestas Last email :   We don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.    Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092   Confirm  from Rep : Oscar S & Banjie N COntact no. :  877-653-0331 ', NULL, NULL, '2021-10-11 09:49:06', '2021-10-11 09:49:06'),
(36948, 1006, 29310, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:06', '2021-05-10 12:25:06'),
(36949, 9057, 29310, NULL, '2021-06-04 00:00:00.000', 'Not Eligible', ' Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-27 16:36:29', '2021-05-27 16:36:29'),
(36950, 1006, 29316, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:07', '2021-05-10 12:25:07'),
(36951, 9057, 29316, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We sent an email to: providerservices@renaissancefamily.com Sub: Requisition of Enrollment - BAQC - Renaissance Physicians Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you ', NULL, NULL, '2021-06-01 08:52:33', '2021-06-01 08:52:33'),
(36952, 11056, 29316, NULL, '2021-06-28 00:00:00.000', 'In Process', 'Email sent to : providerservices@renaissancefamily.com  Sub : Requisition of Enrollment - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-06-21 12:37:30', '2021-06-21 12:37:30'),
(36953, 11056, 29316, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to : 	providerservices@renaissancefamily.com  Sub :  Enrollment Requisition - BAQC - Renaissance Physicians  Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!', NULL, NULL, '2021-07-06 16:13:40', '2021-07-06 16:13:40'),
(36954, 1006, 29316, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email at corrected email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"Greetings,  Hope you are doing well, We wish to enroll our group and providers, find details given below.  Practice: Practice Name: Bay Area Quick Care LLC Practice NPI : 1437481421 Practice TIN : 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Names enlisted below:-  Providers: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you!\"', NULL, NULL, '2021-07-23 16:31:48', '2021-07-23 16:31:48'),
(36955, 1006, 29316, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Requisition - BAQC - Renaissance Physicians  \"HI Brad,  I will be sending this contract this week, they’ve been approved to be submitted for credentialing. May you send me a roster in a word/PDF document with their Name, NPI,  and Specialty.  Jennifer Perez Network Operations Senior Analyst | Cigna-Medicare 2800 North Loop West, Suite 400 | Houston, Texas 77092  cid:image002.png@01D6F326.EEB674D0 Confidential, unpublished property of Cigna Do not duplicate or distribute Use and distribution limited solely to authorized personnel.\"  Replied with roster: \"Hello Jennifer,   I appreciate the update, please find the attached roster. Do let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-07-26 10:51:56', '2021-07-26 10:51:56'),
(36956, 1006, 29316, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you for the clarification. The letter of interest you previously sent, was for Cigna-Medicare through our independent network. However If you wish to be a part of Renaissance Physicians, you will need to fill out a different form as they have their own network. The renaissance physician process is similar, as they will review your form and decide if there is a network need for your group.  Please let me which network you are seeking and I will lead you to the next step.\"  Replied:  \"Hello Jennifer,   I apologize for the delay but as stated before, we want to enroll under both insurances. Here\'s the form for all of the providers.   Please let me know if anything else is required. \"', NULL, NULL, '2021-08-02 14:18:26', '2021-08-02 14:18:26'),
(36957, 1006, 29316, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Sent a f/u email @ TXGQProviderRelations@healthspring.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:   Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-08-12 16:17:27', '2021-08-12 16:17:27'),
(36958, 11056, 29316, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : TXGQProviderRelations@healthspring.com  Sub  : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  I hope you\'re doing well, I wanted to get an update regarding the credentialing status for the following group and providers:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI: 1437481421 Practice TIN: 27-1702009 Practice  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider Details: Provider name: Orsak, Kynda Provider NPI# :1528553724  Provider Name: Malowitz, Cynthia Provider  NPI# :1336173244  Provider Name: Ramsden, Melissa Provider NPI# : 1194376228  Provider Name: Francis, William: Provider NPI# :1457994436  Please get back to me as soon as possible. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:51:39', '2021-08-20 10:51:39'),
(36959, 11056, 29316, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : 	TXGQProviderRelations@healthspring.com, providerservices@renaissancefamily.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  Good morning!  Hope this email finds you well.This is just a follow-up email related to the Renaissance Physicians. I wanted to get the latest updates regarding the enrollment status of the following providers and practice.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 10:57:08', '2021-08-30 10:57:08'),
(36960, 11056, 29316, NULL, '2021-09-06 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status - BAQC - Renaissance Physicians  1st time : Renaissance is not in the Corpus Christi area.     Thank you for your interest.     Cresta Smith   For confirmation:   Renaissance physicians organization is not in corpus Christi, we don’t have a network in that area, as such the provider aren’t in network nor have the ability to be.     I responded with this information last week.     Thanks,  Cresta', NULL, NULL, '2021-08-30 12:20:34', '2021-08-30 12:20:34'),
(36961, 1006, 29317, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:25:07', '2021-05-10 12:25:07'),
(36962, 1006, 29317, NULL, '2021-06-14 00:00:00.000', 'Approved', 'The group is already enrolled with Molina Marketplace, executed contract and welcome letter are attached for reference. ', NULL, NULL, '2021-06-07 08:53:23', '2021-06-07 08:53:23'),
(36963, 1006, 29318, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:36', '2021-05-10 12:27:36'),
(36964, 3040, 29318, NULL, '2021-06-01 00:00:00.000', 'New/Not Initiated', 'Email sent to: providerservices@memorialhermann.org, enterprise.credentialing@memorialhermann.org  Subject: Enroll Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||   Greetings,  Hope you are doing well, I wanted to enroll the below mentioned group & providers in Memorial Hermann for our group Right Step Medical Center LLC under the below location.   Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-25 10:19:40', '2021-05-25 10:19:40'),
(36965, 1006, 29318, NULL, '2021-06-02 00:00:00.000', 'In Process', '', NULL, NULL, '2021-05-26 09:07:47', '2021-05-26 09:07:47'),
(36966, 1006, 29318, NULL, '2021-06-18 00:00:00.000', 'In Process', 'We received the following reply from Enterprise Credentialing Enterprise.Credentialing@memorialhermann.org:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||  \"Thank you for your interest in Memorial Hermann Health System and/or its affiliates. Before an application can be released, you must first complete a Request for Application form.  CLICK HERE to access and complete the Request for Application form for Memorial Hermann hospitals, affiliated hospitals, surgery centers, MHMD membership or Health Plan participation. To avoid any delays, please submit the form in its entirety (via link above) or email the form to enterprise.credentialing@memorialhermann.org. If the pre-screening qualifications are met, you should receive both your eCredentialing Portal and application username and password via email or additional communication within 3 business days.    If you have any questions, please contact us at enterprise.credentialing@memorialhermann.org.  Memorial Hermann Central Credentialing Team\"  Form was filled out and sent. Attached in the main group task for reference as it is an ancillary request. ', NULL, NULL, '2021-06-11 13:58:26', '2021-06-11 13:58:26'),
(36967, 1006, 29318, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann -  Greetings,  Hope you are doing well. I want to inquire about the enrollment status of the providers and group mentioned below. The enrollment form has been submitted in the last email already.  Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you!', NULL, NULL, '2021-06-30 16:37:40', '2021-06-30 16:37:40'),
(36968, 3040, 29318, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enrollment Status Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||  Greetings,  Hope you are doing well, I wanted to know the enrollment status for the mentioned group & providers in Memorial Hermann for our group Right Step Medical Center LLC under the below location.  Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you  ', NULL, NULL, '2021-06-30 16:37:55', '2021-06-30 16:37:55'),
(36969, 11056, 29318, NULL, '2021-07-08 00:00:00.000', 'In Process', 'Email received from : Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann  Good morning,  When did you submit the request for application forms and which email address did you send it to?  Thank you!', NULL, NULL, '2021-07-01 08:29:49', '2021-07-01 08:29:49'),
(36970, 11056, 29318, NULL, '2021-07-08 00:00:00.000', 'In Process', 'Email received from : Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann  Good morning,  When did you submit the request for application forms and which email address did you send it to?  Thank you!', NULL, NULL, '2021-07-01 08:29:50', '2021-07-01 08:29:50'),
(36971, 11056, 29318, NULL, '2021-07-08 00:00:00.000', 'In Process', 'Email sent to : Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann  Good morning,  Hope all is well. The application forms were submitted on June,11th,2021. Email was sent at enterprise.credentialing@memorialhermann.org.  If further information is needed please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-07-01 08:32:22', '2021-07-01 08:32:22'),
(36972, 1006, 29318, NULL, '2021-07-23 00:00:00.000', 'In Process', 'We received the following update from MHHPContracting@memorialhermann.org:  Sub: Memorial Hermann Health Plan Request to Participate  \"We are in receipt of Right Step Medical Center LLC’s request to become a participating provider with Memorial Hermann Health Plans and need additional information to proceed with your request.  Please provide the following information:  List of services provided ·         Do you provide Virtual Health Services?  Current service area and/or list of locations List of all employed/contracted providers (if applicable) including NPs and PAs (please include individual NPIs) What age population is served? Please list 0-2 years of age; 2-18 years of age; 18+ years Where do you have privileges? Please list all Hospitals, Ambulatory Surgery Centers, etc. Link to website Current W-9 Current quality and outcomes data Any additional information you would like presented to the Network Access and Adequacy Committee   Your participation request will be presented at the next NAAC meeting following receipt of the additional information.  Best Regards, MHHP Network Contracting\"  Replied with:  \"Hello,   Please find the attached answers.  Please provide the following information:  List of services provided  Urgentcare Services  ·         Do you provide Virtual Health Services?   Yes, Telehealth services are offered.   Current service area and/or list of locations  Stafford, TX. List of all employed/contracted providers (if applicable) including NPs and PAs (please include individual NPIs) Ramegowda Belakere, MD. Glory Abraham, NP. Shybi Varghese, NP. What age population is served? Please list 0-2 years of age; 2-18 years of age; 18+ years Age limit: 0~99+  Where do you have privileges? Please list all Hospitals, Ambulatory Surgery Centers, etc. Methodist Hospital  Link to website N/A Current W-9 Attached. Current quality and outcomes data N/A Any additional information you would like presented to the Network Access and Adequacy Committee No. \"', NULL, NULL, '2021-07-16 17:09:29', '2021-07-16 17:09:29'),
(36973, 1006, 29318, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent f/u email @ MHHP Contracting MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Hermann  \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers:  Group Name: Right Step Medical Center LLC TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-11 16:56:57', '2021-08-11 16:56:57'),
(36974, 1006, 29318, NULL, '2021-08-20 00:00:00.000', 'In Process', 'We received the following update from MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Hermann  \"Good morning Brad. This provider group will be presented to our Network Access and Adequacy Committee this month. Once I receive a response from them, I will let you know.  Thank you. Camilla Paige\"', NULL, NULL, '2021-08-13 10:30:35', '2021-08-13 10:30:35'),
