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
(52255, 10057, 42806, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:20:17', '2021-11-16 09:20:17'),
(52256, 10057, 42806, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:57', '2021-11-30 14:16:57'),
(52257, 10057, 42806, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:46', '2021-12-07 13:32:46'),
(52258, 10057, 42806, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:40', '2021-12-14 13:15:40'),
(52259, 10057, 42806, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:54', '2021-12-21 13:12:54'),
(52260, 10057, 42806, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:47', '2021-12-29 16:02:47'),
(52261, 19067, 42806, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: fax7814878257@multiplan.com  Subject: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280     We have received your request but additional information is required to proceed, please see attached. The requested information can be submitted by emailing appmissinginfo@multiplan.com or via fax to 781-487-8257.  Please contact MultiPlan\'s Customer Service department for any questions regarding this request. You may also inquire about application status, inquire about your fee schedule or address general questions through MultiPlan\'s customer service portal. There is no log-in or account set-up required. Simply select \"Rendering Practitioner/Facility\" and follow the on screen instructions in order to submit your inquiry. Follow this link to get started https://custservice.multiplan.com.     Prayag D  Provider Data Management  appmissinginfo@multiplan.com     MultiPlan, Inc  16 Crosby Drive  Bedford, MA 01730  Fax: 781-487-8257     Reference: APP0008352280', NULL, NULL, '2022-01-03 13:44:21', '2022-01-03 13:44:21'),
(52262, 19067, 42806, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: appmissinginfo@multiplan.com  Subject: Re: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280   Hello!  I hope you enjoyed the Holidays!  Kindly see the attached form for Edna Michi.  And do let me know if you need anything else.  Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 13:56:18', '2022-01-03 13:56:18'),
(52263, 20067, 42806, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:38:50', '2022-01-05 15:38:50'),
(52264, 20067, 42806, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through portal. Kindly see the attachment', NULL, NULL, '2022-01-18 13:32:23', '2022-01-18 13:32:23'),
(52265, 20067, 42806, NULL, '2022-01-31 00:00:00.000', 'Approved', 'Received the welcome letter  Effective date: 01/03/2022', NULL, NULL, '2022-01-24 14:26:46', '2022-01-24 14:26:46'),
(52266, 10057, 42807, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-28 16:18:44', '2021-10-28 16:18:44'),
(52267, 10057, 42807, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated :   Thank you for your interest in participating with MultiPlan. You should receive an application within ten to fifteen business days. If you do not receive the application, or if you have any questions upon reviewing it, please contact our Service Operations department at (800) 950-7040. You can check the status of your request anytime through the Check Nomination Status option on this page.  Nomination Tracking Number: 102921HG1', NULL, NULL, '2021-10-29 09:22:03', '2021-10-29 09:22:03'),
(52268, 10057, 42807, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:20:11', '2021-11-16 09:20:11'),
(52269, 10057, 42807, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:52', '2021-11-30 14:16:52'),
(52270, 10057, 42807, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:40', '2021-12-07 13:32:40'),
(52271, 10057, 42807, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:35', '2021-12-14 13:15:35'),
(52272, 10057, 42807, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:43', '2021-12-21 13:12:43'),
(52273, 10057, 42807, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:42', '2021-12-29 16:02:42'),
(52274, 19067, 42807, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: fax7814878257@multiplan.com  Subject: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280     We have received your request but additional information is required to proceed, please see attached. The requested information can be submitted by emailing appmissinginfo@multiplan.com or via fax to 781-487-8257.  Please contact MultiPlan\'s Customer Service department for any questions regarding this request. You may also inquire about application status, inquire about your fee schedule or address general questions through MultiPlan\'s customer service portal. There is no log-in or account set-up required. Simply select \"Rendering Practitioner/Facility\" and follow the on screen instructions in order to submit your inquiry. Follow this link to get started https://custservice.multiplan.com.     Prayag D  Provider Data Management  appmissinginfo@multiplan.com     MultiPlan, Inc  16 Crosby Drive  Bedford, MA 01730  Fax: 781-487-8257     Reference: APP0008352280', NULL, NULL, '2022-01-03 13:44:16', '2022-01-03 13:44:16'),
(52275, 19067, 42807, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: appmissinginfo@multiplan.com  Subject: Re: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280   Hello!  I hope you enjoyed the Holidays!  Kindly see the attached form for Edna Michi.  And do let me know if you need anything else.  Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 13:56:29', '2022-01-03 13:56:29'),
(52276, 20067, 42807, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:36:56', '2022-01-05 15:36:56'),
(52277, 20067, 42807, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through portal. Kindly see the attachment', NULL, NULL, '2022-01-18 13:32:12', '2022-01-18 13:32:12'),
(52278, 20067, 42807, NULL, '2022-01-31 00:00:00.000', 'Approved', 'Received the welcome letter  Effective date 01/03/2022', NULL, NULL, '2022-01-24 14:26:07', '2022-01-24 14:26:07'),
(52279, 10057, 42808, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-28 16:18:59', '2021-10-28 16:18:59'),
(52280, 10057, 42808, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated :   Thank you for your interest in participating with MultiPlan. You should receive an application within ten to fifteen business days. If you do not receive the application, or if you have any questions upon reviewing it, please contact our Service Operations department at (800) 950-7040. You can check the status of your request anytime through the Check Nomination Status option on this page.  Nomination Tracking Number: 102921HG1', NULL, NULL, '2021-10-29 09:21:52', '2021-10-29 09:21:52'),
(52281, 10057, 42808, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:20:06', '2021-11-16 09:20:06'),
(52282, 10057, 42808, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:45', '2021-11-30 14:16:45'),
(52283, 10057, 42808, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:35', '2021-12-07 13:32:35'),
(52284, 10057, 42808, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:29', '2021-12-14 13:15:29'),
(52285, 10057, 42808, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:34', '2021-12-21 13:12:34'),
(52286, 10057, 42808, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:36', '2021-12-29 16:02:36'),
(52287, 19067, 42808, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: fax7814878257@multiplan.com  Subject: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280     We have received your request but additional information is required to proceed, please see attached. The requested information can be submitted by emailing appmissinginfo@multiplan.com or via fax to 781-487-8257.  Please contact MultiPlan\'s Customer Service department for any questions regarding this request. You may also inquire about application status, inquire about your fee schedule or address general questions through MultiPlan\'s customer service portal. There is no log-in or account set-up required. Simply select \"Rendering Practitioner/Facility\" and follow the on screen instructions in order to submit your inquiry. Follow this link to get started https://custservice.multiplan.com.     Prayag D  Provider Data Management  appmissinginfo@multiplan.com     MultiPlan, Inc  16 Crosby Drive  Bedford, MA 01730  Fax: 781-487-8257     Reference: APP0008352280', NULL, NULL, '2022-01-03 13:44:10', '2022-01-03 13:44:10'),
(52288, 19067, 42808, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: appmissinginfo@multiplan.com  Subject: Re: Regarding Edna D Michi, MS\'s MultiPlan Application – Reference: APP0008352280   Hello!  I hope you enjoyed the Holidays!  Kindly see the attached form for Edna Michi.  And do let me know if you need anything else.  Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 13:56:23', '2022-01-03 13:56:23'),
(52289, 20067, 42808, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:36:24', '2022-01-05 15:36:24'),
(52290, 20067, 42808, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through portal. Kindly see the attachment', NULL, NULL, '2022-01-18 13:31:58', '2022-01-18 13:31:58'),
(52291, 20067, 42808, NULL, '2022-01-31 00:00:00.000', 'Approved', 'Received the welcome letter  Effective date: 01/03/2022', NULL, NULL, '2022-01-24 14:24:44', '2022-01-24 14:24:44'),
(52292, 10057, 42809, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-28 16:20:17', '2021-10-28 16:20:17'),
(52293, 10057, 42809, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated :  Thank you for your interest in participating with MultiPlan. You should receive an application within ten to fifteen business days. If you do not receive the application, or if you have any questions upon reviewing it, please contact our Service Operations department at (800) 950-7040. You can check the status of your request anytime through the Check Nomination Status option on this page.  Nomination Tracking Number: 102921ZAU', NULL, NULL, '2021-10-29 09:32:56', '2021-10-29 09:32:56'),
(52294, 10057, 42809, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:20:00', '2021-11-16 09:20:00'),
(52295, 10057, 42809, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:40', '2021-11-30 14:16:40'),
(52296, 10057, 42809, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:29', '2021-12-07 13:32:29'),
(52297, 10057, 42809, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:23', '2021-12-14 13:15:23'),
(52298, 10057, 42809, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:23', '2021-12-21 13:12:23'),
(52299, 10057, 42809, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:31', '2021-12-29 16:02:31'),
(52300, 20067, 42809, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:35:46', '2022-01-05 15:35:46'),
(52301, 20067, 42809, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through portal. Kindly see the attachment', NULL, NULL, '2022-01-18 13:31:41', '2022-01-18 13:31:41'),
(52302, 20067, 42809, NULL, '2022-01-31 00:00:00.000', 'Approved', 'Received the welcome letter', NULL, NULL, '2022-01-24 14:21:16', '2022-01-24 14:21:16'),
(52303, 10057, 42810, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-28 16:20:30', '2021-10-28 16:20:30'),
(52304, 10057, 42810, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated :  Thank you for your interest in participating with MultiPlan. You should receive an application within ten to fifteen business days. If you do not receive the application, or if you have any questions upon reviewing it, please contact our Service Operations department at (800) 950-7040. You can check the status of your request anytime through the Check Nomination Status option on this page.  Nomination Tracking Number: 102921ZAU', NULL, NULL, '2021-10-29 09:32:49', '2021-10-29 09:32:49'),
(52305, 10057, 42810, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:19:54', '2021-11-16 09:19:54'),
(52306, 10057, 42810, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:35', '2021-11-30 14:16:35'),
(52307, 10057, 42810, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:20', '2021-12-07 13:32:20'),
(52308, 10057, 42810, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:17', '2021-12-14 13:15:17'),
(52309, 10057, 42810, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:13', '2021-12-21 13:12:13'),
(52310, 10057, 42810, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:25', '2021-12-29 16:02:25'),
(52311, 20067, 42810, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:35:30', '2022-01-05 15:35:30'),
(52312, 20067, 42810, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through portal. Kindly see the attachment', NULL, NULL, '2022-01-18 13:30:45', '2022-01-18 13:30:45'),
(52313, 20067, 42810, NULL, '2022-02-24 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Sub: Demographic Update || Nubia Benavides || VMUCC || Multiplan  Good Afternoon!  I would like to add the below-mentioned tertiary location for provider Nubia Benavides. Attached is the W9.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia O Benavides	1801371935   Thanks & Regards,', NULL, NULL, '2022-02-17 13:38:23', '2022-02-17 13:38:23'),
(52314, 20067, 42810, NULL, '2022-03-22 00:00:00.000', 'Approved', 'Call Multiplan and spoke to Aly P Ref# 7950637  Location is added to provider profile  Effective Date: 02/24/2022', NULL, NULL, '2022-03-15 14:50:44', '2022-03-15 14:50:44'),
(52315, 10057, 42811, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-28 16:20:46', '2021-10-28 16:20:46'),
(52316, 10057, 42811, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated :  Thank you for your interest in participating with MultiPlan. You should receive an application within ten to fifteen business days. If you do not receive the application, or if you have any questions upon reviewing it, please contact our Service Operations department at (800) 950-7040. You can check the status of your request anytime through the Check Nomination Status option on this page.  Nomination Tracking Number: 102921ZAU', NULL, NULL, '2021-10-29 09:32:41', '2021-10-29 09:32:41'),
(52317, 10057, 42811, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Morning,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-16 09:19:43', '2021-11-16 09:19:43'),
(52318, 10057, 42811, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  Can I get the latest update on the below mentioned request.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:16:29', '2021-11-30 14:16:29'),
(52319, 10057, 42811, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello Team,  Hope you are doing well. Could you please let me know the update on the below mentioned request.  Please get back to me as soon as you get a chance. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 13:32:14', '2021-12-07 13:32:14'),
(52320, 10057, 42811, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  Any update on below mentioned request. It is my second reminder, please do the needful.  Thanks & Regards,', NULL, NULL, '2021-12-14 13:15:09', '2021-12-14 13:15:09'),