(36975, 1006, 29318, NULL, '2021-09-02 00:00:00.000', 'In Process', 'We received the following email @ MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Herman  \"Hello,  Memorial Hermann Health Plan (MHHP) has accepted your request to participate in our health plan. Please find attached the Provider Agreement. Please have the agreement signed. Please complete the attached Schedule C Tables 1 and 2 and Schedule D, as applicable. Once all items are complete, please return.  Once the completed documents are received, MHHP’s Credentialing Department will send the provider(s) a credentialing application. The agreement will be fully executed by MHHP and a copy sent to you once the provider is approved by the MHHP Credentialing Committee. The effective date will be assigned by MHHP upon approval of the MHHP Credentialing Committee.  We look forward to welcoming you into our network in the near future.  Best Regards, Camilla Paige\"  Contract signed and sent back to them. Attached in the main group task for reference. ', NULL, NULL, '2021-08-26 16:22:34', '2021-08-26 16:22:34'),
(36976, 11056, 29318, NULL, '2021-09-10 00:00:00.000', 'Approved', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning Brad. Since this is an Urgent Care agreement, could you please re-do Schedule C, Table 2 to only list the Urgent Care Information? Please feel free to only send back that page.     Thank you.     Camilla', NULL, NULL, '2021-09-03 08:31:46', '2021-09-03 08:31:46'),
(36977, 11056, 29318, NULL, '2021-09-10 00:00:00.000', 'Revalidation', 'Please accept my apology. Not approved. In process  Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning Brad. Since this is an Urgent Care agreement, could you please re-do Schedule C, Table 2 to only list the Urgent Care Information? Please feel free to only send back that page.     Thank you.     Camilla', NULL, NULL, '2021-09-03 08:32:49', '2021-09-03 08:32:49'),
(36978, 11056, 29318, NULL, '2021-09-15 00:00:00.000', 'Revalidation', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hello Camilla,   Here\'s the updated Schedule C. Let me know if anything else is required.  Thank you!  Updated Schedule C sent. And asked for the enrollment updates', NULL, NULL, '2021-09-08 10:30:48', '2021-09-08 10:30:48'),
(36979, 11056, 29318, NULL, '2021-09-24 00:00:00.000', 'Revalidation', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann   Good Morning!  Hope this email finds you well. I want to know the enrollment status of the following providers and practice soon. Please update me soon.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-17 10:54:20', '2021-09-17 10:54:20'),
(36980, 11056, 29318, NULL, '2021-10-04 00:00:00.000', 'Revalidation', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning. You should be hearing from our credentialing team soon.   Thank you.  Camilla', NULL, NULL, '2021-09-27 13:35:22', '2021-09-27 13:35:22'),
(36981, 11056, 29318, NULL, '2021-10-11 00:00:00.000', 'Revalidation', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hey Camilia!  Hope this email finds you well. I am still waiting to hear the updates from your credentialing team.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-10-04 12:47:40', '2021-10-04 12:47:40'),
(36982, 11056, 29318, NULL, '2021-10-20 00:00:00.000', 'Revalidation', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hey Camilia!  Hope this email finds you well. I am still waiting to hear the updates from your credentialing team.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-10-13 12:09:10', '2021-10-13 12:09:10'),
(36983, 11056, 29318, NULL, '2021-10-27 00:00:00.000', 'Revalidation', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann   Good afternoon. Credentialing takes 30-45 days. Once I receive the credentialing approvals, I will send the agreement to my leadership team for full execution.', NULL, NULL, '2021-10-20 15:44:34', '2021-10-20 15:44:34'),
(36984, 11056, 29318, NULL, '2021-11-08 00:00:00.000', 'Revalidation', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning. No, I have not yet received the credentialing approval yet.', NULL, NULL, '2021-11-01 08:31:57', '2021-11-01 08:31:57'),
(36985, 11056, 29318, NULL, '2021-11-18 00:00:00.000', 'Revalidation', 'Email received from: MHHPContracting@memorialhermann.org  Sub: Enrollment Status - RSM - Memorial Hermann  Good morning. My apologies for the delay. Our credentialing team is working on a huge project for our Annual Enrollment Period which has taken priority. We should be hearing something soon.     Thank you for your patience.', NULL, NULL, '2021-11-11 16:51:16', '2021-11-11 16:51:16'),
(36986, 11056, 29318, NULL, '2021-11-25 00:00:00.000', 'Revalidation', 'Email sent to: MHHPContracting@memorialhermann.org  Sub: Enrollment Status - RSM - Memorial Hermann  Good afternoon!  Hope you had a great and safe weekend. I would appreciate it if you could please let me know the updated credentialing status for the below-mentioned practice and providers soon with Memorial Hermann. Any updates on the agreement & approval letters?  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-11-18 10:50:29', '2021-11-18 10:50:29'),
(36987, 11056, 29318, NULL, '2021-12-07 00:00:00.000', 'Revalidation', 'Email received from:   MHHPContracting@memorialhermann.org  Sub:  Enrollment Status - RSM - Memorial Hermann   Good morning. I spoke with our credentialing team yesterday and was informed that they are still waiting on documentation from your team to finish the credentialing process. Please follow-up with your team in that regard. We cannot fully execute the agreement until credentialing is approved.', NULL, NULL, '2021-11-30 17:54:26', '2021-11-30 17:54:26'),
(36988, 11056, 29318, NULL, '2021-12-15 00:00:00.000', 'Revalidation', 'Email sent to:  boyd@symplr.com  Sub:  Request for Participation Memorial Hermann Health Plan/ Facility Application/Right Step Medical Center LLC  Good afternoon!  I hope you are doing great. Please find the Facility Application for the practice below in the attachments.  Furthermore, if any further information is needed or documents are required feel free to contact me.   Thank you! Have a wonderful day!', NULL, NULL, '2021-12-08 10:54:35', '2021-12-08 10:54:35'),
(36989, 11056, 29318, NULL, '2021-12-22 00:00:00.000', 'Revalidation', 'Email received from: jcalderon@symplr.com  Sub: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC Enrollment Status - RSM - Memorial Hermann   Good afternoon,     Your facility credentialing applications for participation with Memorial Hermann Healthplan are being prepared. The following information is needed for all three location to continue the credentialing process on behalf of Memorial Hermann Healthplan:  Business License or Certificate of Occupancy Accreditation (If applicable)    Please reply to this message with the information mentioned above within 15 business days from 1st request. If information is not received by this date, your application will be forwarded to Memorial Hermann Healthplan Medical Director for review and may be closed for failure to meet Memorial Hermann Healthplan administrative criteria.     If you have any questions, please contact me at 516-593-1380 Ext. 287 or JCalderon@symplr.com        Johanna Calderon                            Credentialing Specialist  Work: +1 (516) 593-1380 Ext. 287   Fax: 516-620-3054   Email: jcalderon@symplr.com  Letter of occupancy has been provided. Waiting for accreditation letter from provider side.', NULL, NULL, '2021-12-15 12:51:55', '2021-12-15 12:51:55'),
(36990, 11056, 29318, NULL, '2021-12-29 00:00:00.000', 'Revalidation', 'Email sent to: jcalderon@symplr.com  Sub: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Good afternoon!  Hope you are doing well. You haven\'t responded me back to my queries yet. Please let me know what kind of and for which thing you need a letter of accreditation. Have you received the letter of occupancy?  Any updates on the agreement & approval letters of the credentialing process of the providers?  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-22 14:45:02', '2021-12-22 14:45:02'),
(36991, 1006, 29320, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:36', '2021-05-10 12:27:36'),
(36992, 3040, 29320, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Group request submitted online. Please see group task.   Your form was submitted successfully. Thank you for contacting us. A representative will be in contact to discuss your interest in becoming a participating Provider.', NULL, NULL, '2021-05-25 09:22:06', '2021-05-25 09:22:06'),
(36993, 1006, 29320, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We received the following reply from ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Dear Provider:  Thank you for your interest in joining our network, please allow 30 Calendar days for us to review your request.  Sincerely, Network Management – Texas | www.wellcare.com\"', NULL, NULL, '2021-05-26 08:18:21', '2021-05-26 08:18:21'),
(36994, 1006, 29320, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Sent f/u email @ .ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I just wanted to check in on the status of my application.  Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-14 11:26:54', '2021-06-14 11:26:54'),
(36995, 1006, 29320, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Sent f/u email again @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I am still waiting for a response regarding our enrollment request, please get back to me as soon as possible.  Thanks. \"', NULL, NULL, '2021-07-02 16:31:12', '2021-07-02 16:31:12');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(36996, 1006, 29320, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Received reply @ .ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,  This group request has been sent to a Contract Negotiator and you will receive an email from them with further information.  Thank you, Network Management Contracts Coordinator, Contracting & Network Development\"', NULL, NULL, '2021-07-07 10:43:32', '2021-07-07 10:43:32'),
(36997, 1006, 29320, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,  I hope you\'re doing well, we still haven\'t received any response from the contract negotiator. Please get back to me on the status of this request as soon as possible. Thank you.\"', NULL, NULL, '2021-07-27 17:31:35', '2021-07-27 17:31:35'),
(36998, 1006, 29320, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Good morning,  The contract is complete and the providers are in the process of being loaded.  We will reach out once the load is complete.  Thanks Network Management – Texas | www.wellcare.com | www.superiorhealthplan.com\"  ', NULL, NULL, '2021-07-29 10:41:39', '2021-07-29 10:41:39'),
(36999, 1006, 29320, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent f/u email @ ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the group and providers. Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-11 17:12:40', '2021-08-11 17:12:40'),
(37000, 1006, 29320, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Received the following update from ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Good Morning,  The request to add providers is still with configuration.  We will let you know once the providers are loaded.  Thanks\"', NULL, NULL, '2021-08-12 10:24:11', '2021-08-12 10:24:11'),
(37001, 1006, 29320, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Sent f/u email @ ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for our group and providers.  Please get back to me as soon as you\'re able to.  Thank you.\"', NULL, NULL, '2021-09-01 12:47:39', '2021-09-01 12:47:39'),
(37002, 11056, 29320, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Re: Become A Provider - Unsecured - Right Step - Texas  Good Morning!  Hope this email finds you well. I want to know the enrollment status of the following providers and practice soon. Please update me soon.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-08 13:40:46', '2021-09-08 13:40:46'),
(37003, 11056, 29320, NULL, '2021-09-15 00:00:00.000', 'Approved', 'Approval email received from : ProspectiveProviderTX@wellcare.com  Sub : Re: Become A Provider - Unsecured - Right Step - Texas  Hello,   The providers below are PAR effective 5/1/2021. If you need additional providers added to this group please submit your request via Join Our Network website. ', NULL, NULL, '2021-09-08 15:08:46', '2021-09-08 15:08:46'),
(37004, 1006, 29321, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:36', '2021-05-10 12:27:36'),
(37005, 3040, 29321, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: mflores@trpnppo.com  Subject: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  Hello Max,  Hope you are doing well, I wanted to enroll the below mentioned group & providers in TRPN for our group Right Step Medical Center LLC under the below location.   Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   --', NULL, NULL, '2021-05-25 08:48:05', '2021-05-25 08:48:05'),
(37006, 1006, 29321, NULL, '2021-06-18 00:00:00.000', 'In Process', 'We received the following reply from Max Flores mflores@trpnppo.com:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  \"Good morning Adil,  I wanted to take  brief moment to follow up and see if you and your team have had the opportunity to review the proposal and ask if there any questions that you may have? If you would please get back to me when you get an opportunity that would be greatly appreciated. Thank you for your time today, have a great Thursday.  Kind regards, Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117  Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Filled out the agreement and sent it back to the rep. Attached for reference in main group task. ', NULL, NULL, '2021-06-11 10:03:28', '2021-06-11 10:03:28'),
(37007, 1006, 29321, NULL, '2021-06-21 00:00:00.000', 'In Process', 'We received the following reply from Max Flores: \"Good afternoon Brad,  Thank you for getting the signed agreement back to me, you can expect to receive your countersigned copy in 2-3 weeks. If you have any questions in the mean time please feel free to contact me directly for assistance.  Kind regards, Max Flores Contracting Manager 6970 O’Bannon Drive  Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"', NULL, NULL, '2021-06-14 15:12:14', '2021-06-14 15:12:14'),
(37008, 1006, 29321, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  \"Hello Max,   I hope you\'re doing well, I wanted to check in with you on the status of enrollment for our group and providers. Please get back to me as soon as you\'re able to.  Thank you.\"', NULL, NULL, '2021-07-02 16:26:50', '2021-07-02 16:26:50'),
(37009, 1006, 29321, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Response from :mflores@trpnppo.com   \"Good morning Brad,  I apologize for the delay, I was informed that the person who handles the contract executions was out all of last week with Bronchitis and they are returning to the office today. No contract were executed last week, starting today contracts will be executed again and I requested to have yours signed as soon as possible. You should be getting your copy in the next few days, please pardon the delay.\"  Reply:  \"Hello Max,   I appreciate the update, can you please let me know what the status is of the request now?  Thank you.\"', NULL, NULL, '2021-07-27 17:19:29', '2021-07-27 17:19:29'),
(37010, 1006, 29321, NULL, '2021-08-05 00:00:00.000', 'Approved', 'The group and providers have been enrolled with TRPN, attached contract for reference.   Eff: 06/11/2021', NULL, NULL, '2021-07-29 09:56:25', '2021-07-29 09:56:25'),
(37011, 1006, 29322, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:36', '2021-05-10 12:27:36'),
(37012, 3040, 29322, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-05-25 09:35:46', '2021-05-25 09:35:46'),
(37013, 1006, 29322, NULL, '2021-06-25 00:00:00.000', 'Initiated', 'Sent enrollment query @ CSHNproviderrelations@christushealth.org:  Sub; Enrollment Query - RSM - Christus Spohn Health Network  \"Hello,  I hope you\'re doing well, I wanted to verify what the process would be to enroll the following group and providers with Christus Spohn, the information is as follows: Group Name: Right Step Medical Center LLC Address TIN# 85-3252700NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible. Thanks.\"', NULL, NULL, '2021-06-18 16:45:48', '2021-06-18 16:45:48'),
(37014, 1006, 29322, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the status of enrollment for providers and groups mentioned in the previous email.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-07 15:51:48', '2021-07-07 15:51:48'),
(37015, 1006, 29322, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org', NULL, NULL, '2021-07-27 17:06:29', '2021-07-27 17:06:29'),
(37016, 1006, 29322, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent new f/u email @ vicki.guerra@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hello Vicki,   I hope you\'re doing well, I wanted to verify what the process would be to enroll the following group and providers with Christus Spohn, the information is as follows:  Group Name: Right Step Medical Center LLC Address TIN# 85-3252700 NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thanks.\" ', NULL, NULL, '2021-08-11 12:42:56', '2021-08-11 12:42:56'),
(37017, 1006, 29322, NULL, '2021-09-01 00:00:00.000', 'In Process', 'We received the following request from hunter.barrett@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org   Brad,  What hospital do these providers have admitting privileges?   Thanks,\"  Replied with:  \"Hello Hunter,   Sure, the group has admitting privileges at Christus Spohn Hospital (Beeville, TX).  Please let me know if you have any further questions.  Thank you.\"', NULL, NULL, '2021-08-25 15:49:32', '2021-08-25 15:49:32'),
(37018, 11056, 29322, NULL, '2021-09-10 00:00:00.000', 'In Process', 'Email sent to : vicki.guerra@christushealth.org  Sub :  Re: Enrollment Query - RSM - Christus Spohn Health Network  Hey Vicki!  Hope this email finds you well. The representative hasn\'t reached out to us yet. Please provide us with the latest updates as soon as possible.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-02 16:16:19', '2021-09-02 16:16:19'),
(37019, 11056, 29322, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub :  Re: Enrollment Query - RSM - Christus Spohn Health Network  Hey Hunter!  Hope you are doing well. Here are the Provider & background forms and the Group agreement for joining the USFHP network. Please find the attachments.  If you need any documents or information feel free to contact me.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-17 10:07:45', '2021-09-17 10:07:45'),
(37020, 11056, 29322, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network   Good morning Hunter!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications I had submitted to you on 09,Sept,2021. Please let me know how long it will take to be credentialed.  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take care!  Thank you! Have a great day!', NULL, NULL, '2021-09-27 14:08:33', '2021-09-27 14:08:33'),
(37021, 11056, 29322, NULL, '2021-10-11 00:00:00.000', 'In Process', 'Email sent to : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good afternoon!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications I had submitted to you on 09,Sept,2021. Please let me know how long it will take to be credentialed.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-10-04 15:39:27', '2021-10-04 15:39:27'),
(37022, 11056, 29322, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Ahmed,  The contract was just signed and sent to our credentialing team last week. They will assign the effective date once they are complete with the process, please allow them enough time to get to your file before reaching out for an update. They are taking around 6 months to fully process new contract and providers. Please follow up directly with the credentialing department at the email address below.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org   Thanks, Hunter Barrett Network Contracting CHRISTUS Health Plan  CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org', NULL, NULL, '2021-10-13 12:52:48', '2021-10-13 12:52:48'),
(37023, 11056, 29322, NULL, '2021-10-28 00:00:00.000', 'In Process', 'Email sent to :  CHRISTUS.HP.Credentialing@christushealth.org,  Sub  : Re: Enrollment Query - RSM - Christus Spohn Health Network   Good afternoon!  Hope this email finds you well. I am still waiting to get an update of the credentialing status of the following providers under the Below mentioned practice & TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-10-21 07:59:20', '2021-10-21 07:59:20'),
(37024, 11056, 29322, NULL, '2021-11-08 00:00:00.000', 'In Process', 'Email sent to : CHRISTUS.HP.Credentialing@christushealth.org, CSHNproviderrelations@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good morning!  Hope all is well with you. Kindly don\'t test our patience . It has been a long time that our emails have been ignored and not responded back. Please assist with the below at your earliest opportunity.  I am still waiting to get an update of the credentialing status of the following providers under the Below mentioned practice & TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Eagerly, waiting to get back from you soon.  Thank you! Have a blessed day!', NULL, NULL, '2021-11-01 08:49:40', '2021-11-01 08:49:40'),
(37025, 11056, 29322, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email received from: CHRISTUS.HP.Credentialing@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good Afternoon        The Credentialing Department has received the provider’s application and it will be assigned to a Credentialing Coordinator for processing. We will make our best effort to credential the application in a timely manner.              Credentialing Verification Unit  CHRISTUS Health Plan - US Family Health Plan  919 Hidden Ridge Irving, TX 75038  Phone: (469)-282-0368  Fax: 210-766-8857  CHRISTUS.HP.Credentialing@christushealth.org', NULL, NULL, '2021-11-12 13:12:18', '2021-11-12 13:12:18'),
(37026, 11056, 29322, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Email sent to:  christus.hp.credentialing@christushealth.org  Sub:   Re: Enrollment Query - RSM - Christus Spohn Health Network  Good morning!  Hope all is well with you. Has the credentialing department assigned a Credentialing Coordinator for processing our provider’s applications?  Also, do provide me the updates on the applications of the providers.  Please get back to me at your earliest convenience.  Thank you! Have a great day!', NULL, NULL, '2021-11-29 13:59:05', '2021-11-29 13:59:05'),
(37027, 11056, 29322, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email received from:  CHRISTUS.HP.Credentialing@christushealth.org  Sub:   Re: Enrollment Query - RSM - Christus Spohn Health Network  Good Afternoon  The Credentialing Department has received the provider’s application and it has been assigned to a Credentialing Coordinator for processing. We will make our best effort to credential the application in a timely manner.      Credentialing Verification Unit CHRISTUS Health Plan - US Family Health Plan 919 Hidden Ridge Irving, TX 75038  Phone: (469)-282-0368 Fax: 210-766-8857 CHRISTUS.HP.Credentialing@christushealth.org', NULL, NULL, '2021-12-08 13:11:27', '2021-12-08 13:11:27'),
(37028, 11056, 29322, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Lisa H  Status: Applications have been provided to the designated coordinator.   Glory: received application. Not fully credentialed yet. Coordinator: Angelique   Ramegwoda\'s application is with Lisa   Shybi\'s application is with Tommishia  Emails:  angelique.castro@christushealth.org tommishia.offord@christushealth.org lisa.horton2@christushealth.org  Fwd: Ramegowda Belakere, M.D.', NULL, NULL, '2021-12-15 14:00:26', '2021-12-15 14:00:26'),
(37029, 11056, 29322, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org  Sub: Re: Enrollment Query - RSM - Christus Spohn Health Network  Fwd: Ramegowda Belakere, M.D.   Good morning!  Hope you are having a wonderful day. Please provide me with the latest updates on the credentialing process of the provider’s application as soon as possible.  Thanking you in advance for your cooperation.  Have a wonderful day!', NULL, NULL, '2021-12-22 14:25:17', '2021-12-22 14:25:17'),
(37030, 19067, 29322, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email received from: christus.hp.credentialing@christushealth.org, angelique.castro@christushealth.org   Subject: Re: Enrollment Query - RSM - Christus Spohn Health Network  Good afternoon!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications. Please let me know how long it will take to be credentialed.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-12-28 17:29:25', '2021-12-28 17:29:25'),
(37031, 20067, 29322, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, angelique.castro@christushealth.org  Subject: Re: Enrollment Query - RSM - Christus Spohn Health Network   Good Afternoon, Hope you had a great day. I would like to know the enrollment status of the below-mentioned Group and providers under Right Step Medical Center LLC.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite# 12, Stafford, TX 77477-2300 Provider Name	NPI Ancy Kurian	1316558935 SHYBI VARGHESE	1285270991 Glory Abraham	1194206490  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-06 17:36:39', '2022-01-06 17:36:39'),