(52321, 10057, 42811, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Hello,  I\'m still waiting to get a response from your side.  Edna Tracking Number - 102921HG1 Nubia Tracking Number - 102921ZAU  Group Name	Valley Med Urgent Care PLLC  Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Benavides, Nubia Olivama	1801371935 Michi, Edna	1992293906  Please get back to ASAP!  Regards,', NULL, NULL, '2021-12-21 13:12:02', '2021-12-21 13:12:02'),
(52322, 10057, 42811, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : registrar@multiplan.com  Sub : Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Greetings!  This is my THIRD REMINDER on the below request. Your early response is highly appreciated.  Regards,', NULL, NULL, '2021-12-29 16:02:19', '2021-12-29 16:02:19'),
(52323, 20067, 42811, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com, fax7814878257@multiplan.com  Subject: Enrollment Query || VMUC || Edna Michi & Nubia Benavides || Multiplan  Good Afternoon,  Hope you are well. I want to know the enrollment status of the below-mentioned providers under these locations  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 15:35:08', '2022-01-05 15:35:08'),
(52324, 20067, 42811, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Checked status through multiplan provider portal Kindly see the attachment.', NULL, NULL, '2022-01-18 13:29:25', '2022-01-18 13:29:25'),
(52325, 20067, 42811, NULL, '2022-02-24 00:00:00.000', 'Approved', 'Called Multiplan and spoken to Paige Ref# 7918251  Location is enrolled and the effective date is 12/27/2021 Kindly see the primary location task for the welcome letter', NULL, NULL, '2022-02-17 13:24:29', '2022-02-17 13:24:29'),
(52326, 11056, 43682, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:33:51', '2021-10-29 08:33:51'),
(52327, 11056, 43682, NULL, '2021-11-05 00:00:00.000', 'Initiated', '	 Application submitted through the call.  Rep : Tom M  Status :   8002446224. Call credentialing for follow-up after 15 days. Time frame for credentialing is 90 - 120 days  Application no 12785885  REF CODE : tom10282021', NULL, NULL, '2021-10-29 08:35:45', '2021-10-29 08:35:45'),
(52328, 11056, 43682, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Rep : Santana A  Status: Still in process. 10/28/21 case started. Turn around time 90-120 days.  Ref code: Santanaa11092021', NULL, NULL, '2021-11-09 10:35:44', '2021-11-09 10:35:44'),
(52329, 11056, 43682, NULL, '2021-11-26 00:00:00.000', 'In Process', '	 Rep: Cherrelle C  Status: Application is still in process.Time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-19 13:06:23', '2021-11-19 13:06:23'),
(52330, 11056, 43682, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: Danny V   Status: Cureently in process in the credentialing department Application no 12785885  Refcode: Danny11302021', NULL, NULL, '2021-11-30 17:01:59', '2021-11-30 17:01:59'),
(52331, 11056, 43682, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Marco C  Status: The Application still is in process  contact no: 800-353-1232  Refcode: marcoc12152021', NULL, NULL, '2021-12-15 17:59:45', '2021-12-15 17:59:45'),
(52332, 11056, 43682, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Rep: Joiya B  Status: Application is in process.  Refcode: 12202021joiya', NULL, NULL, '2021-12-20 13:38:50', '2021-12-20 13:38:50'),
(52333, 19067, 43682, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||  Hello,  I would like to know the enrollment status of the following provider.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville TX 78363 Elsa Pearce	1083784102	6646 S. Staples St 122 Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill Corpus Christi TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive Corpus Christi TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 17:40:01', '2021-12-28 17:40:01'),
(52334, 19067, 43682, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Secure email received from: PDMCOGZ@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||     Dear Health Care Professional,     We received your recent request, a copy of which is enclosed. This request has been completed.                                                                                                                                                                                                                                               If you have any questions, please send an email to Intake PDM@cigna.com and include:                                                                                                                                                                                                                                         Cigna Internal Reference # (W202112282077482).                                                                                                                                                                                                                                                                                                                             PID  HCP Name     Effective\\ Term  date  9462619  ELSA, PEARCE  9/1/2021                                                                                                                                                                                                                                                                                                                                                           As per the source document the list of the above provider request has been completed.                                                                                                                                                                                                                                                 Sincerely,  PDM .                                                                                                                                                                                             \"Thank you for your submission. This is to confirm that your request has been completed. Please do not reply to this email message. The return address is not monitored. All future requests should be sent to Intake_PDM@cigna.com\"', NULL, NULL, '2022-01-10 16:21:06', '2022-01-10 16:21:06'),
(52335, 19067, 43682, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: pdmcogz@cigna.com  Subject: Re: FW: [External] Enrollment Query || Elsa Pearce || RHC || Cigna ||   Hello!  Could you please confirm the locations which got affected.    Regards, Hammad.', NULL, NULL, '2022-01-26 16:25:11', '2022-01-26 16:25:11'),
(52336, 1019, 43682, NULL, '2022-02-16 00:00:00.000', 'Approved', 'Received the following email from Cigna.  Dear ELSA PEARCE PA,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Effective Date: 01/04/2022. See attachments for Plans, Approval Confirmation and Locations Confirmation. ', NULL, NULL, '2022-02-09 13:56:57', '2022-02-09 13:56:57'),
(52337, 11056, 43683, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:34:05', '2021-10-29 08:34:05'),
(52338, 11056, 43683, NULL, '2021-11-05 00:00:00.000', 'Initiated', '	 Application submitted through the call.  Rep : Tom M  Status :   8002446224. Call credentialing for follow-up after 15 days. Time frame for credentialing is 90 - 120 days  Application no 12785885  REF CODE : tom10282021', NULL, NULL, '2021-10-29 08:35:39', '2021-10-29 08:35:39'),
(52339, 11056, 43683, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Rep : Santana A  Status: Still in process. 10/28/21 case started. Turn around time 90-120 days.  Ref code: Santanaa11092021', NULL, NULL, '2021-11-09 10:35:37', '2021-11-09 10:35:37'),
(52340, 11056, 43683, NULL, '2021-11-26 00:00:00.000', 'In Process', '	 Rep: Cherrelle C  Status: Application is still in process.Time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-19 13:07:02', '2021-11-19 13:07:02'),
(52341, 11056, 43683, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: Danny V   Status: Cureently in process in the credentialing department Application no 12785885  Refcode: Danny11302021', NULL, NULL, '2021-11-30 17:01:52', '2021-11-30 17:01:52'),
(52342, 11056, 43683, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Marco C  Status: The Application still is in process  contact no: 800-353-1232  Refcode: marcoc12152021', NULL, NULL, '2021-12-15 17:59:40', '2021-12-15 17:59:40'),
(52343, 11056, 43683, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Rep: Joiya B  Status: Application is in process.  Refcode: 12202021joiya', NULL, NULL, '2021-12-20 13:38:40', '2021-12-20 13:38:40'),
(52344, 19067, 43683, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||  Hello,  I would like to know the enrollment status of the following provider.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville TX 78363 Elsa Pearce	1083784102	6646 S. Staples St 122 Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill Corpus Christi TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive Corpus Christi TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 17:39:57', '2021-12-28 17:39:57'),
(52345, 19067, 43683, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Secure email received from: PDMCOGZ@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||     Dear Health Care Professional,     We received your recent request, a copy of which is enclosed. This request has been completed.                                                                                                                                                                                                                                               If you have any questions, please send an email to Intake PDM@cigna.com and include:                                                                                                                                                                                                                                         Cigna Internal Reference # (W202112282077482).                                                                                                                                                                                                                                                                                                                             PID  HCP Name     Effective\\ Term  date  9462619  ELSA, PEARCE  9/1/2021                                                                                                                                                                                                                                                                                                                                                           As per the source document the list of the above provider request has been completed.                                                                                                                                                                                                                                                 Sincerely,  PDM .                                                                                                                                                                                             \"Thank you for your submission. This is to confirm that your request has been completed. Please do not reply to this email message. The return address is not monitored. All future requests should be sent to Intake_PDM@cigna.com\"', NULL, NULL, '2022-01-10 16:21:02', '2022-01-10 16:21:02'),
(52346, 19067, 43683, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: pdmcogz@cigna.com  Subject: Re: FW: [External] Enrollment Query || Elsa Pearce || RHC || Cigna ||   Hello!  Could you please confirm the locations which got affected.    Regards, Hammad.', NULL, NULL, '2022-01-26 16:25:18', '2022-01-26 16:25:18'),
(52347, 1019, 43683, NULL, '2022-02-16 00:00:00.000', 'Approved', 'Received the following email from Cigna.  Dear ELSA PEARCE PA,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Effective Date: 01/04/2022. See attachments for Plans, Approval Confirmation and Locations Confirmation. ', NULL, NULL, '2022-02-09 13:56:41', '2022-02-09 13:56:41'),
(52348, 11056, 43684, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:34:22', '2021-10-29 08:34:22'),
(52349, 11056, 43684, NULL, '2021-11-05 00:00:00.000', 'Initiated', '	 Application submitted through the call.  Rep : Tom M  Status :   8002446224. Call credentialing for follow-up after 15 days. Time frame for credentialing is 90 - 120 days  Application no 12785885  REF CODE : tom10282021', NULL, NULL, '2021-10-29 08:35:31', '2021-10-29 08:35:31'),
(52350, 11056, 43684, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Rep : Santana A  Status: Still in process. 10/28/21 case started. Turn around time 90-120 days.  Ref code: Santanaa11092021', NULL, NULL, '2021-11-09 10:35:28', '2021-11-09 10:35:28'),
(52351, 11056, 43684, NULL, '2021-11-26 00:00:00.000', 'In Process', '	 Rep: Cherrelle C  Status: Application is still in process.Time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-19 13:06:57', '2021-11-19 13:06:57'),
(52352, 11056, 43684, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: Danny V   Status: Cureently in process in the credentialing department Application no 12785885  Refcode: Danny11302021', NULL, NULL, '2021-11-30 17:01:45', '2021-11-30 17:01:45'),
(52353, 11056, 43684, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Marco C  Status: The Application still is in process  contact no: 800-353-1232  Refcode: marcoc12152021', NULL, NULL, '2021-12-15 17:59:33', '2021-12-15 17:59:33'),
(52354, 11056, 43684, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Rep: Joiya B  Status: Application is in process.  Refcode: 12202021joiya', NULL, NULL, '2021-12-20 13:38:28', '2021-12-20 13:38:28'),
(52355, 19067, 43684, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||  Hello,  I would like to know the enrollment status of the following provider.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville TX 78363 Elsa Pearce	1083784102	6646 S. Staples St 122 Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill Corpus Christi TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive Corpus Christi TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 17:39:53', '2021-12-28 17:39:53');
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