(37032, 19067, 29322, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email received from: lisa.horton2@christushealth.org  Subject: Re: Enrollment Query - RSM - Christus Spohn Health Network    Good morning Talha,     Please pardon the delay in response.     Here are the statuses on the below providers:     Ramegowda Belakere, M.D.-I emailed Brad P at aa@claimsmedinc.com on 12/13/2021 for Certificate of Insurance and Covering Physician. I will email 2nd request today. Glory Abraham, NP-This provider is being credentialed by Angelique Castro, please reach out to her at Angelique.castro@christushealth.org for more information. Shybi Varghese, NP-This provider is being credentialed by Tommishia Offord at Tommishia.offord@christushealth.org for more information.    Enjoy your day.        Appreciate the blessings of the Lord in 2021,     Lisa Horton  Credentialing Coordinator  CHRISTUS Health  919 Hidden Ridge  Irving, TX 75038  Phone: 469-282-3549  Fax: (210) 766-9564', NULL, NULL, '2022-01-25 13:19:28', '2022-01-25 13:19:28'),
(37033, 19067, 29322, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email sent to: lisa.horton2@christushealth.org  Subject: Re: Enrollment Query - RSM - Christus Spohn Health Network   Greetings!  Attached is the COI for Dr. Ramegowda Belakere and Brad P no longer works here.  Shiva Satish M.D. is the covering physician NPI is 1629099635.  Don\'t hesitate to reach out if you need any document or information.   Regards,  Hammad Ahmed. ', NULL, NULL, '2022-02-08 13:39:06', '2022-02-08 13:39:06'),
(37034, 19067, 29322, NULL, '2022-03-23 00:00:00.000', 'In Process', 'Email received from: tommishia.offord@christushealth.org  Subject: Re: Enrollment Query - RSM - Shybi Varghese - Christus Spohn Health Network   Good morning,   Happy Wednesday!  Please send all future application status requests to the credentialing inbox. You can also reach out to the credentialing coordinator that is processing the files. Thanks!   Credentialing Inbox Email  CHRISTUS.HP.Credentialing@christushealth.org     Ramegowda Belakere, M.D – complete and awaiting Credentials Committee on March 8, 2022 Glory Abraham, NP – Incomplete – Reach out to Castro, Angelique angelique.castro@christushealth.org Shybi Varghese, NP – In Process – Reach out to Randall,  Tera tera.randall@christushealth.org    Thank you,  Tommishia Offord, CPCS  Credentialing Supervisor', NULL, NULL, '2022-03-16 11:18:19', '2022-03-16 11:18:19'),
(37035, 22077, 29322, NULL, '2022-04-11 00:00:00.000', 'In Process', 'Email sent to: 	tommishia.offord@christushealth.org  Subject: Enrollment Query - RSM - Ramegowda Belakere - Christus Spohn Health Network  Hi,  Any updates on the credentialing process of the provider, Ramegowda Belakere.  Thanks, Alex', NULL, NULL, '2022-04-04 10:31:16', '2022-04-04 10:31:16'),
(37036, 19067, 29322, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: Tommishia.offord@christushealth.org  Subject: Re: Enrollment Query - RSM - Ramegowda Belakere - Christus Spohn Health Network    Hi Tommishia,  The hospital admitting privileges for Dr. Ramegowda Belakere is Houston Methodist Willowbrook Hospital.   Thanks! Have a blessed day!', NULL, NULL, '2022-04-13 12:58:23', '2022-04-13 12:58:23'),
(37037, 1006, 29323, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:36', '2021-05-10 12:27:36'),
(37038, 3040, 29323, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: ccnprovider@triwest.com  Subject: Enroll Group & Providers || Right Step Medical Center LLC || TriWest ||  Greetings,  Hope you are doing well, I wanted to enroll the below mentioned group & providers in Triwest for our group Right Step Medical Center LLC under the below location.   Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-25 08:56:28', '2021-05-25 08:56:28'),
(37039, 1006, 29323, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Ancillary enrollment request submitted via Triwest\'s website as per my discussion with them. It\'s attached for reference in main group task since it is an urgentcare  request.  \"Request Id: 150819; Request was successfully saved.\"', NULL, NULL, '2021-06-11 14:05:38', '2021-06-11 14:05:38'),
(37040, 3040, 29323, NULL, '2021-07-07 00:00:00.000', 'In Process', 'I had a word with (Nicole L) Triwest and she said the request is still in process.   Ref: PH-1336296-N1T3B1', NULL, NULL, '2021-06-30 16:33:18', '2021-06-30 16:33:18'),
(37041, 1006, 29323, NULL, '2021-08-03 00:00:00.000', 'In Process', 'F/u @ Provider Services ProviderServices@TriWest.com:  Sub: Enrollment Status - RSM - Triwest  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687 Provider Name: Glory Abraham NPI# 1194206490 Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-07-27 17:23:55', '2021-07-27 17:23:55'),
(37042, 1006, 29323, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Services ProviderServices@triwest.com:   Sub: Enrollment Status - RSM - Triwest  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-11 17:10:00', '2021-08-11 17:10:00'),
(37043, 1006, 29323, NULL, '2021-08-19 00:00:00.000', 'In Process', 'We received the following reply from providerservices@triwest.com:  Sub: RE: Enrollment Status - RSM - Triwest  \"TriWest Classification: Sensitive  Hello,  Unfortunately I am unable to locate anything with the information provided. When did you request to be contracted with TriWest?  Thank you,  Tracy L Brooks Provider Services Email Support Specialist TriWest Healthcare Alliance 866.284-3743 www.triwest.com\"  Replied with:  \"Hello Tracy,   The request we submitted had the following ID# 150819, also as per my discussion with a representative regarding the request here\'s the reference number for the call as well PH-1336296-N1T3B1.   Thank you.\"', NULL, NULL, '2021-08-12 10:45:26', '2021-08-12 10:45:26'),
(37044, 1006, 29323, NULL, '2021-08-20 00:00:00.000', 'In Process', 'We received the following update from providerservices@triwest.com:  Sub: RE: Enrollment Status - RSM - Triwest  \"TriWest Classification: Sensitive  Hi,  I apologize. I was able to find your request, however it is in the very beginning stage. Your request is being reviewed to ensure you meet the requirements for the program and evaluated against anticipated demand for services. If it is determined that your specialty type is needed, a TriWest representative will contact you.  Unfortunately we cannot give you a timeframe at this time. Submitting a request for a contract does not guarantee you meet program requirements or that your services are currently needed by VA.  Thank you,  Tracy L Brooks Provider Services Email Support Specialist TriWest Healthcare Alliance 866.284-3743 www.triwest.com\"', NULL, NULL, '2021-08-13 14:12:21', '2021-08-13 14:12:21'),
(37045, 1006, 29323, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Sent f/u email @ providerservices@TriWest.com:  Sub: RE: Enrollment Status - RSM - Triwest  \"Hello Tracy,   I hope you\'re doing well, I wanted to get an update regarding the status of enrollment if there had been any changes?  Thank you!\"', NULL, NULL, '2021-09-01 10:53:46', '2021-09-01 10:53:46'),
(37046, 11056, 29323, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email received from : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  TriWest Classification: Sensitive  Hello,   According to our systems, it appears that your contract request is currently in an “Identified” status. This means that the request has been identified by TriWest Healthcare Alliance, but it has not yet been determined that the group will be needed for CCN. Your request will be reviewed and evaluated against anticipated demand for services. We have your information on file and while there is no guarantee of a contract, we will reach out with a contract offer should we determine there is a need and be advised this answers any future status inquiries. Please let us know if you have any additional questions.     **Network Providers: Remember to take your VA-mandated training on opioid safety, and the highly encouraged military and Veteran culture training, within 180 days! Register today at https://train2serve.com/.      Warm Regards,     Jesus Valenzuela Jr.  Provider Email Support Specialist  TriWest Healthcare Alliance  Phone: 866-284-3743  www.triwest.com', NULL, NULL, '2021-09-08 10:41:53', '2021-09-08 10:41:53'),
(37047, 11056, 29323, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  Good morning!  Hope all is well. I wanted to check in on the status of the enrollment process of the below mentioned providers and practice. Please get back to me as soon as possible with the updates on my query.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a wonderful day!    Jesus Valenzuela Jr. Provider Email Support Specialist TriWest Healthcare Alliance Phone: 866-284-3743', NULL, NULL, '2021-09-17 10:19:15', '2021-09-17 10:19:15'),
(37048, 11056, 29323, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest   Hello,  Thank you for your interest in becoming a TriWest Healthcare Alliance provider.  Your online request for a contract will be reviewed and evaluated against anticipated demand for services. If it is determined that your specialty type is needed, a TriWest representative will contact you.  Please keep in mind that this is only a contract request and there is no guarantee that you will receive one.  We do not have a timeframe for this process.  Thank you,  Mr. Shannon Berger, Provider E-mail Support Specialist | TriWest Healthcare Alliance  866-284-3743 providerservices@triwest.com www.triwest.com Community Care Network Region 4 Contact Center: 877-CCN-TRIW (226-8749)  Remember to now send your claims to PGBA! TriWest has a new claims processor and Payer ID. For more information, visit www.triwest.com/claimsconversion.', NULL, NULL, '2021-09-27 13:54:57', '2021-09-27 13:54:57'),
(37049, 11056, 29323, NULL, '2021-10-11 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  Good afternoon!  Hope you had a great and safe weekend. Our facility is an Urgent Care Clinic. Has our request for a contract been reviewed and evaluated yet or not? Please let me know the latest enrollment status of the following providers and practice with Triwest soon.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere  (M.D)	1235166687 Glory Abraham   (FNP)	1194206490 Shybi Varghese   (FNP)	1285270991  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a blessed week ahead!', NULL, NULL, '2021-10-04 15:42:36', '2021-10-04 15:42:36'),
(37050, 11056, 29323, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email received from : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  TriWest Classification: Confidential  Hello,  It is still under review.', NULL, NULL, '2021-10-13 12:35:03', '2021-10-13 12:35:03'),
(37051, 11056, 29323, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from  : providerservices@triwest.com  Sub  : RE: Enrollment Status - RSM - Triwest  TriWest Classification: Confidential     Hello,  It is still under review.  Thank you,     Mr. Shannon Berger, Provider E-mail Support Specialist | TriWest Healthcare Alliance  866-284-3743  providerservices@triwest.com  www.triwest.com  Community Care Network Region 4 Contact Center: 877-CCN-TRIW (226-8749)     Remember to now send your claims to PGBA! TriWest has a new claims processor and Payer ID. For more information, visit www.triwest.com/claimsconversion.     **Network Providers: Remember to take your VA-mandated training on opioid safety, and the highly encouraged military and Veteran culture training, within 180 days! Register today at https://train2serve.com/. ', NULL, NULL, '2021-10-20 16:49:22', '2021-10-20 16:49:22'),
(37052, 11056, 29323, NULL, '2021-11-08 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  Good morning!  Hope all is well with you. Have my applications been reviewed yet or not? Any latest updates related to my applications?  Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-11-01 09:15:46', '2021-11-01 09:15:46'),
(37053, 11056, 29323, NULL, '2021-11-18 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  Good morning!  Hope this email finds you well. How long is this going to take to review the applications? Has our request for a contract been reviewed and evaluated yet or not? Please let me know the latest enrollment status of the following providers and practice with Triwest soon.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere  (M.D)	1235166687 Glory Abraham   (FNP)	1194206490 Shybi Varghese   (FNP)	1285270991  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a blessed day!', NULL, NULL, '2021-11-11 18:01:29', '2021-11-11 18:01:29'),
(37054, 11056, 29323, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email received from: providerservices@triwest.com  Sub : RE: Enrollment Status - RSM - Triwest  TriWest Classification: Confidential     Hello,  The request is still under review.  I apologize, but we do not have a timeframe for this process.     Thank you,     Mr. Shannon Berger, Provider E-mail Support Specialist | TriWest Healthcare Alliance providerservices@triwest.com', NULL, NULL, '2021-11-18 12:11:58', '2021-11-18 12:11:58'),
(37055, 11056, 29323, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email sent to: providerservices@triwest.com  Sub:  RE: Enrollment Status - RSM - Triwest  Good evening!  Hope this email finds you well. Any updates on the applications?  Has our request for a contract been reviewed and evaluated yet or not?  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-01 10:31:01', '2021-12-01 10:31:01'),
(37056, 19067, 29323, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Still in review. Rep: Geva Ref# PH-1632349-C6G7G3', NULL, NULL, '2021-12-08 12:33:59', '2021-12-08 12:33:59'),
(37057, 11056, 29323, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Email sent to: providerservices@triwest.com  Sub: RE: Enrollment Status - RSM - Triwest  Good evening!  Hope this email finds you well. Any updates on the applications?  Has our request for a contract been reviewed and evaluated yet or not?  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-15 13:25:23', '2021-12-15 13:25:23'),
(37058, 11056, 29323, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: providerservices@triwest.com  & smiguel@triwest.com  Sub: RE: Enrollment Status - RSM - Triwest   Good afternoon!  Hope you are having a blessed day. Please provide me with the welcome letters for the below-mentioned providers under facility TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Provider Name	NPI Ramegowda Belakere  (M.D)	1235166687 Glory Abraham   (FNP)	1194206490 Shybi Varghese   (FNP)	1285270991  Please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a nice day!', NULL, NULL, '2021-12-22 14:33:14', '2021-12-22 14:33:14'),
(37059, 19067, 29323, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: credentialing@triwest.com, smiguel@triwest.com, providerservices@triwest.com  Subject: Request for Welcome Letters || Ramegowda, Glory, Shybi ||RSM || Triwest ||   Hello!  Hope you are having a blessed day. Please provide me with the welcome letters for the below-mentioned providers under facility TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Provider Name	NPI Ramegowda Belakere  (M.D)	1235166687 Glory Abraham   (FNP)	1194206490 Shybi Varghese   (FNP)	1285270991  Please do not hesitate to reach out if you have any questions or concerns.  Thanks & Regards, Hammad Ahmed. ', NULL, NULL, '2022-01-09 20:27:15', '2022-01-09 20:27:15'),
(37060, 19067, 29323, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email received from: smiguel@triwest.com  Subject: Request for Welcome Letters || Ramegowda, Glory, Shybi ||RSM || Triwest ||     TriWest Classification: Confidential     Hello, I am showing no results for the providers mentioned below.     Shannael Miguel  Provider Credentialing Spec  TriWest Healthcare Alliance  smiguel@triwest.com   www.triwest.com', NULL, NULL, '2022-01-25 16:11:00', '2022-01-25 16:11:00'),
(37061, 19067, 29323, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email sent to: smiguel@triwest.com   Subject: Re: Request for Welcome Letters || Ramegowda, Glory, Shybi ||RSM || Triwest ||    Hello Shannael!  Hope this email finds you well.  If these providers are not showing up then I would like to enroll them. Please advise the process of enrollment.   Thanks, Hammad.', NULL, NULL, '2022-02-11 17:52:50', '2022-02-11 17:52:50'),
(37062, 19067, 29323, NULL, '2022-02-25 00:00:00.000', 'In Process', 'Email received from: smiguel@triwest.com  Subject: Request for Welcome Letters || Ramegowda, Glory, Shybi ||RSM || Triwest ||    TriWest Classification: Confidential     Hello,     Please complete the attached application for each provider and send to credentialing@triwest.com once completed.', NULL, NULL, '2022-02-18 18:02:20', '2022-02-18 18:02:20'),
(37063, 19067, 29323, NULL, '2022-03-23 00:00:00.000', 'In Process', 'Email sent to: smiguel@triwest.com  Subject: Request for Welcome Letters || Ramegowda, Glory, Shybi ||RSM || Triwest ||    Hello,  Hope this email finds you well.  Kindly see the attached applications as per requested.  Thanks,  Hammad Ahmed', NULL, NULL, '2022-03-16 14:00:41', '2022-03-16 14:00:41'),
(37064, 1006, 29324, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37065, 1006, 29324, NULL, '2021-06-01 00:00:00.000', 'Not Eligible', 'Paramount is an Ohio specific insurance and is no longer eligible for enrollment as per discussion with the billing team. ', NULL, NULL, '2021-05-25 09:27:04', '2021-05-25 09:27:04'),
(37066, 1006, 29329, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37067, 3040, 29329, NULL, '2021-06-01 00:00:00.000', 'Not Eligible', 'Renaissance Physicians does not cover Stafford , we are unable to enroll with them.   Please take a look at the cities listed here @ https://myrpo.com/providers/how-to-join', NULL, NULL, '2021-05-25 08:36:47', '2021-05-25 08:36:47'),
(37068, 1006, 29330, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37069, 1006, 29330, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'The task is pending due to Medicaid enrollment. ', NULL, NULL, '2021-05-25 10:18:32', '2021-05-25 10:18:32'),
(37070, 1006, 29330, NULL, '2021-06-21 00:00:00.000', 'In Process', 'The request is in process in the main Molina task. Need to allow more time. ', NULL, NULL, '2021-06-14 15:09:26', '2021-06-14 15:09:26'),
(37071, 1006, 29330, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Sent corrected email & form @ MHTContractrequest mhtcontractrequest@molinahealthcare.com:  Sub: Enrollment Request - RSM - Molina Health  \"Hello,   Please find the attached provider contract request form with the W9 attached, please let me know if anything else is required.   Thank you. \"  The form is attached in main group task for reference.  ', NULL, NULL, '2021-07-02 16:20:20', '2021-07-02 16:20:20'),
(37072, 1006, 29330, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Received the following update from MHTContractrequest MHTContractrequest@molinahealthcare.com:  Sub: Molina Provider Contract - Ramegowda Belakere  \"Good Afternoon,  Thank you again for your patience. Thank you for taking the first step to becoming a part of the Molina Healthcare Family. I have received your application for (Ramegowda Belakere ) to contract under TAX ID number (85-3252700).  I am pleased to inform you that I have verified and placed your application in process and it is now with your designated coordinator.  Your designated coordinator will be your source of information for any questions you may have or for status checks. Every Coordinator services certain areas, based on the address information provided on the application; I have provided your Coordinators information.  Also, for an alternative route of provider/facility information, email TexasExpansionContracting@MolinaHealthcare.com Please see your designated Coordinators information below: JEFFERSON Evelin Suazo Evelin.Suazo@molinahealthcare.com 888-562-5442 x207438   Have a wonderful day! Thank you,  Tyhesha Price MHT| Provider Contracts Molina Healthcare of Texas, Inc. 1660 Westridge Circle N Irving, TX 75038 Mhtcontractrequest@Molinahealthcare.com\"  Sent f/u email @ \"Suazo, Evelin\" Evelin.Suazo@molinahealthcare.com:  \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687 Provider Name: Glory Abraham NPI# 1194206490 Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-07-27 17:17:05', '2021-07-27 17:17:05'),
(37073, 1006, 29330, NULL, '2021-08-18 00:00:00.000', 'In Process', 'We received the following update from Evelin.Suazo@molinahealthcare.com:  Sub: RE: Enrollment Status - RSM - Molina Health PDL 180032  \"Good Morning Brad,  Yes, please go ahead and submit the contract request for the other two providers, also could please kindly sent me the additional forms to resume the contracting process, still missing the sample claim and data collection. Thank you  Evelin Suazo Associate Specialist,Provider Contracts Molina Healthcare of Texas, Inc. evelin.suazo@molinahealthcare.com 1660 Westridge Circle N Irving, Texas, 75038 1888-562-5442 Ext. 207438 www.MolinaHealthcare.com Your Extended Family\"  Replied with the information requested:  \"Hello Evelin,  Please find the attached information, let me know if anything else is required.  Thank you. \" ', NULL, NULL, '2021-08-11 17:01:07', '2021-08-11 17:01:07'),
(37074, 1006, 29330, NULL, '2021-09-07 00:00:00.000', 'In Process', 'Sent f/u email @ Evelin.Suazo@molinahealthcare.com;  Sub: RE: Enrollment Status - RSM - Molina Health PDL 180032  \"Hello Evelin,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for our group and providers.  Thank you. \"', NULL, NULL, '2021-08-31 14:47:04', '2021-08-31 14:47:04'),
(37075, 11056, 29330, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email sent to : Evelin.Suazo@molinahealthcare.com  Sub : RE: Enrollment Status - RSM - Molina Health PDL 180032  Good Morning!  Hope this email finds you well. I want to know an update regarding the credentialing & contracting status of the following providers and practice soon. Please provide me with the latest updates soon.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!    Left out a voice mail regarding the enrollment status too!', NULL, NULL, '2021-09-08 13:45:56', '2021-09-08 13:45:56'),
(37076, 11056, 29330, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : evelin.suazo@molinahealthcare.com, mhtxproviderservices@molinahealthcare.com  Sub : Re: Enrollment Issue | Group & Providers | RSM | Molina 2nd ATTEMPT  Hello, I need an update on the applications of our providers and group for enrollment, with Molina as it has been while our applications are pending with Molina Credentialing/Contracting Dept, as of today we have entertain 100+ patients of Molina, as we are an Urgent care and we have to see the patients as its in emergency situation, due to Covid so if someone can get back to discuss on this issue, if there is a way we can get reimburse for our claims, or if we can get authorization from Molina to see those patients unless we are fully credentialed as it is impacting our financials now. Below are the details you can reach me at   Group: Right Step Medical Center LLC Tax ID: 853252700 NPI: 1063008084 Phone: (713) 893-6214    Regards, Alex Garrett', NULL, NULL, '2021-09-21 11:03:52', '2021-09-21 11:03:52'),
(37077, 11056, 29330, NULL, '2021-10-05 00:00:00.000', 'Approved', 'Email received from : evelin.suazo@molinahealthcare.com  Sub : [SEND SECURE] FW: Enrollment Issue | Group & Providers | RSM | Molina 181023 180032 181021  Good Afternoon,  Please find the status of your requested providers:  Ramegowda Belakere Provider is officially loaded please find a copy of the welcome letter along with a copy of the executed contract and effective date  Glory Abraham Provider is on the last step of contracting I am just waiting to received the notification that provider is officially loaded  Shybi Varghese Provider is on the first step of contracting with our credentialing department, request was recently received, please check status again within 30 days.  Thank you for doing Business with Molina Healthcare of Texas.   Group: Right Step Medical Center LLC Tax ID: 853252700 NPI: 1063008084  Evelin Suazo Associate Specialist,Provider Contracts Molina Healthcare of Texas, Inc.  evelin.suazo@molinahealthcare.com 1660 Westridge Circle N Irving, Texas, 75038 1888-562-5442 Ext. 207438  www.MolinaHealthcare.com Your Extended Family   Eff date is : 10/01/2021  Please see the attached welcome letter', NULL, NULL, '2021-09-28 08:32:21', '2021-09-28 08:32:21'),
(37078, 1006, 29331, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(37079, 3040, 29331, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-05-25 09:28:13', '2021-05-25 09:28:13'),
(37080, 1006, 29331, NULL, '2021-06-25 00:00:00.000', 'Initiated', 'Sent enrollment query @ \"Simms, Michal\" michal.simms@christushealth.org:  Sub; Enrollment Request - RSM - Christus Healthplan  \"Hello Michal, I hope you\'re doing great, I wanted to verify what would be required to enroll the following group with Christus Healthplan:   Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700 Address: 11925 Southwest Freeway, Suite 12, Stafford, TX 77477-2300  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as you\'re able to.  Thank you!\'', NULL, NULL, '2021-06-18 16:26:11', '2021-06-18 16:26:11'),
(37081, 1006, 29331, NULL, '2021-06-29 00:00:00.000', 'In Process', 'We received the following reply from \"CHRISTUS.HP.Credentialing\" CHRISTUS.HP.Credentialing@christushealth.org:  Sub: Prospective Provider Form - RSM  \"Hello Brad,  Please submit your requests on a Prospective Provider Form and submit per instructed.  Your request(s) will then be assigned to the proper representative for handling.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan\"  The enrollment form is attached in the main group task, as it\'s an ancillary request.', NULL, NULL, '2021-06-22 15:05:53', '2021-06-22 15:05:53'),
(37082, 1006, 29331, NULL, '2021-07-15 00:00:00.000', 'In Process', 'Sent f/u email @ \"Simms, Michal\" michal.simms@christushealth.org:  Sub: Enrollment Request - RSM - Christus Healthplan  \"Hello Michal,   I hope you\'re doing well, I just wanted to verify if the prospective provider form was received and was being worked on yet or not?  Thank you. \"', NULL, NULL, '2021-07-08 16:23:56', '2021-07-08 16:23:56'),