(52356, 19067, 43684, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Secure email received from: PDMCOGZ@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||     Dear Health Care Professional,     We received your recent request, a copy of which is enclosed. This request has been completed.                                                                                                                                                                                                                                               If you have any questions, please send an email to Intake PDM@cigna.com and include:                                                                                                                                                                                                                                         Cigna Internal Reference # (W202112282077482).                                                                                                                                                                                                                                                                                                                             PID  HCP Name     Effective\\ Term  date  9462619  ELSA, PEARCE  9/1/2021                                                                                                                                                                                                                                                                                                                                                           As per the source document the list of the above provider request has been completed.                                                                                                                                                                                                                                                 Sincerely,  PDM .                                                                                                                                                                                             \"Thank you for your submission. This is to confirm that your request has been completed. Please do not reply to this email message. The return address is not monitored. All future requests should be sent to Intake_PDM@cigna.com\"', NULL, NULL, '2022-01-10 16:20:57', '2022-01-10 16:20:57'),
(52357, 19067, 43684, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: pdmcogz@cigna.com  Subject: Re: FW: [External] Enrollment Query || Elsa Pearce || RHC || Cigna ||   Hello!  Could you please confirm the locations which got affected.    Regards, Hammad.', NULL, NULL, '2022-01-26 16:25:23', '2022-01-26 16:25:23'),
(52358, 1019, 43684, NULL, '2022-02-16 00:00:00.000', 'Approved', 'Received the following email from Cigna.  Dear ELSA PEARCE PA,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Effective Date: 01/04/2022. See attachments for Plans, Approval Confirmation and Locations Confirmation. ', NULL, NULL, '2022-02-09 13:55:46', '2022-02-09 13:55:46'),
(52359, 11056, 43685, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:34:35', '2021-10-29 08:34:35'),
(52360, 11056, 43685, NULL, '2021-11-05 00:00:00.000', 'Initiated', '	 Application submitted through the call.  Rep : Tom M  Status :   8002446224. Call credentialing for follow-up after 15 days. Time frame for credentialing is 90 - 120 days  Application no 12785885  REF CODE : tom10282021', NULL, NULL, '2021-10-29 08:35:25', '2021-10-29 08:35:25'),
(52361, 11056, 43685, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Rep : Santana A  Status: Still in process. 10/28/21 case started. Turn around time 90-120 days.  Ref code: Santanaa11092021', NULL, NULL, '2021-11-09 10:35:15', '2021-11-09 10:35:15'),
(52362, 11056, 43685, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Rep: Cherrelle C  Status: Application is still in process.Time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-24 16:46:02', '2021-11-24 16:46:02'),
(52363, 11056, 43685, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: Danny V   Status: Cureently in process in the credentialing department Application no 12785885  Refcode: Danny11302021 ', NULL, NULL, '2021-11-30 17:00:15', '2021-11-30 17:00:15'),
(52364, 11056, 43685, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Marco C  Status: The Application still is in process  contact no: 800-353-1232  Refcode: marcoc12152021', NULL, NULL, '2021-12-15 17:59:28', '2021-12-15 17:59:28'),
(52365, 11056, 43685, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Rep: Joiya B  Status: Application is in process.  Refcode: 12202021joiya', NULL, NULL, '2021-12-20 13:38:20', '2021-12-20 13:38:20'),
(52366, 19067, 43685, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||  Hello,  I would like to know the enrollment status of the following provider.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville TX 78363 Elsa Pearce	1083784102	6646 S. Staples St 122 Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill Corpus Christi TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive Corpus Christi TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 17:39:48', '2021-12-28 17:39:48'),
(52367, 19067, 43685, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Secure email received from: PDMCOGZ@cigna.com  Subject: Enrollment Query || Elsa Pearce || RHC || Cigna ||     Dear Health Care Professional,     We received your recent request, a copy of which is enclosed. This request has been completed.                                                                                                                                                                                                                                               If you have any questions, please send an email to Intake PDM@cigna.com and include:                                                                                                                                                                                                                                         Cigna Internal Reference # (W202112282077482).                                                                                                                                                                                                                                                                                                                             PID  HCP Name     Effective\\ Term  date  9462619  ELSA, PEARCE  9/1/2021                                                                                                                                                                                                                                                                                                                                                           As per the source document the list of the above provider request has been completed.                                                                                                                                                                                                                                                 Sincerely,  PDM .                                                                                                                                                                                             \"Thank you for your submission. This is to confirm that your request has been completed. Please do not reply to this email message. The return address is not monitored. All future requests should be sent to Intake_PDM@cigna.com\"', NULL, NULL, '2022-01-10 16:20:47', '2022-01-10 16:20:47'),
(52368, 19067, 43685, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: pdmcogz@cigna.com  Subject: Re: FW: [External] Enrollment Query || Elsa Pearce || RHC || Cigna ||   Hello!  Could you please confirm the locations which got affected.    Regards, Hammad.', NULL, NULL, '2022-01-26 16:25:28', '2022-01-26 16:25:28'),
(52369, 1019, 43685, NULL, '2022-02-16 00:00:00.000', 'Approved', 'Received the following email from Cigna.  Dear ELSA PEARCE PA,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Effective Date: 01/04/2022. See attachments for Plans, Approval Confirmation and Locations Confirmation. ', NULL, NULL, '2022-02-09 13:55:31', '2022-02-09 13:55:31'),
(52370, 11056, 43686, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:36:45', '2021-10-29 08:36:45'),
(52371, 11056, 43686, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Application submitted through the call.  Rep : Tom M  Status :   8002446224. Call credentialing for follow-up after 15 days. Time frame for credentialing is 90 - 120 days  Application no. 12785882  REF CODE : tom10282021', NULL, NULL, '2021-10-29 08:37:11', '2021-10-29 08:37:11'),
(52372, 11056, 43686, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Rep : Santana A  Status: Still in process. 10/28/21 case started. Turn around time 90-120 days.  Ref code: Santanaa11092021', NULL, NULL, '2021-11-09 10:34:09', '2021-11-09 10:34:09'),
(52373, 11056, 43686, NULL, '2021-11-26 00:00:00.000', 'In Process', '	 Rep: Cherrelle C  Status: Application is still in process.Time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-19 13:07:25', '2021-11-19 13:07:25'),
(52374, 11056, 43686, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Rep: Cherrelle C  Status: The application is still in process. The time frame for credentialing is 90 - 120 days  Refcode: 11192021Cherrellec', NULL, NULL, '2021-11-19 13:07:55', '2021-11-19 13:07:55'),
(52375, 11056, 43686, NULL, '2021-12-07 00:00:00.000', 'In Process', '	 Email received from:   9psscent@cigna.com  Sub:  Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12785882 Application complete: Credentialing process to begin Dear LETICIA ALEMAN-LISTENBEE,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-11-30 12:31:51', '2021-11-30 12:31:51'),
(52376, 11056, 43686, NULL, '2021-12-07 00:00:00.000', 'In Process', '	 Email received from:   9psscent@cigna.com  Sub:  Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12785882 Application complete: Credentialing process to begin Dear LETICIA ALEMAN-LISTENBEE,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-11-30 12:31:52', '2021-11-30 12:31:52'),
(52377, 11056, 43686, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Rep: Marco C  Status: The Application still is in process  contact no: 800-353-1232  Refcode: marcoc12152021 ', NULL, NULL, '2021-12-15 17:59:02', '2021-12-15 17:59:02'),
(52378, 11056, 43686, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Rep: Joiya B  Status: Application is in process.  Refcode: 12202021joiya', NULL, NULL, '2021-12-20 13:37:53', '2021-12-20 13:37:53'),
(52379, 11056, 43686, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email received from: Jillian.MacDonald@cigna.com  Sub: Provider: Leticia Aleman-Listenbee   Good afternoon,     While credentialing this provider, I noticed the name appearing on the license is, “Leticia Aleman.” I do not see this listed as an alias on the application, so I wanted to confirm this is the same person as our provider. Could you please confirm?     Thanks,  Jillian Provider SOLUTIONS & OPERATIONS  Jillian MacDonald Network Solutions & Operations | Network Operations | Credentialing Representative T: 804.546.2275 | E: jillian.macdonald@cigna.com | F: 860.771.4223   Replied:  Good Afternoon,  Yes, \"Leticia Aleman-Listenbee\"  and “Leticia Aleman” are the same person as the provider. Let me know if you have any questions.    Regards, Alex', NULL, NULL, '2021-12-23 17:22:42', '2021-12-23 17:22:42'),
(52380, 19067, 43686, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: jillian.macdonald@cigna.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Cigna ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Provider.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street, Live Oak County, George West , TX 78022-3663    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 14:13:05', '2021-12-30 14:13:05'),
(52381, 19067, 43686, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: Jillian.MacDonald@cigna.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Cigna ||    Good morning,   This provider was sent to committee for approval on 12/30/2021. If you have further questions, I would encourage you to call 1-800-88-CIGNA and they can assist you further.   Thanks,  Jillian', NULL, NULL, '2022-01-03 09:27:40', '2022-01-03 09:27:40'),
(52382, 19067, 43686, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: jillian.macdonald@cigna.com  Subject: Re: [External] Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Cigna ||  Greetings!  Any updates on the previously mentioned request?  And when are we expecting the welcome letter?  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:18:38', '2022-01-09 22:18:38'),
(52383, 19067, 43686, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email received from: Jillian.MacDonald@cigna.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Cigna ||    Good morning,     Unfortunately, I do not know any of that information as my job is to gather information and be sure the provider has everything they need for the credentialing process. I would urge you to call provider services at 1-800-882-4462 and they can answer your questions.', NULL, NULL, '2022-01-26 16:10:55', '2022-01-26 16:10:55'),
(52384, 1019, 43686, NULL, '2022-02-09 00:00:00.000', 'Approved', 'Received the following email from WelcomeHealthCareProvider@cigna.com  Sub: Welcome to the Cigna network   Dear LETICIA ALEMAN-LISTENBEE MSN,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Attached are the Plans & Approval Confirmations', NULL, NULL, '2022-02-02 12:53:26', '2022-02-02 12:53:26'),
(52385, 11056, 43687, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:40:20', '2021-10-29 08:40:20'),
(52386, 11056, 43687, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Thank You! Request ID for this Submission: 40515837  Your request to join the network has been received.  We have sent a copy of your Request ID and submission confirmation to the submitter email entered in your request. If you have not heard from us within 60 days, you can call us at 1-800-353-1232. You can provide your Request ID to assist in locating your submission.', NULL, NULL, '2021-10-29 08:42:04', '2021-10-29 08:42:04'),
(52387, 11056, 43687, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Rep: Gelo C   Status: Application has get rejected. Aetna has no need for new providers. 859-455-8650 fax LOI   Ref code: 6056836804', NULL, NULL, '2021-11-08 17:01:13', '2021-11-08 17:01:13'),
(52388, 11056, 43687, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Rep: Kim P  Status:  canceled and discontinued. the network is not accepting the provider specialty full capacity. out of network The new opening is from 12/1/2021  ref code: 6058198794', NULL, NULL, '2021-11-17 09:56:51', '2021-11-17 09:56:51'),
(52389, 11056, 43687, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: CJ S   Status:Closed not accepting Mid-level and new practitioner. Panel is closed Not have schedule of re-opening.   Refcode: 6060463093', NULL, NULL, '2021-11-30 14:21:33', '2021-11-30 14:21:33'),