(37083, 1006, 29331, NULL, '2021-07-19 00:00:00.000', 'In Process', 'We received the following email from CHP.networkdevelopment CHP.networkdevelopment@christushealth.org:  Sub: Enrollment Request - RSM - Christus Healthplan   \"Hello Brad,  Can you  please resend the prospective provider form? When did you send it?  Thank You\"  Replied to them with: \"Hello,   Please find the attached email, the form was sent on the 22nd of June. Please let me know if you have any further questions.  Thank you. \" ', NULL, NULL, '2021-07-12 10:25:39', '2021-07-12 10:25:39'),
(37084, 1006, 29331, NULL, '2021-07-23 00:00:00.000', 'Not Eligible', 'Rejection email received from Hunter Barrett hunter.barrett@christushealth.org:  Sub; Right Step Medical USFHP  \"Brad,  At this time we are unable to enroll the group. We require the providers to admit to an in network hospital.  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org\"', NULL, NULL, '2021-07-16 16:50:42', '2021-07-16 16:50:42'),
(37085, 19067, 29331, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email received from: lisa.horton2@christushealth.org  Subject: RE: Ramegowda Belakere, M.D.   URGENT: 2ND REQUEST     Hello Ahmed,     Please provide a copy of the 2022-2023 Certificate of Insurance for Dr. Ramegowda Belakere, M.D. to meet criteria for Initial credentialing with Christus Health.     At this time the process is pending until we receive the requested information in our office.     Thank you in advance for your promptness in this matter.        Appreciate the blessings of the Lord in 2021,     Lisa Horton  Credentialing Coordinator  CHRISTUS Health  919 Hidden Ridge  Irving, TX 75038  Phone: 469-282-3549  Fax: (210) 766-9564  www.christushealth.org', NULL, NULL, '2022-01-11 13:30:55', '2022-01-11 13:30:55'),
(37086, 19067, 29331, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: lisa.horton2@christushealth.org  Subject: RE: Ramegowda Belakere, M.D.   Hello Lisa,  Attached is the Updated copy of COI for Ramegowda Belakere. Let me know if anything else is required.    Regards, Alex', NULL, NULL, '2022-01-11 13:31:26', '2022-01-11 13:31:26'),
(37087, 19067, 29331, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: lisa.horton2@christushealth.org  Subject: Re: Ramegowda Belakere, M.D.  Greetings!  Any updates on the below mentioned request?  Regards, Hammad.', NULL, NULL, '2022-01-25 17:56:48', '2022-01-25 17:56:48'),
(37088, 19067, 29331, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email received from: lisa.horton2@christushealth.org  Subject: RE: Ramegowda Belakere, M.D.   Good morning Hammad,     I have completed the credentialing process of Dr. Ramegowda Belakere, M.D. and he is now awaiting  to go before the Committee next week.     You will receive an email upon the decision of the Committee.     I hope this information helps in some way.', NULL, NULL, '2022-02-08 13:24:02', '2022-02-08 13:24:02'),
(37089, 19067, 29331, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email sent to: lisa.horton2@christushealth.org  Subject: Re: Ramegowda Belakere, M.D.   Hello!  Has the committee made the decision based on our hope? If so then provide a welcome kit and effective date.  Thanks, Hammad. ', NULL, NULL, '2022-02-08 13:27:59', '2022-02-08 13:27:59'),
(37090, 19067, 29331, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email received from: lisa.horton2@christushealth.org  Subject: RE: Ramegowda Belakere, M.D.    Hello Hammad,     Dr. Ramegowda Belakere, M.D. was fully credentialed on 01/24/2022 and is awaiting to go before the Committee for a decision. At that time you will receive an email/letter with their decision.     My apologies for the delay in response.        Appreciate the blessings of the Lord in 2022,', NULL, NULL, '2022-02-08 16:15:42', '2022-02-08 16:15:42'),
(37091, 19067, 29331, NULL, '2022-03-23 00:00:00.000', 'Approved', 'Email received from: noreply@christushealth.org, shonterence.adams@christushealth.org  Subject: Important Information from CHRISTUS Health    Greetings -  Please review the important message from CHRISTUS Health.  Thank you for your time!  CHRISTUS Health', NULL, NULL, '2022-03-16 09:41:41', '2022-03-16 09:41:41'),
(37092, 1006, 29332, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37093, 3040, 29332, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: providerservices@memorialhermann.org, enterprise.credentialing@memorialhermann.org  Subject: Enroll Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||   Greetings,  Hope you are doing well, I wanted to enroll the below mentioned group & providers in Memorial Hermann for our group Right Step Medical Center LLC under the below location.   Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-25 10:19:45', '2021-05-25 10:19:45'),
(37094, 1006, 29332, NULL, '2021-06-18 00:00:00.000', 'In Process', 'We received the following reply from Enterprise Credentialing Enterprise.Credentialing@memorialhermann.org:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||  \"Thank you for your interest in Memorial Hermann Health System and/or its affiliates. Before an application can be released, you must first complete a Request for Application form.  CLICK HERE to access and complete the Request for Application form for Memorial Hermann hospitals, affiliated hospitals, surgery centers, MHMD membership or Health Plan participation. To avoid any delays, please submit the form in its entirety (via link above) or email the form to enterprise.credentialing@memorialhermann.org. If the pre-screening qualifications are met, you should receive both your eCredentialing Portal and application username and password via email or additional communication within 3 business days.    If you have any questions, please contact us at enterprise.credentialing@memorialhermann.org.  Memorial Hermann Central Credentialing Team\"  Form was filled out and sent. Attached in the main group task for reference as it is an ancillary request. ', NULL, NULL, '2021-06-11 13:58:22', '2021-06-11 13:58:22'),
(37095, 1006, 29332, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann -  Greetings,  Hope you are doing well. I want to inquire about the enrollment status of the providers and group mentioned below. The enrollment form has been submitted in the last email already.  Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you!', NULL, NULL, '2021-06-30 16:37:13', '2021-06-30 16:37:13'),
(37096, 3040, 29332, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enrollment Status Group & Providers || Right Step Medical Center LLC || Memorial Hermann ||  Greetings,  Hope you are doing well, I wanted to know the enrollment status for the mentioned group & providers in Memorial Hermann for our group Right Step Medical Center LLC under the below location.  Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you  ', NULL, NULL, '2021-06-30 16:37:51', '2021-06-30 16:37:51'),
(37097, 11056, 29332, NULL, '2021-07-08 00:00:00.000', 'In Process', 'Email received from : Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann  Good morning,  When did you submit the request for application forms and which email address did you send it to?  Thank you!', NULL, NULL, '2021-07-01 08:29:14', '2021-07-01 08:29:14'),
(37098, 11056, 29332, NULL, '2021-07-08 00:00:00.000', 'In Process', ' Email sent to : Enterprise.Credentialing@memorialhermann.org  Sub : Enrollment Status Query - Right Step Medical Center LLC - Memorial Hermann  Good morning,  Hope all is well. The application forms were submitted on June,11th,2021. Email was sent at enterprise.credentialing@memorialhermann.org.  If further information is needed please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-07-01 08:31:55', '2021-07-01 08:31:55'),
(37099, 1006, 29332, NULL, '2021-07-23 00:00:00.000', 'In Process', 'We received the following update from MHHPContracting@memorialhermann.org:  Sub: Memorial Hermann Health Plan Request to Participate  \"We are in receipt of Right Step Medical Center LLC’s request to become a participating provider with Memorial Hermann Health Plans and need additional information to proceed with your request.  Please provide the following information:  List of services provided ·         Do you provide Virtual Health Services?  Current service area and/or list of locations List of all employed/contracted providers (if applicable) including NPs and PAs (please include individual NPIs) What age population is served? Please list 0-2 years of age; 2-18 years of age; 18+ years Where do you have privileges? Please list all Hospitals, Ambulatory Surgery Centers, etc. Link to website Current W-9 Current quality and outcomes data Any additional information you would like presented to the Network Access and Adequacy Committee   Your participation request will be presented at the next NAAC meeting following receipt of the additional information.  Best Regards, MHHP Network Contracting\"  Replied with:  \"Hello,   Please find the attached answers.  Please provide the following information:  List of services provided  Urgentcare Services  ·         Do you provide Virtual Health Services?   Yes, Telehealth services are offered.   Current service area and/or list of locations  Stafford, TX. List of all employed/contracted providers (if applicable) including NPs and PAs (please include individual NPIs) Ramegowda Belakere, MD. Glory Abraham, NP. Shybi Varghese, NP. What age population is served? Please list 0-2 years of age; 2-18 years of age; 18+ years Age limit: 0~99+  Where do you have privileges? Please list all Hospitals, Ambulatory Surgery Centers, etc. Methodist Hospital  Link to website N/A Current W-9 Attached. Current quality and outcomes data N/A Any additional information you would like presented to the Network Access and Adequacy Committee No. \"', NULL, NULL, '2021-07-16 17:09:26', '2021-07-16 17:09:26'),
(37100, 1006, 29332, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent f/u email @ MHHP Contracting MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Hermann  \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers:  Group Name: Right Step Medical Center LLC TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-11 16:56:53', '2021-08-11 16:56:53'),
(37101, 1006, 29332, NULL, '2021-08-20 00:00:00.000', 'In Process', 'We received the following update from MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Hermann  \"Good morning Brad. This provider group will be presented to our Network Access and Adequacy Committee this month. Once I receive a response from them, I will let you know.  Thank you. Camilla Paige\"', NULL, NULL, '2021-08-13 10:30:39', '2021-08-13 10:30:39'),
(37102, 1006, 29332, NULL, '2021-09-02 00:00:00.000', 'In Process', 'We received the following email @ MHHPContracting@memorialhermann.org:  Sub: Enrollment Status - RSM - Memorial Herman  \"Hello,  Memorial Hermann Health Plan (MHHP) has accepted your request to participate in our health plan. Please find attached the Provider Agreement. Please have the agreement signed. Please complete the attached Schedule C Tables 1 and 2 and Schedule D, as applicable. Once all items are complete, please return.  Once the completed documents are received, MHHP’s Credentialing Department will send the provider(s) a credentialing application. The agreement will be fully executed by MHHP and a copy sent to you once the provider is approved by the MHHP Credentialing Committee. The effective date will be assigned by MHHP upon approval of the MHHP Credentialing Committee.  We look forward to welcoming you into our network in the near future.  Best Regards, Camilla Paige\"  Contract signed and sent back to them. Attached in the main group task for reference. ', NULL, NULL, '2021-08-26 16:22:37', '2021-08-26 16:22:37'),
(37103, 11056, 29332, NULL, '2021-09-10 00:00:00.000', 'In Process', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning Brad. Since this is an Urgent Care agreement, could you please re-do Schedule C, Table 2 to only list the Urgent Care Information? Please feel free to only send back that page.     Thank you.     Camilla', NULL, NULL, '2021-09-03 08:31:40', '2021-09-03 08:31:40'),
(37104, 11056, 29332, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hello Camilla,   Here\'s the updated Schedule C. Let me know if anything else is required.  Thank you!  Updated Schedule C sent. And asked for the enrollment updates', NULL, NULL, '2021-09-08 10:32:16', '2021-09-08 10:32:16'),
(37105, 11056, 29332, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann   Good Morning!  Hope this email finds you well. I want to know the enrollment status of the following providers and practice soon. Please update me soon.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-17 10:54:12', '2021-09-17 10:54:12'),
(37106, 11056, 29332, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning. You should be hearing from our credentialing team soon.   Thank you.  Camilla', NULL, NULL, '2021-09-27 13:35:17', '2021-09-27 13:35:17'),
(37107, 11056, 29332, NULL, '2021-10-11 00:00:00.000', 'In Process', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hey Camilia!  Hope this email finds you well. I am still waiting to hear the updates from your credentialing team.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-10-04 12:47:31', '2021-10-04 12:47:31'),
(37108, 11056, 29332, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Hey Camilia!  Hope this email finds you well. I am still waiting to hear the updates from your credentialing team.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-10-13 12:09:31', '2021-10-13 12:09:31'),
(37109, 11056, 29332, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann   Good afternoon. Credentialing takes 30-45 days. Once I receive the credentialing approvals, I will send the agreement to my leadership team for full execution.', NULL, NULL, '2021-10-20 15:44:29', '2021-10-20 15:44:29'),
(37110, 11056, 29332, NULL, '2021-11-08 00:00:00.000', 'In Process', 'Email received from : MHHPContracting@memorialhermann.org  Sub : Enrollment Status - RSM - Memorial Hermann  Good morning. No, I have not yet received the credentialing approval yet.', NULL, NULL, '2021-11-01 08:31:53', '2021-11-01 08:31:53'),
(37111, 11056, 29332, NULL, '2021-11-18 00:00:00.000', 'Initiated', 'Email received from: MHHPContracting@memorialhermann.org  Sub: Enrollment Status - RSM - Memorial Hermann  Good morning. My apologies for the delay. Our credentialing team is working on a huge project for our Annual Enrollment Period which has taken priority. We should be hearing something soon.     Thank you for your patience.', NULL, NULL, '2021-11-11 16:51:11', '2021-11-11 16:51:11'),
(37112, 11056, 29332, NULL, '2021-11-18 00:00:00.000', 'In Process', 'Email received from: MHHPContracting@memorialhermann.org  Sub: Enrollment Status - RSM - Memorial Hermann  Good morning. My apologies for the delay. Our credentialing team is working on a huge project for our Annual Enrollment Period which has taken priority. We should be hearing something soon.     Thank you for your patience.', NULL, NULL, '2021-11-11 16:51:40', '2021-11-11 16:51:40'),
(37113, 11056, 29332, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email sent to: MHHPContracting@memorialhermann.org  Sub: Enrollment Status - RSM - Memorial Hermann  Good afternoon!  Hope you had a great and safe weekend. I would appreciate it if you could please let me know the updated credentialing status for the below-mentioned practice and providers soon with Memorial Hermann. Any updates on the agreement & approval letters?  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-11-18 10:50:07', '2021-11-18 10:50:07'),
(37114, 11056, 29332, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email received from:   MHHPContracting@memorialhermann.org  Sub:  Enrollment Status - RSM - Memorial Hermann   Good morning. I spoke with our credentialing team yesterday and was informed that they are still waiting on documentation from your team to finish the credentialing process. Please follow-up with your team in that regard. We cannot fully execute the agreement until credentialing is approved.', NULL, NULL, '2021-11-30 17:54:22', '2021-11-30 17:54:22'),
(37115, 11056, 29332, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Email received from: jcalderon@symplr.com  Sub: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC Enrollment Status - RSM - Memorial Hermann   Good afternoon,     Your facility credentialing applications for participation with Memorial Hermann Healthplan are being prepared. The following information is needed for all three location to continue the credentialing process on behalf of Memorial Hermann Healthplan:  Business License or Certificate of Occupancy Accreditation (If applicable)    Please reply to this message with the information mentioned above within 15 business days from 1st request. If information is not received by this date, your application will be forwarded to Memorial Hermann Healthplan Medical Director for review and may be closed for failure to meet Memorial Hermann Healthplan administrative criteria.     If you have any questions, please contact me at 516-593-1380 Ext. 287 or JCalderon@symplr.com        Johanna Calderon                            Credentialing Specialist  Work: +1 (516) 593-1380 Ext. 287   Fax: 516-620-3054   Email: jcalderon@symplr.com  Letter of occupancy has been provided. Waiting for accreditation letter from provider side.', NULL, NULL, '2021-12-15 12:51:47', '2021-12-15 12:51:47'),
(37116, 11056, 29332, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: jcalderon@symplr.com  Sub: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Good afternoon!  Hope you are doing well. You haven\'t responded me back to my queries yet. Please let me know what kind of and for which thing you need a letter of accreditation. Have you received the letter of occupancy?  Any updates on the agreement & approval letters of the credentialing process of the providers?  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-22 14:44:57', '2021-12-22 14:44:57'),
(37117, 19067, 29332, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: jcalderon@symplr.com  Subject: Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC  Hello!  This is a reminder of the previous request.  Kindly get in touch as soon as you get time.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 21:14:21', '2022-01-09 21:14:21'),
(37118, 19067, 29332, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: jcalderon@symplr.com  Subject: Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Greetings!  Any updates on the mentioned request?   Kindly respond promptly.  Regards, Hammad', NULL, NULL, '2022-01-25 16:04:47', '2022-01-25 16:04:47'),
(37119, 19067, 29332, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: jcalderon@symplr.com   Subject: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Good afternoon Hammad,     Sorry for my delay in replying to you. Attached you will find the approval letter and the original email notification that went out.     Kind Regards,', NULL, NULL, '2022-02-11 17:12:38', '2022-02-11 17:12:38'),
(37120, 19067, 29332, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email sent to: jcalderon@symplr.com  Subject: Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Hi,  Please advise if it is an Ancillary Plan or a Group Contract and do share the Agreement Letter. That would be of great help!  Regards, Hammad', NULL, NULL, '2022-02-11 17:13:34', '2022-02-11 17:13:34'),
(37121, 19067, 29332, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: MHHPContracting@memorialhermann.org  Subject: RE: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Good morning Hammad. I am working on getting the Urgent Care agreement fully executed by our leadership team. Once it has been fully executed, I will send you a copy. Please let me know if you have any other questions.  ', NULL, NULL, '2022-02-11 17:14:39', '2022-02-11 17:14:39'),
(37122, 19067, 29332, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email sent to: mhhpcontracting@memorialhermann.org  Subject: Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Good Morning!  Hope this email finds you well. Any updates as of now? Kindly update me.  And don\'t hesitate to reach me if you need anything.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-16 10:16:31', '2022-02-16 10:16:31'),
(37123, 19067, 29332, NULL, '2022-02-25 00:00:00.000', 'In Process', 'Email received from: MHHPContracting@memorialhermann.org  Subject: RE: [EXTERNAL] Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC    Good morning. My apologies for the delay. I am hoping to have this agreement back to you by early next week.     Thank you.     Camilla', NULL, NULL, '2022-02-18 09:57:50', '2022-02-18 09:57:50'),
(37124, 19067, 29332, NULL, '2022-03-18 00:00:00.000', 'In Process', 'Email sent to: mhhpcontracting@memorialhermann.org  Subject: Re: [EXTERNAL] Re: 3rd & Final Request/ Memorial Hermann Health plan/ Right Step Medical Center LLC   Hi Camilia!  I haven\'t received the agreement yet. Kindly look into this.  Regards, Hammad Ahmed.', NULL, NULL, '2022-03-11 11:18:53', '2022-03-11 11:18:53'),
(37125, 19067, 29332, NULL, '2022-04-12 00:00:00.000', 'On Hold', 'Provider no longer practices @ RSM', NULL, NULL, '2022-04-05 13:05:11', '2022-04-05 13:05:11'),
(37126, 1006, 29334, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37127, 3040, 29334, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Group request submitted online. Please see group task.   Your form was submitted successfully. Thank you for contacting us. A representative will be in contact to discuss your interest in becoming a participating Provider.', NULL, NULL, '2021-05-25 09:22:11', '2021-05-25 09:22:11'),
(37128, 1006, 29334, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We received the following reply from ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Dear Provider:  Thank you for your interest in joining our network, please allow 30 Calendar days for us to review your request.  Sincerely, Network Management – Texas | www.wellcare.com\"', NULL, NULL, '2021-05-26 08:18:35', '2021-05-26 08:18:35'),
(37129, 1006, 29334, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Sent f/u email @ .ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I just wanted to check in on the status of my application.  Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-14 11:26:47', '2021-06-14 11:26:47'),
(37130, 1006, 29334, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Sent f/u email again @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I am still waiting for a response regarding our enrollment request, please get back to me as soon as possible.  Thanks. \"', NULL, NULL, '2021-07-02 16:31:08', '2021-07-02 16:31:08'),
(37131, 1006, 29334, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Received reply @ .ProspectiveProviderTX ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,  This group request has been sent to a Contract Negotiator and you will receive an email from them with further information.  Thank you, Network Management Contracts Coordinator, Contracting & Network Development\"', NULL, NULL, '2021-07-07 10:43:29', '2021-07-07 10:43:29'),
(37132, 1006, 29334, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,  I hope you\'re doing well, we still haven\'t received any response from the contract negotiator. Please get back to me on the status of this request as soon as possible. Thank you.\"', NULL, NULL, '2021-07-27 17:31:39', '2021-07-27 17:31:39'),
(37133, 1006, 29334, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Good morning,  The contract is complete and the providers are in the process of being loaded.  We will reach out once the load is complete.  Thanks Network Management – Texas | www.wellcare.com | www.superiorhealthplan.com\"  ', NULL, NULL, '2021-07-29 10:41:31', '2021-07-29 10:41:31'),
(37134, 1006, 29334, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent f/u email @ ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the group and providers. Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-11 17:12:36', '2021-08-11 17:12:36'),
(37135, 1006, 29334, NULL, '2021-08-19 00:00:00.000', 'In Process', 'Received the following update from ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Good Morning,  The request to add providers is still with configuration.  We will let you know once the providers are loaded.  Thanks\"', NULL, NULL, '2021-08-12 10:24:35', '2021-08-12 10:24:35'),
(37136, 1006, 29334, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Sent f/u email @ ProspectiveProviderTX@wellcare.com:  Sub: RE: Become A Provider - Unsecured - Right Step - Texas  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for our group and providers.  Please get back to me as soon as you\'re able to.  Thank you.\"', NULL, NULL, '2021-09-01 12:47:48', '2021-09-01 12:47:48'),
(37137, 11056, 29334, NULL, '2021-09-15 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Re: Become A Provider - Unsecured - Right Step - Texas  Good Morning!  Hope this email finds you well. I want to know the enrollment status of the following providers and practice soon. Please update me soon.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-08 13:40:34', '2021-09-08 13:40:34'),
(37138, 11056, 29334, NULL, '2021-09-15 00:00:00.000', 'Approved', 'Approval email received from : ProspectiveProviderTX@wellcare.com  Sub : Re: Become A Provider - Unsecured - Right Step - Texas  Hello,   The providers below are PAR effective 5/1/2021. If you need additional providers added to this group please submit your request via Join Our Network website. ', NULL, NULL, '2021-09-08 15:08:07', '2021-09-08 15:08:07'),