(52390, 11056, 43687, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Rep:  Amby J   Status: LOI sent out again for linking and adding the provider under the TIN    Refcode: 6063556901  Please see the attachment.', NULL, NULL, '2021-12-13 14:39:07', '2021-12-13 14:39:07'),
(52391, 11056, 43687, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status: Application has been set again and in processing  Tracking no.: pvb1376698   Ref code: 6065804152', NULL, NULL, '2021-12-22 13:53:53', '2021-12-22 13:53:53'),
(52392, 19067, 43687, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || CBUC & GWMC || Leticia Aleman-Listenbee || Aetna ||  Hello,  Hope you are doing well.  I would like to know the enrollment status of the following provider with Aetna.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S Hillside DR STE 04, Beeville, TX 78102 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County George West, TX 78022    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 14:28:27', '2021-12-28 14:28:27'),
(52393, 19067, 43687, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: RE: [EXTERNAL] Enrollment Status || CBUC & GWMC || Leticia Aleman-Listenbee || Aetna ||   This tin is also on a facility/ancillary agreement, this is not a provider/physician’s contract therefore providers are not added to facility contracts, thank you.', NULL, NULL, '2022-01-03 09:31:57', '2022-01-03 09:31:57'),
(52394, 19067, 43687, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: 	Re: [EXTERNAL] Enrollment Status || CBUC & GWMC || Leticia Aleman-Listenbee || Aetna ||   Hello!  How do I link this provider to the TIN?  Thanks!', NULL, NULL, '2022-01-09 22:15:39', '2022-01-09 22:15:39'),
(52395, 19067, 43687, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Re: [EXTERNAL] Enrollment Status || CBUC & GWMC || Leticia Aleman-Listenbee || Aetna ||   Hi,  Please provide the effective date for the group.   Regards.', NULL, NULL, '2022-01-26 16:08:37', '2022-01-26 16:08:37'),
(52396, 1019, 43687, NULL, '2022-02-09 00:00:00.000', 'Approved', 'Group is enrolled as an urgentcare. The contract is attached in the group task.   Eff: 01/15/2018', NULL, NULL, '2022-02-02 12:39:57', '2022-02-02 12:39:57'),
(52397, 11056, 43688, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:48:36', '2021-10-29 08:48:36'),
(52398, 11056, 43688, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Thank You! Request ID for this Submission: 34249714  Your request to join the network has been received.  We have sent a copy of your Request ID and submission confirmation to the submitter email entered in your request. If you have not heard from us within 60 days, you can call us at 1-800-353-1232. You can provide your Request ID to assist in locating your submission.', NULL, NULL, '2021-10-29 08:51:12', '2021-10-29 08:51:12'),
(52399, 11056, 43688, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Rep: Gelo C   Status: Application has get rejected. Aetna has no need for new providers. 859-455-8650 fax LOI   Ref code: 6056836804', NULL, NULL, '2021-11-08 17:03:05', '2021-11-08 17:03:05'),
(52400, 11056, 43688, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Rep: Kim P  Status:  canceled and discontinued. the network is not accepting the provider specialty full capacity. out of network New opening is from 12/1/2021  ref code: 6058198794', NULL, NULL, '2021-11-17 09:58:17', '2021-11-17 09:58:17'),
(52401, 11056, 43688, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: CJ S   Status:Closed not accepting Mid-level and new practitioner. Panel is closed Not have schedule of re-opening.   Refcode: 6060463093', NULL, NULL, '2021-11-30 14:21:46', '2021-11-30 14:21:46'),
(52402, 11056, 43688, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Rep:  Amby J   Status: LOI sent out again for linking and adding the provider under the TIN    Refcode: 6063556901  Please see the attachment.', NULL, NULL, '2021-12-13 15:05:07', '2021-12-13 15:05:07'),
(52403, 11056, 43688, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status: Application has been set again and in processing  Tracking no.: Pvb1377229   Ref code: 6065804152', NULL, NULL, '2021-12-22 13:53:18', '2021-12-22 13:53:18'),
(52404, 19067, 43688, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 14:18:08', '2021-12-28 14:18:08'),
(52405, 19067, 43688, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Fwd: Enrollment Status || RHC || Elsa Pearce || Aetna ||  Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-10 10:25:56', '2022-01-10 10:25:56'),
(52406, 19067, 43688, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||    Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-25 11:36:29', '2022-01-25 11:36:29'),
(52407, 19067, 43688, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: 	RE: [EXTERNAL] Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hammad,  Please contact provider services as I do not manage Facility agreements, I have mentioned previously and I am still getting these requests from you, If we can be a little more proactive and familiarize yourself with the provider service center, thank you     Check on credentialing status at 1-800-353-1232 (option 3).  Provider Services: 1-888-632-3862     Sylvia Machado-Petry Sr. Analyst, Network Ops Network Management – South TX Markets', NULL, NULL, '2022-02-11 13:08:42', '2022-02-11 13:08:42'),
(52408, 19067, 43688, NULL, '2022-03-02 00:00:00.000', 'In Process', 'Spoke with Ava A. She said that we are on facility contract and we don\'t have to enroll individual providers.  Ref: 6076423137', NULL, NULL, '2022-02-23 15:07:27', '2022-02-23 15:07:27'),
(52409, 19067, 43688, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Spoke with Anna. She said that the Rockport location is not loaded yet allow them more time and provider Elsa Pearce is not linked to the tax id, we have to bill under group as we have facility contract with Aetna.  Ref# 6079946138', NULL, NULL, '2022-03-15 14:19:41', '2022-03-15 14:19:41'),
(52410, 11056, 43689, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:48:46', '2021-10-29 08:48:46'),
(52411, 11056, 43689, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Thank You! Request ID for this Submission: 34249714  Your request to join the network has been received.  We have sent a copy of your Request ID and submission confirmation to the submitter email entered in your request. If you have not heard from us within 60 days, you can call us at 1-800-353-1232. You can provide your Request ID to assist in locating your submission.', NULL, NULL, '2021-10-29 08:51:04', '2021-10-29 08:51:04'),
(52412, 11056, 43689, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Rep: Gelo C   Status: Application has get rejected. Aetna has no need for new providers. 859-455-8650 fax LOI   Ref code: 6056836804', NULL, NULL, '2021-11-08 17:03:12', '2021-11-08 17:03:12'),
(52413, 11056, 43689, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Rep: Kim P  Status:  canceled and discontinued. the network is not accepting the provider specialty full capacity. out of network New opening is from 12/1/2021  ref code: 6058198794', NULL, NULL, '2021-11-17 09:58:10', '2021-11-17 09:58:10'),
(52414, 11056, 43689, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: CJ S   Status:Closed not accepting Mid-level and new practitioner. Panel is closed Not have schedule of re-opening.   Refcode: 6060463093', NULL, NULL, '2021-11-30 14:21:53', '2021-11-30 14:21:53'),
(52415, 11056, 43689, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Rep:  Amby J   Status: LOI sent out again for linking and adding the provider under the TIN    Refcode: 6063556901  Please see the attachment.', NULL, NULL, '2021-12-13 15:05:11', '2021-12-13 15:05:11'),
(52416, 11056, 43689, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status: Application has been set again and in processing  Tracking no.: Pvb1377229   Ref code: 6065804152', NULL, NULL, '2021-12-22 13:53:14', '2021-12-22 13:53:14'),
(52417, 19067, 43689, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 14:18:02', '2021-12-28 14:18:02'),
(52418, 19067, 43689, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Fwd: Enrollment Status || RHC || Elsa Pearce || Aetna ||  Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-10 10:25:50', '2022-01-10 10:25:50'),
(52419, 19067, 43689, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||    Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-25 11:36:23', '2022-01-25 11:36:23'),
(52420, 19067, 43689, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: 	RE: [EXTERNAL] Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hammad,  Please contact provider services as I do not manage Facility agreements, I have mentioned previously and I am still getting these requests from you, If we can be a little more proactive and familiarize yourself with the provider service center, thank you     Check on credentialing status at 1-800-353-1232 (option 3).  Provider Services: 1-888-632-3862     Sylvia Machado-Petry Sr. Analyst, Network Ops Network Management – South TX Markets', NULL, NULL, '2022-02-11 13:08:47', '2022-02-11 13:08:47'),
(52421, 19067, 43689, NULL, '2022-03-02 00:00:00.000', 'In Process', 'Spoke with Ava A. She said that we are on facility contract and we don\'t have to enroll individual providers.  Ref: 6076423137', NULL, NULL, '2022-02-23 15:07:23', '2022-02-23 15:07:23'),
(52422, 19067, 43689, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Spoke with Anna. She said that the Rockport location is not loaded yet allow them more time and provider Elsa Pearce is not linked to the tax id, we have to bill under group as we have facility contract with Aetna.  Ref# 6079946138', NULL, NULL, '2022-03-15 14:19:36', '2022-03-15 14:19:36'),
(52423, 11056, 43690, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:48:56', '2021-10-29 08:48:56'),
(52424, 11056, 43690, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Thank You! Request ID for this Submission: 34249714  Your request to join the network has been received.  We have sent a copy of your Request ID and submission confirmation to the submitter email entered in your request. If you have not heard from us within 60 days, you can call us at 1-800-353-1232. You can provide your Request ID to assist in locating your submission.', NULL, NULL, '2021-10-29 08:50:49', '2021-10-29 08:50:49'),
(52425, 11056, 43690, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Rep: Gelo C   Status: Application has get rejected. Aetna has no need for new providers. 859-455-8650 fax LOI   Ref code: 6056836804', NULL, NULL, '2021-11-08 17:03:19', '2021-11-08 17:03:19'),
(52426, 11056, 43690, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Rep: Kim P  Status:  canceled and discontinued. the network is not accepting the provider specialty full capacity. out of network New opening is from 12/1/2021  ref code: 6058198794', NULL, NULL, '2021-11-17 09:57:45', '2021-11-17 09:57:45'),
(52427, 11056, 43690, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: CJ S   Status:Closed not accepting Mid-level and new practitioner. Panel is closed Not have schedule of re-opening.   Refcode: 6060463093', NULL, NULL, '2021-11-30 14:21:59', '2021-11-30 14:21:59'),
(52428, 11056, 43690, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Rep:  Amby J   Status: LOI sent out again for linking and adding the provider under the TIN    Refcode: 6063556901  Please see the attachment.', NULL, NULL, '2021-12-13 15:05:16', '2021-12-13 15:05:16'),
(52429, 11056, 43690, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status: Application has been set again and in processing  Tracking no.: Pvb1377229   Ref code: 6065804152', NULL, NULL, '2021-12-22 13:53:08', '2021-12-22 13:53:08'),
(52430, 19067, 43690, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 14:17:57', '2021-12-28 14:17:57'),
(52431, 19067, 43690, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Fwd: Enrollment Status || RHC || Elsa Pearce || Aetna ||  Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-10 10:25:46', '2022-01-10 10:25:46'),
(52432, 19067, 43690, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||    Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-25 11:36:17', '2022-01-25 11:36:17'),
(52433, 19067, 43690, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: 	RE: [EXTERNAL] Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hammad,  Please contact provider services as I do not manage Facility agreements, I have mentioned previously and I am still getting these requests from you, If we can be a little more proactive and familiarize yourself with the provider service center, thank you     Check on credentialing status at 1-800-353-1232 (option 3).  Provider Services: 1-888-632-3862     Sylvia Machado-Petry Sr. Analyst, Network Ops Network Management – South TX Markets', NULL, NULL, '2022-02-11 13:08:53', '2022-02-11 13:08:53'),
(52434, 19067, 43690, NULL, '2022-03-02 00:00:00.000', 'In Process', 'Spoke with Ava A. She said that we are on facility contract and we don\'t have to enroll individual providers.  Ref: 6076423137', NULL, NULL, '2022-02-23 15:07:19', '2022-02-23 15:07:19'),
(52435, 19067, 43690, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Spoke with Anna. She said that the Rockport location is not loaded yet allow them more time and provider Elsa Pearce is not linked to the tax id, we have to bill under group as we have facility contract with Aetna.  Ref# 6079946138', NULL, NULL, '2022-03-15 14:19:31', '2022-03-15 14:19:31'),
(52436, 11056, 43691, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 08:49:12', '2021-10-29 08:49:12'),
(52437, 11056, 43691, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Thank You! Request ID for this Submission: 34249714  Your request to join the network has been received.  We have sent a copy of your Request ID and submission confirmation to the submitter email entered in your request. If you have not heard from us within 60 days, you can call us at 1-800-353-1232. You can provide your Request ID to assist in locating your submission.', NULL, NULL, '2021-10-29 08:49:53', '2021-10-29 08:49:53'),
(52438, 11056, 43691, NULL, '2021-11-15 00:00:00.000', 'Initiated', '', NULL, NULL, '2021-11-08 17:03:24', '2021-11-08 17:03:24'),
(52439, 11056, 43691, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Rep: Gelo C   Status: Application has get rejected. Aetna has no need for new providers. 859-455-8650 fax LOI   Ref code: 6056836804', NULL, NULL, '2021-11-08 17:03:36', '2021-11-08 17:03:36'),
(52440, 11056, 43691, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Rep: Kim P  Status:  canceled and discontinued. the network is not accepting the provider specialty full capacity. out of network New opening is from 12/1/2021  ref code: 6058198794', NULL, NULL, '2021-11-17 09:57:40', '2021-11-17 09:57:40'),
(52441, 11056, 43691, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: CJ S   Status:Closed not accepting Mid-level and new practitioner. Panel is closed Not have schedule of re-opening.   Refcode: 6060463093', NULL, NULL, '2021-11-30 14:22:12', '2021-11-30 14:22:12'),
(52442, 11056, 43691, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Rep:  Amby J   Status: LOI sent out again for linking and adding the provider under the TIN    Refcode: 6063556901  Please see the attachment.', NULL, NULL, '2021-12-13 15:05:22', '2021-12-13 15:05:22'),
(52443, 11056, 43691, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status: Application has been set again and in processing  Tracking no.: Pvb1377229   Ref code: 6065804152', NULL, NULL, '2021-12-22 13:53:03', '2021-12-22 13:53:03'),
(52444, 19067, 43691, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 14:17:50', '2021-12-28 14:17:50'),
(52445, 19067, 43691, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Fwd: Enrollment Status || RHC || Elsa Pearce || Aetna ||  Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-10 10:25:39', '2022-01-10 10:25:39'),
(52446, 19067, 43691, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Subject: Enrollment Status || RHC || Elsa Pearce || Aetna ||    Hello,  Hope you are doing well.  I would like to know the enrollment status for the following provider with Aetna.   Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Provider Name	NPI	Location Elsa Pearce	1083784102	500 E Caesar Kingsville, TX, 78363 Elsa Pearce	1083784102	6646 S. Staples St, 122, Corpus Christi, TX 78413 Elsa Pearce	1083784102	4042 River Hill, Corpus Christi, TX 78410 Elsa Pearce	1083784102	3817 South Padre Island Drive, Corpus Christi, TX 78415 Elsa Pearce	1083784102	2102 FM 2165 Rockport, TX 78382   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-25 11:36:11', '2022-01-25 11:36:11'),
(52447, 19067, 43691, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: 	RE: [EXTERNAL] Enrollment Status || RHC || Elsa Pearce || Aetna ||   Hammad,  Please contact provider services as I do not manage Facility agreements, I have mentioned previously and I am still getting these requests from you, If we can be a little more proactive and familiarize yourself with the provider service center, thank you     Check on credentialing status at 1-800-353-1232 (option 3).  Provider Services: 1-888-632-3862     Sylvia Machado-Petry Sr. Analyst, Network Ops Network Management – South TX Markets', NULL, NULL, '2022-02-11 13:08:58', '2022-02-11 13:08:58'),
(52448, 19067, 43691, NULL, '2022-03-02 00:00:00.000', 'In Process', 'Spoke with Ava A. She said that we are on facility contract and we don\'t have to enroll individual providers.  Ref: 6076423137', NULL, NULL, '2022-02-23 15:07:14', '2022-02-23 15:07:14'),
(52449, 19067, 43691, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Spoke with Anna. She said that the Rockport location is not loaded yet allow them more time and provider Elsa Pearce is not linked to the tax id, we have to bill under group as we have facility contract with Aetna.  Ref# 6079946138', NULL, NULL, '2022-03-15 14:19:26', '2022-03-15 14:19:26'),
(52450, 10057, 43692, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:34:49', '2021-10-29 09:34:49'),
(52451, 10057, 43692, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349778  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date.', NULL, NULL, '2021-10-29 13:39:32', '2021-10-29 13:39:32'),
(52452, 10057, 43692, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Resubmitted Application ID: 350293', NULL, NULL, '2021-11-01 16:57:00', '2021-11-01 16:57:00'),
(52453, 10057, 43692, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned provider under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Nubia Benavides	1801371935  Please get back to me as soon as possible. Have a great day.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:22:46', '2021-11-15 17:22:46'),
(52454, 10057, 43692, NULL, '2021-11-29 00:00:00.000', 'In Process', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Good afternoon,  The onboarding case (#3070636) for Nubia O. Benavides APN was submitted on 11.1.21 and is still in process.  These cases can take at least 3-4 months to be processed.   All the Best,  Noemi Diaz Network Management Consultant | Network Management - West Region  Blue Cross and Blue Shield of Texas phone (210) 558-5149', NULL, NULL, '2021-11-22 17:06:43', '2021-11-22 17:06:43'),
(52455, 10057, 43692, NULL, '2021-11-30 00:00:00.000', 'In Process', 'Email Received From: TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Dear Provider,  Please see the enclosed attachments.  Thank you,  Network Operations and Solution Delivery Blue Cross Blue Shield of TX ', NULL, NULL, '2021-11-23 11:14:36', '2021-11-23 11:14:36'),
(52456, 10057, 43692, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email Sent To : TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Hello,  Hope this email finds you well. Could you please let me know the enrollment status for Nubia Benavides.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-12-03 10:58:02', '2021-12-03 10:58:02'),
(52457, 10057, 43692, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Called to check the status - (806) 798-6317  Provider effective from 11/24/2021.  I requested to send the confirmation email at vmuc@claimsmedinc.com ', NULL, NULL, '2021-12-15 10:30:41', '2021-12-15 10:30:41'),
(52458, 10057, 43692, NULL, '2021-12-22 00:00:00.000', 'Approved', 'Email Received From : Connie_Traylor@bcbstx.com  Sub : Nubia Benavides, APN  Good morning,  Per our phone conversation, Nubia Benavides, APN, is in network for Blue Choice PPO, Blue Essentials HMO, Health Select, Blue Advantage HMO, and Medicare Advantage PPO, effective 11/24/2021. Provider ID, 8QP154, tied to TIN ending in 3542.  Noemi Diaz is your provider representative, I have copied her on the email.  Please include your TIN on all correspondence.  Thank you,  Connie Traylor Network Management Consultant Blue Cross and Blue Shield of Texas Lubbock, Texas 79424 Ph: 806-798-6317', NULL, NULL, '2021-12-15 10:59:46', '2021-12-15 10:59:46'),
(52459, 10057, 43693, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:35:00', '2021-10-29 09:35:00'),
(52460, 10057, 43693, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349778  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date.', NULL, NULL, '2021-10-29 13:39:20', '2021-10-29 13:39:20'),
(52461, 10057, 43693, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Resubmitted Application ID: 350293', NULL, NULL, '2021-11-01 16:56:54', '2021-11-01 16:56:54'),
(52462, 10057, 43693, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned provider under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Nubia Benavides	1801371935  Please get back to me as soon as possible. Have a great day.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:22:41', '2021-11-15 17:22:41'),
(52463, 10057, 43693, NULL, '2021-11-29 00:00:00.000', 'In Process', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Good afternoon,  The onboarding case (#3070636) for Nubia O. Benavides APN was submitted on 11.1.21 and is still in process.  These cases can take at least 3-4 months to be processed.   All the Best,  Noemi Diaz Network Management Consultant | Network Management - West Region  Blue Cross and Blue Shield of Texas phone (210) 558-5149', NULL, NULL, '2021-11-22 17:06:37', '2021-11-22 17:06:37'),
(52464, 10057, 43693, NULL, '2021-11-30 00:00:00.000', 'In Process', 'Email Received From: TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Dear Provider,  Please see the enclosed attachments.  Thank you,  Network Operations and Solution Delivery Blue Cross Blue Shield of TX ', NULL, NULL, '2021-11-23 11:13:59', '2021-11-23 11:13:59'),
(52465, 10057, 43693, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email Sent To : TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Hello,  Hope this email finds you well. Could you please let me know the enrollment status for Nubia Benavides.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-12-03 10:57:53', '2021-12-03 10:57:53');
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
(52466, 10057, 43693, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Called to check the status - (806) 798-6317  Provider effective from 11/24/2021.  I requested to send the confirmation email at vmuc@claimsmedinc.com ', NULL, NULL, '2021-12-15 10:30:35', '2021-12-15 10:30:35'),
(52467, 10057, 43693, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : Connie_Traylor@bcbstx.com  Sub : Nubia Benavides, APN  Good morning,  Per our phone conversation, Nubia Benavides, APN, is in network for Blue Choice PPO, Blue Essentials HMO, Health Select, Blue Advantage HMO, and Medicare Advantage PPO, effective 11/24/2021. Provider ID, 8QP154, tied to TIN ending in 3542.  Noemi Diaz is your provider representative, I have copied her on the email.  Please include your TIN on all correspondence.  Thank you,  Connie Traylor Network Management Consultant Blue Cross and Blue Shield of Texas Lubbock, Texas 79424 Ph: 806-798-6317', NULL, NULL, '2021-12-21 10:15:53', '2021-12-21 10:15:53'),
(52468, 10057, 43693, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : connie_traylor@bcbstx.com & Noemi_Diaz@bcbstx.com  Sub : Nubia Benavides, APN  Hello Connie,  Thank you so much for your prompt response. I really appreciate your kind assistance.  Have a lovely day!  Regards,', NULL, NULL, '2021-12-28 11:42:06', '2021-12-28 11:42:06'),
(52469, 19067, 43693, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: connie_traylor@bcbstx.com  Subject: Re: Nubia Benavides, APN   Greetings!  Can you please provide us with the welcome letter?   Thanks, Hammad Ahmed.', NULL, NULL, '2022-01-10 13:34:44', '2022-01-10 13:34:44'),
(52470, 20067, 43693, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: Noemi_Diaz@bcbstx.com  Sub: Fwd: Nubia Benavides, APN   Good afternoon,  Please see the attached letters that were sent via email on 11.23.21.  All the Best,   Noemi Diaz Network Management Consultant | Network Management - West Region  Blue Cross and Blue Shield of Texas phone (210) 558-5149  email Noemi_Diaz@bcbstx.com ', NULL, NULL, '2022-01-18 12:15:52', '2022-01-18 12:15:52'),
(52471, 20067, 43693, NULL, '2022-02-04 00:00:00.000', 'Approved', 'Effective Date: 11/24/2021  See the attachment of provider directory.', NULL, NULL, '2022-01-28 17:39:39', '2022-01-28 17:39:39'),
(52472, 10057, 43694, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:35:11', '2021-10-29 09:35:11'),
(52473, 10057, 43694, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349778  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date.', NULL, NULL, '2021-10-29 13:39:14', '2021-10-29 13:39:14'),
(52474, 10057, 43694, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Resubmitted Application ID: 350293', NULL, NULL, '2021-11-01 16:56:46', '2021-11-01 16:56:46'),
(52475, 10057, 43694, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned provider under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Nubia Benavides	1801371935  Please get back to me as soon as possible. Have a great day.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:22:35', '2021-11-15 17:22:35'),
(52476, 10057, 43694, NULL, '2021-11-29 00:00:00.000', 'In Process', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Query || VMUC || Nubia Benavides || BCBS  Good afternoon,  The onboarding case (#3070636) for Nubia O. Benavides APN was submitted on 11.1.21 and is still in process.  These cases can take at least 3-4 months to be processed.   All the Best,  Noemi Diaz Network Management Consultant | Network Management - West Region  Blue Cross and Blue Shield of Texas phone (210) 558-5149', NULL, NULL, '2021-11-22 17:06:31', '2021-11-22 17:06:31'),
(52477, 10057, 43694, NULL, '2021-11-30 00:00:00.000', 'In Process', 'Email Received From: TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Dear Provider,  Please see the enclosed attachments.  Thank you,  Network Operations and Solution Delivery Blue Cross Blue Shield of TX ', NULL, NULL, '2021-11-23 11:13:14', '2021-11-23 11:13:14'),
(52478, 10057, 43694, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email Sent To : TXProviderUpdateSubmission@bcbstx.com  Sub : PEDI Onboarding Existing Group/Clinic Provider : Case Number - 03070636  Hello,  Hope this email finds you well. Could you please let me know the enrollment status for Nubia Benavides.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-12-03 10:57:43', '2021-12-03 10:57:43'),
(52479, 10057, 43694, NULL, '2021-12-22 00:00:00.000', 'In Process', 'Called to check the status - (806) 798-6317  Provider effective from 11/24/2021.  I requested to send the confirmation email at vmuc@claimsmedinc.com ', NULL, NULL, '2021-12-15 10:30:29', '2021-12-15 10:30:29'),
(52480, 10057, 43694, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : Connie_Traylor@bcbstx.com  Sub : Nubia Benavides, APN  Good morning,  Per our phone conversation, Nubia Benavides, APN, is in network for Blue Choice PPO, Blue Essentials HMO, Health Select, Blue Advantage HMO, and Medicare Advantage PPO, effective 11/24/2021. Provider ID, 8QP154, tied to TIN ending in 3542.  Noemi Diaz is your provider representative, I have copied her on the email.  Please include your TIN on all correspondence.  Thank you,  Connie Traylor Network Management Consultant Blue Cross and Blue Shield of Texas Lubbock, Texas 79424 Ph: 806-798-6317', NULL, NULL, '2021-12-21 10:15:47', '2021-12-21 10:15:47'),
(52481, 10057, 43694, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : connie_traylor@bcbstx.com & Noemi_Diaz@bcbstx.com  Sub : Nubia Benavides, APN  Hello Connie,  Thank you so much for your prompt response. I really appreciate your kind assistance.  Have a lovely day!  Regards,', NULL, NULL, '2021-12-28 11:41:57', '2021-12-28 11:41:57'),
(52482, 19067, 43694, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: connie_traylor@bcbstx.com  Subject: Re: Nubia Benavides, APN   Greetings!  Can you please provide us with the welcome letter?   Thanks, Hammad Ahmed.', NULL, NULL, '2022-01-10 13:34:40', '2022-01-10 13:34:40'),
(52483, 20067, 43694, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: Noemi_Diaz@bcbstx.com  Sub: Fwd: Nubia Benavides, APN   Good afternoon,  Please see the attached letters that were sent via email on 11.23.21.  All the Best,   Noemi Diaz Network Management Consultant | Network Management - West Region  Blue Cross and Blue Shield of Texas phone (210) 558-5149  email Noemi_Diaz@bcbstx.com  ', NULL, NULL, '2022-01-18 12:15:42', '2022-01-18 12:15:42'),
(52484, 20067, 43694, NULL, '2022-02-04 00:00:00.000', 'Approved', 'Effective Date: 11/24/2021  See the attachment of provider directory.', NULL, NULL, '2022-01-28 17:38:03', '2022-01-28 17:38:03'),