(37139, 1006, 29335, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37140, 3040, 29335, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: mflores@trpnppo.com  Subject: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  Hello Max,  Hope you are doing well, I wanted to enroll the below mentioned group & providers in TRPN for our group Right Step Medical Center LLC under the below location.   Practice Details: Practice Name: Right Step Medical Center LLC Practice Tax ID# 85-3252700 Practice NPI# 1063008084 Practice Address: 11925 Southwest Freeway,  Suite 12  Stafford , TX 77477  Provider 1: Provider Name: Belakere, Ramegowda Provider NPI# 1235166687  Provider 2:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 3:   Provider Name: VARGHESE, SHYBI Peniyel Provider NPI# 1285270991  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   --', NULL, NULL, '2021-05-25 08:48:09', '2021-05-25 08:48:09'),
(37141, 1006, 29335, NULL, '2021-06-18 00:00:00.000', 'In Process', 'We received the following reply from Max Flores mflores@trpnppo.com:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  \"Good morning Adil,  I wanted to take  brief moment to follow up and see if you and your team have had the opportunity to review the proposal and ask if there any questions that you may have? If you would please get back to me when you get an opportunity that would be greatly appreciated. Thank you for your time today, have a great Thursday.  Kind regards, Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117  Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Filled out the agreement and sent it back to the rep. Attached for reference in main group task. ', NULL, NULL, '2021-06-11 10:03:22', '2021-06-11 10:03:22'),
(37142, 1006, 29335, NULL, '2021-06-21 00:00:00.000', 'In Process', 'We received the following reply from Max Flores: \"Good afternoon Brad,  Thank you for getting the signed agreement back to me, you can expect to receive your countersigned copy in 2-3 weeks. If you have any questions in the mean time please feel free to contact me directly for assistance.  Kind regards, Max Flores Contracting Manager 6970 O’Bannon Drive  Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"', NULL, NULL, '2021-06-14 15:12:11', '2021-06-14 15:12:11'),
(37143, 1006, 29335, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Enroll Group & Providers || Right Step Medical Center LLC || TRPN ||  \"Hello Max,   I hope you\'re doing well, I wanted to check in with you on the status of enrollment for our group and providers. Please get back to me as soon as you\'re able to.  Thank you.\"', NULL, NULL, '2021-07-02 16:26:46', '2021-07-02 16:26:46'),
(37144, 1006, 29335, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Response from :mflores@trpnppo.com   \"Good morning Brad,  I apologize for the delay, I was informed that the person who handles the contract executions was out all of last week with Bronchitis and they are returning to the office today. No contract were executed last week, starting today contracts will be executed again and I requested to have yours signed as soon as possible. You should be getting your copy in the next few days, please pardon the delay.\"  Reply:  \"Hello Max,   I appreciate the update, can you please let me know what the status is of the request now?  Thank you.\"', NULL, NULL, '2021-07-27 17:19:26', '2021-07-27 17:19:26'),
(37145, 1006, 29335, NULL, '2021-08-05 00:00:00.000', 'Approved', 'The group and providers have been enrolled with TRPN, attached contract for reference.   Eff: 06/11/2021', NULL, NULL, '2021-07-29 09:56:05', '2021-07-29 09:56:05'),
(37146, 1006, 29336, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 12:27:37', '2021-05-10 12:27:37'),
(37147, 3040, 29336, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-05-25 09:35:49', '2021-05-25 09:35:49'),
(37148, 1006, 29336, NULL, '2021-06-25 00:00:00.000', 'Initiated', 'Sent enrollment query @ CSHNproviderrelations@christushealth.org:  Sub; Enrollment Query - RSM - Christus Spohn Health Network  \"Hello,  I hope you\'re doing well, I wanted to verify what the process would be to enroll the following group and providers with Christus Spohn, the information is as follows: Group Name: Right Step Medical Center LLC Address TIN# 85-3252700NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible. Thanks.\"', NULL, NULL, '2021-06-18 16:45:45', '2021-06-18 16:45:45'),
(37149, 1006, 29336, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the status of enrollment for providers and groups mentioned in the previous email.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-07 15:51:51', '2021-07-07 15:51:51'),
(37150, 1006, 29336, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org', NULL, NULL, '2021-07-27 17:06:25', '2021-07-27 17:06:25'),
(37151, 1006, 29336, NULL, '2021-08-18 00:00:00.000', 'In Process', 'Sent new f/u email @ vicki.guerra@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hello Vicki,   I hope you\'re doing well, I wanted to verify what the process would be to enroll the following group and providers with Christus Spohn, the information is as follows:  Group Name: Right Step Medical Center LLC Address TIN# 85-3252700 NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thanks.\" ', NULL, NULL, '2021-08-11 12:43:07', '2021-08-11 12:43:07'),
(37152, 1006, 29336, NULL, '2021-09-01 00:00:00.000', 'In Process', 'We received the following request from hunter.barrett@christushealth.org:  Sub: Enrollment Query - RSM - Christus Spohn Health Network  \"Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org   Brad,  What hospital do these providers have admitting privileges?   Thanks,\"  Replied with:  \"Hello Hunter,   Sure, the group has admitting privileges at Christus Spohn Hospital (Beeville, TX).  Please let me know if you have any further questions.  Thank you.\"', NULL, NULL, '2021-08-25 15:49:28', '2021-08-25 15:49:28'),
(37153, 11056, 29336, NULL, '2021-09-10 00:00:00.000', 'In Process', 'Email sent to : vicki.guerra@christushealth.org  Sub :  Re: Enrollment Query - RSM - Christus Spohn Health Network  Hey Vicki!  Hope this email finds you well. The representative hasn\'t reached out to us yet. Please provide us with the latest updates as soon as possible.  Practice Details : Practice Name : Right Step Medical Center LLC Practice TIN # : 85-3252700 Practice NPI # : 1063008084 Practice  Address : 11925 Southwest Freeway, Suite 12, Stafford , TX 77477-2300  Provider Details: Provider Name : Belakere, Ramegowda Provider NPI # : 1235166687  Provider Name: Glory Abraham Provider NPI # : 1194206490  Provider Name: Shybi Varghese Provider NPI # :1285270991  If you need any documents or information feel free to contact me. Waiting to hear from you soon.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-02 16:16:13', '2021-09-02 16:16:13'),
(37154, 11056, 29336, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub :  Re: Enrollment Query - RSM - Christus Spohn Health Network  Hey Hunter!  Hope you are doing well. Here are the Provider & background forms and the Group agreement for joining the USFHP network. Please find the attachments.  If you need any documents or information feel free to contact me.  Thank you! Have a wonderful week ahead!', NULL, NULL, '2021-09-17 10:07:18', '2021-09-17 10:07:18'),
(37155, 11056, 29336, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email sent to : hunter.barrett@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network   Good morning Hunter!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications I had submitted to you on 09,Sept,2021. Please let me know how long it will take to be credentialed.  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take care!  Thank you! Have a great day!', NULL, NULL, '2021-09-27 14:08:27', '2021-09-27 14:08:27'),
(37156, 11056, 29336, NULL, '2021-10-11 00:00:00.000', 'In Process', 'Email sent to : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good afternoon!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications I had submitted to you on 09,Sept,2021. Please let me know how long it will take to be credentialed.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-10-04 15:39:18', '2021-10-04 15:39:18'),
(37157, 11056, 29336, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Ahmed,  The contract was just signed and sent to our credentialing team last week. They will assign the effective date once they are complete with the process, please allow them enough time to get to your file before reaching out for an update. They are taking around 6 months to fully process new contract and providers. Please follow up directly with the credentialing department at the email address below.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org   Thanks, Hunter Barrett Network Contracting CHRISTUS Health Plan  CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org', NULL, NULL, '2021-10-13 12:52:43', '2021-10-13 12:52:43'),
(37158, 11056, 29336, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email sent to :  CHRISTUS.HP.Credentialing@christushealth.org,  Sub  : Re: Enrollment Query - RSM - Christus Spohn Health Network   Good afternoon!  Hope this email finds you well. I am still waiting to get an update of the credentialing status of the following providers under the Below mentioned practice & TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-10-20 17:01:23', '2021-10-20 17:01:23'),
(37159, 11056, 29336, NULL, '2021-11-08 00:00:00.000', 'In Process', 'Email sent to : CHRISTUS.HP.Credentialing@christushealth.org, CSHNproviderrelations@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good morning!  Hope all is well with you. Kindly don\'t test our patience . It has been a long time that our emails have been ignored and not responded back. Please assist with the below at your earliest opportunity.  I am still waiting to get an update of the credentialing status of the following providers under the Below mentioned practice & TIN.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford , TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Eagerly, waiting to get back from you soon.  Thank you! Have a blessed day!', NULL, NULL, '2021-11-01 08:50:00', '2021-11-01 08:50:00'),
(37160, 11056, 29336, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email received from: CHRISTUS.HP.Credentialing@christushealth.org  Sub : Re: Enrollment Query - RSM - Christus Spohn Health Network  Good Afternoon        The Credentialing Department has received the provider’s application and it will be assigned to a Credentialing Coordinator for processing. We will make our best effort to credential the application in a timely manner.              Credentialing Verification Unit  CHRISTUS Health Plan - US Family Health Plan  919 Hidden Ridge Irving, TX 75038  Phone: (469)-282-0368  Fax: 210-766-8857  CHRISTUS.HP.Credentialing@christushealth.org', NULL, NULL, '2021-11-12 13:12:14', '2021-11-12 13:12:14'),
(37161, 11056, 29336, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Email sent to:  christus.hp.credentialing@christushealth.org  Sub:   Re: Enrollment Query - RSM - Christus Spohn Health Network  Good morning!  Hope all is well with you. Has the credentialing department assigned a Credentialing Coordinator for processing our provider’s applications?  Also, do provide me the updates on the applications of the providers.  Please get back to me at your earliest convenience.  Thank you! Have a great day!', NULL, NULL, '2021-11-29 13:58:59', '2021-11-29 13:58:59'),
(37162, 11056, 29336, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Lisa H  Status: Applications have been provided to the designated coordinator.   Glory: received application. Not fully credentialed yet. Coordinator: Angelique   Ramegwoda\'s application is with Lisa   Shybi\'s application is with Tommishia  Emails:  angelique.castro@christushealth.org tommishia.offord@christushealth.org lisa.horton2@christushealth.org  Fwd: Ramegowda Belakere, M.D.', NULL, NULL, '2021-12-15 14:00:21', '2021-12-15 14:00:21'),
(37163, 11056, 29336, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org  Sub: Re: Enrollment Query - RSM - Christus Spohn Health Network  Fwd: Ramegowda Belakere, M.D.   Good morning!  Hope you are having a wonderful day. Please provide me with the latest updates on the credentialing process of the provider’s application as soon as possible.  Thanking you in advance for your cooperation.  Have a wonderful day!', NULL, NULL, '2021-12-22 14:25:12', '2021-12-22 14:25:12'),
(37164, 19067, 29336, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email received from: christus.hp.credentialing@christushealth.org, angelique.castro@christushealth.org   Subject: Re: Enrollment Query - RSM - Christus Spohn Health Network  Good afternoon!  Hope this email finds you well. I wanted to check in on the status of the enrollment process & the applications. Please let me know how long it will take to be credentialed.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Provider Name	NPI Ramegowda Belakere	1235166687 Glory Abraham	1194206490 Shybi Varghese	1285270991  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a blessed day!', NULL, NULL, '2021-12-28 17:29:21', '2021-12-28 17:29:21');