(52485, 10057, 43695, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:35:46', '2021-10-29 09:35:46'),
(52486, 10057, 43695, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349776  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date. ', NULL, NULL, '2021-10-29 13:21:14', '2021-10-29 13:21:14'),
(52487, 10057, 43695, NULL, '2021-11-09 00:00:00.000', 'Initiated', 'New Application - 350223', NULL, NULL, '2021-11-02 10:23:29', '2021-11-02 10:23:29'),
(52488, 10057, 43695, NULL, '2021-11-22 00:00:00.000', 'Approved', 'Email Received From : txintaketeampiermailbox@bcbstx.com  Sub : BCBSTX New Provider Information  Group Name : VALLEY MED URGENT CARE PLLC Group Record Id : H000Q9Z701  Provider Name : EDNA D MICHI Provider Record Number : H08QN14501 Specialty : Physician Assistant  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	11/16/2021 HMO - Blue Essentials	11/16/2021 BCA - BlueChoice PPO	11/16/2021 HME - Health Select	11/16/2021 PMC - Medicare Advantage PPO	11/16/2021 ', NULL, NULL, '2021-11-15 11:18:27', '2021-11-15 11:18:27'),
(52489, 10057, 43696, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:35:56', '2021-10-29 09:35:56'),
(52490, 10057, 43696, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349776  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date. ', NULL, NULL, '2021-10-29 13:20:57', '2021-10-29 13:20:57'),
(52491, 10057, 43696, NULL, '2021-11-09 00:00:00.000', 'Initiated', 'New Application - 350223', NULL, NULL, '2021-11-02 10:23:19', '2021-11-02 10:23:19'),
(52492, 10057, 43696, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Hello,  Can I get the latest update on the below mentioned providers for 02 locations.  Group Name	Valley Med Urgent Care PLLC (Two locations) Tax ID	81-5123542 Group NPI	1518404631 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name	NPI Juan Hernandez	1225617558 Edna Michi	1992293906  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 11:28:05', '2021-11-30 11:28:05'),
(52493, 10057, 43696, NULL, '2021-12-16 00:00:00.000', 'In Process', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Good afternoon,  Juan Hernandez does have the 2 locations listed for him.  I sent a request to our provider relations area to get those added to Edna Michi as well.  Thank you,  All the Best,  Noemi Diaz Network Management Consultant | Network Management - West Region Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-12-06 16:27:11', '2021-12-06 16:27:11'),
(52494, 10057, 43696, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Greetings!  Thank you for your response. I just want to follow-up on location addition requests, is there any update on that ?  Please let me know, once you get a chance.  Kind Regards,', NULL, NULL, '2021-12-16 10:51:12', '2021-12-16 10:51:12'),
(52495, 10057, 43696, NULL, '2021-12-23 00:00:00.000', 'Approved', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Good morning,  The satellite locations have been added to Edna Michi, PA.', NULL, NULL, '2021-12-16 13:45:43', '2021-12-16 13:45:43'),
(52496, 10057, 43697, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 09:36:06', '2021-10-29 09:36:06'),
(52497, 10057, 43697, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Request Initiated: Application ID: 349776  Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date. ', NULL, NULL, '2021-10-29 13:20:40', '2021-10-29 13:20:40'),
(52498, 10057, 43697, NULL, '2021-11-09 00:00:00.000', 'Initiated', 'New Application : 350223', NULL, NULL, '2021-11-02 10:22:29', '2021-11-02 10:22:29'),
(52499, 10057, 43697, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Hello,  Can I get the latest update on the below mentioned providers for 02 locations.  Group Name	Valley Med Urgent Care PLLC (Two locations) Tax ID	81-5123542 Group NPI	1518404631 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name	NPI Juan Hernandez	1225617558 Edna Michi	1992293906  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 11:27:58', '2021-11-30 11:27:58'),
(52500, 10057, 43697, NULL, '2021-12-16 00:00:00.000', 'In Process', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Good afternoon,  Juan Hernandez does have the 2 locations listed for him.  I sent a request to our provider relations area to get those added to Edna Michi as well.  Thank you,  All the Best,  Noemi Diaz Network Management Consultant | Network Management - West Region Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-12-06 16:27:02', '2021-12-06 16:27:02'),
(52501, 10057, 43697, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email Sent To : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Greetings!  Thank you for your response. I just want to follow-up on location addition requests, is there any update on that ?  Please let me know, once you get a chance.  Kind Regards,', NULL, NULL, '2021-12-16 10:51:04', '2021-12-16 10:51:04'),
(52502, 10057, 43697, NULL, '2021-12-23 00:00:00.000', 'Approved', 'Email Received From : Noemi_Diaz@bcbstx.com  Sub : Enrollment Status || VMUC || Edna Michi & Juan Hernandez || BCBS  Good morning,  The satellite locations have been added to Edna Michi, PA.', NULL, NULL, '2021-12-16 13:47:34', '2021-12-16 13:47:34'),
(52503, 11056, 43698, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 12:49:50', '2021-10-29 12:49:50'),
(52504, 11056, 43698, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'View Summary Thank you for completing the BCBSIL enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date. Application ID: 349737', NULL, NULL, '2021-10-29 12:50:33', '2021-10-29 12:50:33'),
(52505, 11056, 43698, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Corrected 1  View Summary Thank you for completing the BCBSTX enrollment. We will notify you once your application has been processed. If you requested to be contracted, please note that your claims may pay out of network for services rendered until your contracts have been accepted, the credentialing process has been completed, and you receive an effective date. Application ID: 349775', NULL, NULL, '2021-10-29 13:20:48', '2021-10-29 13:20:48'),
(52506, 11056, 43698, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from: txintaketeampiermailbox@bcbstx.com  Sub : BCBS of Texas Provider On-boarding Request Form Received : Case Number - 03063270  AHMED TALHA,  Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your request, case number 03063270, for COASTAL BEND URGENT CARE LLC.  Your request may take up to 60-90 days to process. Once completed, a notification will be sent to the email address you provided during your submission.  To check the status of your case, please click on status checker or for any questions, please contact 1-877-229-0719.   Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-11-08 16:27:20', '2021-11-08 16:27:20'),
(52507, 11056, 43698, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Case no. :  03063270 Please see the attachment.', NULL, NULL, '2021-11-16 14:05:14', '2021-11-16 14:05:14'),
(52508, 11056, 43698, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to:  provider_relations_south_texas@bcbstx.com  Sub:   BCBS of Texas Provider Onboarding Request Form Received: Case Number - 03063270  Good afternoon!  Hope all is well with you. Please provide me the latest updates on Case no.:03063270 &  Application ID: 349775 of the provider, Letica Aleman-Listenbee regarding credentialing and enrollment processing with BCBS.  Eagerly, waiting for the updates.  Thank you!', NULL, NULL, '2021-11-24 13:41:19', '2021-11-24 13:41:19'),
(52509, 11056, 43698, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Case no. : 03063270  In progress. Please see the attachment.', NULL, NULL, '2021-12-03 15:54:54', '2021-12-03 15:54:54'),
(52510, 11056, 43698, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Please see the attachment.', NULL, NULL, '2021-12-14 14:46:59', '2021-12-14 14:46:59'),
(52511, 11056, 43698, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Please see the attachment.', NULL, NULL, '2021-12-14 14:47:08', '2021-12-14 14:47:08'),
(52512, 11056, 43698, NULL, '2021-12-27 00:00:00.000', 'In Process', 'REp: Geraldi   Provider ID: 8QN604   Status: Credentialing is still is in process. Welcome letter may be expected in first week of jan  REFCODE: Geraldi12202021', NULL, NULL, '2021-12-20 13:17:21', '2021-12-20 13:17:21'),
(52513, 11056, 43698, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Case no. : 03063270  In progress. Please see the attachment.', NULL, NULL, '2021-12-22 10:44:41', '2021-12-22 10:44:41'),
(52514, 19067, 43698, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Case no. : 03063270  In progress. Please see the attachment.', NULL, NULL, '2021-12-28 17:11:56', '2021-12-28 17:11:56'),
(52515, 19067, 43698, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: provider_relations_south_texas@bcbstx.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || BCBS TX ||  Good Morning!  Hope you are having a productive day.  I would like to know the enrollment status of the following Provider and Group.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	504A Houston Street, Live Oak County, George West, TX 78022-3663 Leticia Aleman-Listenbee	1154999654	301 S Hillside, DR STE 4, Beeville, TX 78102-5324   Kindly respond promptly.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 12:57:00', '2022-01-04 12:57:00'),
(52516, 19067, 43698, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: txintaketeampiermailbox@bcbstx.com  Subject: BCBS of Texas Inquiry Received: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || BCBS TX || : Case Number - 03307181   Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your inquiry, case number is 03307181.  We will respond to your inquiry in the order it was received.To check the status of your case, please click on status checker.    Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2022-01-05 16:26:49', '2022-01-05 16:26:49'),
(52517, 19067, 43698, NULL, '2022-01-19 00:00:00.000', 'In Process', 'In Progress, check the attachment.', NULL, NULL, '2022-01-12 13:31:44', '2022-01-12 13:31:44'),
(52518, 19067, 43698, NULL, '2022-02-02 00:00:00.000', 'Approved', 'See attachment of provider directory as a reference.', NULL, NULL, '2022-01-26 09:51:43', '2022-01-26 09:51:43'),
(52519, 11056, 43699, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:01:58', '2021-10-29 14:01:58'),
(52520, 11056, 43699, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'View Summary  Thank you for completing the BCBSTX enrollment. We will notify you once your application has beenprocessed. If you requested to be contracted, please note that your claims may pay out of network forservices rendered until your contracts have been accepted, the credentialing process has been completed,and you receive an effective date. Application ID: 349759', NULL, NULL, '2021-10-29 14:03:17', '2021-10-29 14:03:17'),
(52521, 11056, 43699, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : txintaketeampiermailbox@bcbstx.com  Sub : BCBS of Texas Provider On-boarding Request Form Received : Case Number - 03063690  AHMED TALHA,  Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your request, case number 03063690, for STATCARE MINOR EMERGENCY CLINIC.  Your request may take up to 60-90 days to process. Once completed, a notification will be sent to the email address you provided during your submission.  To check the status of your case, please click on status checker or for any questions, please contact 1-877-229-0719.   Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-11-08 16:29:21', '2021-11-08 16:29:21'),
(52522, 11056, 43699, NULL, '2021-11-23 00:00:00.000', 'In Process', '	 Case no. : 03063690  In progress. Please see the attachment', NULL, NULL, '2021-11-16 13:59:34', '2021-11-16 13:59:34'),
(52523, 11056, 43699, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-29 17:20:11', '2021-11-29 17:20:11'),
(52524, 19067, 43699, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Called BCBS TX as there was no one to talk to so I\'ve left a voicemail. The automated said they will respond within 3 business days. ', NULL, NULL, '2021-12-07 17:27:25', '2021-12-07 17:27:25'),
(52525, 11056, 43699, NULL, '2021-12-20 00:00:00.000', 'Approved', '	 Email received from: txintaketeampiermailbox@bcbstx.com & Connie_Traylor@bcbstx.com  Sub: BCBSTX New Provider Information   Group Name : STATCARE MINOR EMERGENCY CLINIC Group Record Id : H00084YJ01  Provider Name : ELSA C PEARCE Provider Record Number : H08QN60101 Specialty : Physician Assistant  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	11/24/2021 BCA - BlueChoice PPO	11/24/2021 HMO - Blue Essentials	11/24/2021 HME - Health Select	11/24/2021 PMC - Medicare Advantage PPO	11/24/2021  Please see the attachments.', NULL, NULL, '2021-12-13 11:40:14', '2021-12-13 11:40:14'),
(52526, 11056, 43700, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:02:10', '2021-10-29 14:02:10'),
(52527, 11056, 43700, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'View Summary  Thank you for completing the BCBSTX enrollment. We will notify you once your application has beenprocessed. If you requested to be contracted, please note that your claims may pay out of network forservices rendered until your contracts have been accepted, the credentialing process has been completed,and you receive an effective date. Application ID: 349759', NULL, NULL, '2021-10-29 14:03:36', '2021-10-29 14:03:36'),
(52528, 11056, 43700, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : txintaketeampiermailbox@bcbstx.com  Sub : BCBS of Texas Provider On-boarding Request Form Received : Case Number - 03063690  AHMED TALHA,  Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your request, case number 03063690, for STATCARE MINOR EMERGENCY CLINIC.  Your request may take up to 60-90 days to process. Once completed, a notification will be sent to the email address you provided during your submission.  To check the status of your case, please click on status checker or for any questions, please contact 1-877-229-0719.   Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-11-08 16:29:14', '2021-11-08 16:29:14'),
(52529, 11056, 43700, NULL, '2021-11-23 00:00:00.000', 'In Process', '	 Case no. : 03063690  In progress. Please see the attachment', NULL, NULL, '2021-11-16 13:58:58', '2021-11-16 13:58:58'),
(52530, 11056, 43700, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-29 17:19:15', '2021-11-29 17:19:15'),
(52531, 19067, 43700, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Called BCBS TX as there was no one to talk to so I\'ve left a voicemail. The automated said they will respond within 3 business days. ', NULL, NULL, '2021-12-07 17:27:17', '2021-12-07 17:27:17'),
(52532, 11056, 43700, NULL, '2021-12-20 00:00:00.000', 'Approved', '	 Email received from: txintaketeampiermailbox@bcbstx.com & Connie_Traylor@bcbstx.com  Sub: BCBSTX New Provider Information   Group Name : STATCARE MINOR EMERGENCY CLINIC Group Record Id : H00084YJ01  Provider Name : ELSA C PEARCE Provider Record Number : H08QN60101 Specialty : Physician Assistant  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	11/24/2021 BCA - BlueChoice PPO	11/24/2021 HMO - Blue Essentials	11/24/2021 HME - Health Select	11/24/2021 PMC - Medicare Advantage PPO	11/24/2021  Please see the attachments.', NULL, NULL, '2021-12-13 11:40:09', '2021-12-13 11:40:09'),
(52533, 11056, 43701, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:02:18', '2021-10-29 14:02:18'),
(52534, 11056, 43701, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'View Summary  Thank you for completing the BCBSTX enrollment. We will notify you once your application has beenprocessed. If you requested to be contracted, please note that your claims may pay out of network forservices rendered until your contracts have been accepted, the credentialing process has been completed,and you receive an effective date. Application ID: 349759', NULL, NULL, '2021-10-29 14:04:28', '2021-10-29 14:04:28'),
(52535, 11056, 43701, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : txintaketeampiermailbox@bcbstx.com  Sub : BCBS of Texas Provider On-boarding Request Form Received : Case Number - 03063690  AHMED TALHA,  Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your request, case number 03063690, for STATCARE MINOR EMERGENCY CLINIC.  Your request may take up to 60-90 days to process. Once completed, a notification will be sent to the email address you provided during your submission.  To check the status of your case, please click on status checker or for any questions, please contact 1-877-229-0719.   Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-11-08 16:29:07', '2021-11-08 16:29:07'),
(52536, 11056, 43701, NULL, '2021-11-23 00:00:00.000', 'In Process', '	 Case no. : 03063690  In progress. Please see the attachment', NULL, NULL, '2021-11-16 13:58:40', '2021-11-16 13:58:40'),
(52537, 11056, 43701, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-29 17:19:05', '2021-11-29 17:19:05'),
(52538, 19067, 43701, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Called BCBS TX as there was no one to talk to so I\'ve left a voicemail. The automated said they will respond within 3 business days. ', NULL, NULL, '2021-12-07 17:27:09', '2021-12-07 17:27:09'),
(52539, 11056, 43701, NULL, '2021-12-20 00:00:00.000', 'Approved', '	 Email received from: txintaketeampiermailbox@bcbstx.com & Connie_Traylor@bcbstx.com  Sub: BCBSTX New Provider Information   Group Name : STATCARE MINOR EMERGENCY CLINIC Group Record Id : H00084YJ01  Provider Name : ELSA C PEARCE Provider Record Number : H08QN60101 Specialty : Physician Assistant  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	11/24/2021 BCA - BlueChoice PPO	11/24/2021 HMO - Blue Essentials	11/24/2021 HME - Health Select	11/24/2021 PMC - Medicare Advantage PPO	11/24/2021  Please see the attachments.', NULL, NULL, '2021-12-13 11:40:05', '2021-12-13 11:40:05'),
(52540, 11056, 43702, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:02:27', '2021-10-29 14:02:27'),
(52541, 11056, 43702, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'View Summary  Thank you for completing the BCBSTX enrollment. We will notify you once your application has beenprocessed. If you requested to be contracted, please note that your claims may pay out of network forservices rendered until your contracts have been accepted, the credentialing process has been completed,and you receive an effective date. Application ID: 349759', NULL, NULL, '2021-10-29 14:03:01', '2021-10-29 14:03:01'),
(52542, 11056, 43702, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : txintaketeampiermailbox@bcbstx.com  Sub : BCBS of Texas Provider On-boarding Request Form Received : Case Number - 03063690  AHMED TALHA,  Thank you for contacting Blue Cross and Blue Shield of Texas.  This email is confirmation we have received your request, case number 03063690, for STATCARE MINOR EMERGENCY CLINIC.  Your request may take up to 60-90 days to process. Once completed, a notification will be sent to the email address you provided during your submission.  To check the status of your case, please click on status checker or for any questions, please contact 1-877-229-0719.   Sincerely, Blue Cross and Blue Shield of Texas', NULL, NULL, '2021-11-08 16:28:40', '2021-11-08 16:28:40'),
(52543, 11056, 43702, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-16 13:56:10', '2021-11-16 13:56:10'),
(52544, 11056, 43702, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-16 13:56:14', '2021-11-16 13:56:14'),
(52545, 11056, 43702, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-16 13:56:15', '2021-11-16 13:56:15'),
(52546, 11056, 43702, NULL, '2021-12-06 00:00:00.000', 'In Process', 'Case no. : 03063690  In progress. Please see the attachment.', NULL, NULL, '2021-11-29 15:47:01', '2021-11-29 15:47:01'),
(52547, 19067, 43702, NULL, '2021-12-14 00:00:00.000', 'In Process', 'Called BCBS TX as there was no one to talk to so I\'ve left a voicemail. The automated said they will respond within 3 business days. ', NULL, NULL, '2021-12-07 17:27:00', '2021-12-07 17:27:00'),
(52548, 11056, 43702, NULL, '2021-12-20 00:00:00.000', 'Approved', 'Email received from: txintaketeampiermailbox@bcbstx.com & Connie_Traylor@bcbstx.com  Sub: BCBSTX New Provider Information   Group Name : STATCARE MINOR EMERGENCY CLINIC Group Record Id : H00084YJ01  Provider Name : ELSA C PEARCE Provider Record Number : H08QN60101 Specialty : Physician Assistant  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	11/24/2021 BCA - BlueChoice PPO	11/24/2021 HMO - Blue Essentials	11/24/2021 HME - Health Select	11/24/2021 PMC - Medicare Advantage PPO	11/24/2021  Please see the attachments.', NULL, NULL, '2021-12-13 11:39:44', '2021-12-13 11:39:44'),
(52549, 10057, 43703, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:13:51', '2021-10-29 14:13:51'),
(52550, 10057, 43703, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:16:09', '2021-11-01 14:16:09'),
(52551, 10057, 43703, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:48:26', '2021-11-05 09:48:26'),
(52552, 10057, 43703, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:33:34', '2021-11-05 10:33:34'),
(52553, 10057, 43703, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:28', '2021-11-30 14:04:28'),
(52554, 10057, 43703, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:13:41', '2021-12-07 13:13:41'),
(52555, 10057, 43703, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:20:08', '2021-12-14 11:20:08'),
(52556, 10057, 43703, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:43:46', '2021-12-21 10:43:46'),
(52557, 10057, 43703, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:30', '2021-12-29 11:37:30'),
(52558, 20067, 43703, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:37:07', '2022-01-05 14:37:07'),
(52559, 20067, 43703, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:57:23', '2022-01-11 12:57:23'),
(52560, 20067, 43703, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:59:13', '2022-01-11 12:59:13'),
(52561, 20067, 43703, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:41:37', '2022-01-18 12:41:37'),
(52562, 20067, 43703, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:45:15', '2022-01-26 15:45:15'),
(52563, 10057, 43704, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:14:02', '2021-10-29 14:14:02'),
(52564, 10057, 43704, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:16:02', '2021-11-01 14:16:02'),
(52565, 10057, 43704, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:47:58', '2021-11-05 09:47:58'),
(52566, 10057, 43704, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:33:24', '2021-11-05 10:33:24'),
(52567, 10057, 43704, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:23', '2021-11-30 14:04:23'),
(52568, 10057, 43704, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:13:28', '2021-12-07 13:13:28'),
(52569, 10057, 43704, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:20:02', '2021-12-14 11:20:02'),
(52570, 10057, 43704, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:42:12', '2021-12-21 10:42:12'),
(52571, 10057, 43704, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:24', '2021-12-29 11:37:24'),
(52572, 20067, 43704, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:36:39', '2022-01-05 14:36:39'),
(52573, 20067, 43704, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:57:15', '2022-01-11 12:57:15'),
(52574, 20067, 43704, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:59:07', '2022-01-11 12:59:07'),
(52575, 20067, 43704, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:41:46', '2022-01-18 12:41:46'),
(52576, 20067, 43704, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:45:08', '2022-01-26 15:45:08'),
(52577, 10057, 43705, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:14:14', '2021-10-29 14:14:14'),
(52578, 10057, 43705, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:15:56', '2021-11-01 14:15:56'),
(52579, 10057, 43705, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:48:15', '2021-11-05 09:48:15'),
(52580, 10057, 43705, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:33:12', '2021-11-05 10:33:12');
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
(52581, 10057, 43705, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:17', '2021-11-30 14:04:17'),
(52582, 10057, 43705, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:13:13', '2021-12-07 13:13:13'),
(52583, 10057, 43705, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:19:57', '2021-12-14 11:19:57'),
(52584, 10057, 43705, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:42:04', '2021-12-21 10:42:04'),
(52585, 10057, 43705, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:19', '2021-12-29 11:37:19'),
(52586, 20067, 43705, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:36:14', '2022-01-05 14:36:14'),
(52587, 20067, 43705, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:57:06', '2022-01-11 12:57:06'),
(52588, 20067, 43705, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:59:00', '2022-01-11 12:59:00'),
(52589, 20067, 43705, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:41:54', '2022-01-18 12:41:54'),
(52590, 20067, 43705, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:44:59', '2022-01-26 15:44:59'),
(52591, 10057, 43706, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:14:44', '2021-10-29 14:14:44'),
(52592, 10057, 43706, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:15:51', '2021-11-01 14:15:51'),
(52593, 10057, 43706, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:49:27', '2021-11-05 09:49:27'),
(52594, 10057, 43706, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:34:21', '2021-11-05 10:34:21'),
(52595, 10057, 43706, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:11', '2021-11-30 14:04:11'),
(52596, 10057, 43706, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:12:53', '2021-12-07 13:12:53'),
(52597, 10057, 43706, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:19:52', '2021-12-14 11:19:52'),
(52598, 10057, 43706, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:41:57', '2021-12-21 10:41:57'),
(52599, 10057, 43706, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:13', '2021-12-29 11:37:13'),
(52600, 20067, 43706, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:36:02', '2022-01-05 14:36:02'),
(52601, 20067, 43706, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:56:59', '2022-01-11 12:56:59'),
(52602, 20067, 43706, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:58:54', '2022-01-11 12:58:54'),
(52603, 20067, 43706, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:42:01', '2022-01-18 12:42:01'),
(52604, 20067, 43706, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:44:51', '2022-01-26 15:44:51'),
(52605, 10057, 43707, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:15:18', '2021-10-29 14:15:18'),
(52606, 10057, 43707, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:15:44', '2021-11-01 14:15:44'),
(52607, 10057, 43707, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:49:18', '2021-11-05 09:49:18'),
(52608, 10057, 43707, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:34:11', '2021-11-05 10:34:11'),
(52609, 10057, 43707, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:06', '2021-11-30 14:04:06'),
(52610, 10057, 43707, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:12:40', '2021-12-07 13:12:40'),
(52611, 10057, 43707, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:19:47', '2021-12-14 11:19:47'),
(52612, 10057, 43707, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:41:50', '2021-12-21 10:41:50'),
(52613, 10057, 43707, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:07', '2021-12-29 11:37:07'),
(52614, 20067, 43707, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:34:14', '2022-01-05 14:34:14'),
(52615, 20067, 43707, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:56:52', '2022-01-11 12:56:52'),
(52616, 20067, 43707, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:58:48', '2022-01-11 12:58:48'),
(52617, 20067, 43707, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:42:10', '2022-01-18 12:42:10'),
(52618, 20067, 43707, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:44:44', '2022-01-26 15:44:44'),
(52619, 10057, 43708, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:15:28', '2021-10-29 14:15:28'),
(52620, 10057, 43708, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : HumanaHoustonPD@humana.com, jtrenz@humana.com, pcalupaz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Humana. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 14:15:38', '2021-11-01 14:15:38'),
(52621, 10057, 43708, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Both these NPIs are certified with TRICARE East.  Please submit a complete credentialing application packet by email to me for each provider.  Information to include in your packet include:  Incomplete packets cannot be processed.  If possible, please send information for each provider in a separate email.   Thank you, Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-11-05 09:49:09', '2021-11-05 09:49:09'),
(52622, 10057, 43708, NULL, '2021-11-12 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. I want to enroll the below mentioned providers with Humana. Please find the updated attached Roaster.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  If you require any further information please let me know. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-05 10:34:01', '2021-11-05 10:34:01'),
(52623, 10057, 43708, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Can I get the latest updates on below mentioned details.  Looking forward to hearing from you soon.  Thanks & Regards,', NULL, NULL, '2021-11-30 14:04:00', '2021-11-30 14:04:00'),
(52624, 10057, 43708, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com & STXNM@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,  Hope this email finds you well. Please find the attached documents for NUBIA & EDNA MICHI for your reference.  Please let me know if you have any questions or concerns.  Thanks & Regards,', NULL, NULL, '2021-12-07 13:12:21', '2021-12-07 13:12:21'),
(52625, 10057, 43708, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Dear Sir:  Both of these providers are already “certified” with TRICARE East.  If you want to get them “credentialed”, I would need a credentialing application for both of them.  The applications you emailed are certification applications, not credentialing applications.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-14 11:19:40', '2021-12-14 11:19:40'),
(52626, 10057, 43708, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email Received From: jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Also, the names do not match for Nubia Benavides.  Our system shows this NPI for Olivama Benavides. That would need to be corrected before we can proceed with credentialing.  Please also remove the email address for stxnm@humana.com.   It is no longer a valid email address.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 10:41:37', '2021-12-21 10:41:37'),
(52627, 10057, 43708, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Please send me the link for credentialing application.  Regards,', NULL, NULL, '2021-12-29 11:37:02', '2021-12-29 11:37:02'),
(52628, 20067, 43708, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:32:08', '2022-01-05 14:32:08'),
(52629, 20067, 43708, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana |  Good afternoon,     NPI 1992293906 is certified non-network at this time.  A full credentialing packet is need to complete the provider’s profile. This has been communicated to Mr. Steve Albert on 11/1/21, 12/1/21 and 12/7/21.     NPI 1801371935 is certified non-network at this time. Requires credentialing to complete profile.  Email sent to Steve Albert on 12/29/21 with credentialing packet information.     Thank you!  Jacque Trenz  Health System Consultant  Humana Military TRICARE East', NULL, NULL, '2022-01-11 12:56:44', '2022-01-11 12:56:44'),
(52630, 20067, 43708, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Good afternoon, Hope this email finds you well. I would like to enroll in the below-mentioned providers as in-network. Kindly tell me the procedure and also send me the link for the credentialing application.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 12:58:39', '2022-01-11 12:58:39'),
(52631, 20067, 43708, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub: Fwd: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Humana ||  Hello,     Your request was received and is in the queue to be worked.  Please allow 45-60 days for completion of addition requests.   You will receive an email notification once your request has been completed.         Thank you  Network Operations Coordinator – Provider Contracting', NULL, NULL, '2022-01-18 12:42:18', '2022-01-18 12:42:18'),
(52632, 20067, 43708, NULL, '2022-02-02 00:00:00.000', 'Approved', '	 Effective Date: 11/01/2017  Group has an ancillary contract.', NULL, NULL, '2022-01-26 15:44:35', '2022-01-26 15:44:35'),
(52633, 10057, 43709, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:45:21', '2021-10-29 14:45:21'),
(52634, 10057, 43709, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:47:52', '2021-10-29 14:47:52'),
(52635, 10057, 43709, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:09:00', '2021-11-16 11:09:00'),
(52636, 10057, 43709, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good morning,   Thank you for contacting the UnitedHealthcare Network Management Resource Team.   Credentialing for Edna Michi is showing as current and active, however, provider is not linked to TIN 815123542.  There are two ways you can submit your request regarding adding a practitioner to an existing Medical Group Participation Agreement: 	a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Nubia Benavides is currently not credentialed.  You can find complete information on our process and requirements on our Credentialing page: https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp  Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-19 11:34:40', '2021-11-19 11:34:40'),
(52637, 10057, 43709, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:40:03', '2021-11-24 09:40:03'),
(52638, 10057, 43709, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:07:06', '2021-12-03 16:07:06'),
(52639, 10057, 43709, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope you are doing well. Please find the attached form.  Let me know if you need anything else. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 15:07:33', '2021-12-07 15:07:33'),
(52640, 10057, 43709, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:51:30', '2021-12-14 13:51:30'),
(52641, 10057, 43709, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 14:57:11', '2021-12-21 14:57:11'),
(52642, 10057, 43709, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:35', '2021-12-28 15:38:35'),
(52643, 20067, 43709, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:24:11', '2022-01-05 17:24:11'),
(52644, 20067, 43709, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:42', '2022-01-18 14:30:42'),
(52645, 20067, 43709, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:52', '2022-01-31 10:58:52'),
(52646, 20067, 43709, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:37', '2022-02-16 17:49:37'),
(52647, 20067, 43709, NULL, '2022-03-04 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Feb 7, 2022 8:28:58 PM. Your request was assigned reference number PR-6466939 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*  PLEASE DO NOT REPLY TO THIS EMAIL ADDRESS  ', NULL, NULL, '2022-02-25 14:43:03', '2022-02-25 14:43:03'),
(52648, 20067, 43709, NULL, '2022-03-11 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Dec 7, 2021 8:14:59 PM. Your request was assigned reference number PR-6354393 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--* ', NULL, NULL, '2022-03-04 13:19:54', '2022-03-04 13:19:54'),
(52649, 20067, 43709, NULL, '2022-03-24 00:00:00.000', 'Approved', 'Check Status through UHC provider Portal  Provider is Effective From 02/05/2022', NULL, NULL, '2022-03-17 15:40:37', '2022-03-17 15:40:37'),
(52650, 10057, 43710, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:45:37', '2021-10-29 14:45:37'),
(52651, 10057, 43710, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:47:42', '2021-10-29 14:47:42'),
(52652, 10057, 43710, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:08:53', '2021-11-16 11:08:53'),
(52653, 10057, 43710, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good morning,   Thank you for contacting the UnitedHealthcare Network Management Resource Team.   Credentialing for Edna Michi is showing as current and active, however, provider is not linked to TIN 815123542.  There are two ways you can submit your request regarding adding a practitioner to an existing Medical Group Participation Agreement: 	a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Nubia Benavides is currently not credentialed.  You can find complete information on our process and requirements on our Credentialing page: https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp  Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-19 11:34:35', '2021-11-19 11:34:35');
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
(52654, 10057, 43710, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:39:57', '2021-11-24 09:39:57'),
(52655, 10057, 43710, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:07:00', '2021-12-03 16:07:00'),
(52656, 10057, 43710, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope you are doing well. Please find the attached form.  Let me know if you need anything else. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 15:07:24', '2021-12-07 15:07:24'),
(52657, 10057, 43710, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:51:21', '2021-12-14 13:51:21'),
(52658, 10057, 43710, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 14:57:04', '2021-12-21 14:57:04'),
(52659, 10057, 43710, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:30', '2021-12-28 15:38:30'),
(52660, 20067, 43710, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:23:45', '2022-01-05 17:23:45'),
(52661, 20067, 43710, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:36', '2022-01-18 14:30:36'),
(52662, 20067, 43710, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:47', '2022-01-31 10:58:47'),
(52663, 20067, 43710, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:31', '2022-02-16 17:49:31'),
(52664, 20067, 43710, NULL, '2022-03-04 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Feb 7, 2022 8:28:58 PM. Your request was assigned reference number PR-6466939 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*  PLEASE DO NOT REPLY TO THIS EMAIL ADDRESS  ', NULL, NULL, '2022-02-25 14:42:55', '2022-02-25 14:42:55'),
(52665, 20067, 43710, NULL, '2022-03-11 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Dec 7, 2021 8:14:59 PM. Your request was assigned reference number PR-6354393 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--* ', NULL, NULL, '2022-03-04 13:19:46', '2022-03-04 13:19:46'),
(52666, 20067, 43710, NULL, '2022-03-24 00:00:00.000', 'Approved', 'Check Status through UHC provider Portal  Provider is Effective From 02/05/2022', NULL, NULL, '2022-03-17 15:40:21', '2022-03-17 15:40:21'),
(52667, 10057, 43711, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:45:49', '2021-10-29 14:45:49'),
(52668, 10057, 43711, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:47:33', '2021-10-29 14:47:33'),
(52669, 10057, 43711, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:08:48', '2021-11-16 11:08:48'),
(52670, 10057, 43711, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good morning,   Thank you for contacting the UnitedHealthcare Network Management Resource Team.   Credentialing for Edna Michi is showing as current and active, however, provider is not linked to TIN 815123542.  There are two ways you can submit your request regarding adding a practitioner to an existing Medical Group Participation Agreement: 	a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Nubia Benavides is currently not credentialed.  You can find complete information on our process and requirements on our Credentialing page: https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp  Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-19 11:34:28', '2021-11-19 11:34:28'),
(52671, 10057, 43711, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:39:51', '2021-11-24 09:39:51'),
(52672, 10057, 43711, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:06:54', '2021-12-03 16:06:54'),
(52673, 10057, 43711, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope you are doing well. Please find the attached form.  Let me know if you need anything else. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-07 15:06:41', '2021-12-07 15:06:41'),
(52674, 10057, 43711, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:51:10', '2021-12-14 13:51:10'),
(52675, 10057, 43711, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 14:56:56', '2021-12-21 14:56:56'),
(52676, 10057, 43711, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:25', '2021-12-28 15:38:25'),
(52677, 20067, 43711, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:23:25', '2022-01-05 17:23:25'),
(52678, 20067, 43711, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:29', '2022-01-18 14:30:29'),
(52679, 20067, 43711, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:40', '2022-01-31 10:58:40'),
(52680, 20067, 43711, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:24', '2022-02-16 17:49:24'),
(52681, 20067, 43711, NULL, '2022-03-04 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Feb 7, 2022 8:28:58 PM. Your request was assigned reference number PR-6466939 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*  PLEASE DO NOT REPLY TO THIS EMAIL ADDRESS  ', NULL, NULL, '2022-02-25 14:42:45', '2022-02-25 14:42:45'),
(52682, 20067, 43711, NULL, '2022-03-11 00:00:00.000', 'In Process', 'Email received from: united_healthcare_provider_operations@uhc.com  Sub: Secure Message from united_healthcare_provider_operations@uhc.com  Good news! We’ve completed the provider/group updates you requested on Dec 7, 2021 8:14:59 PM. Your request was assigned reference number PR-6354393 .  Please see the attached report for details. For your convenience, your original submission is also attached.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--* ', NULL, NULL, '2022-03-04 13:19:36', '2022-03-04 13:19:36'),
(52683, 20067, 43711, NULL, '2022-03-24 00:00:00.000', 'Approved', 'Check Status through UHC provider Portal  Provider is Effective From 02/05/2022', NULL, NULL, '2022-03-17 15:39:53', '2022-03-17 15:39:53'),
(52684, 11056, 43712, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:47:20', '2021-10-29 14:47:20'),
(52685, 11056, 43712, NULL, '2021-11-05 00:00:00.000', 'Initiated', '	 Email sent to : networkhelp@uhc.com  Sub : Enrollment Query - CBUC & GWMC - UHC  Good afternoon!  Hope this email finds you well. Kindly assist me with the enrollment procedure for the below-mentioned provider with UHC. Please guide me on how to proceed with the credentialing process for the provider with two locations.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654  Please respond to my query at your earliest convenience.  Thank You! Have a wonderful day!', NULL, NULL, '2021-10-29 14:47:43', '2021-10-29 14:47:43'),
(52686, 11056, 43712, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : networkhelp@uhc.com   Sub : Secure Message from estrellita_thomas@uhc.com  Good Morning,     Thank you for contacting the Network Management Resource Team (NMRT) about the UnitedHealthcare credentialing and contracting process for medical health care professionals.     Please follow these steps to request to join our medical networks:     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Confirm you have access to the UnitedHealthcare Provider Portal: Our credentialing/contracting request tool is within our secure Provider Portal, and a One Healthcare ID is required to access the portal. If you don’t currently have access, you’ll need to set up an account.    Submit a request using OnboardPro: Once you have access to the portal, sign in and select the OnboardPro tile. The attached quick reference guide has instructions. For more information or additional assistance, please visit https://www.uhcprovider.com/en/resource-library/link-provider-self-service/onboard-pro.html.    One Healthcare ID assistance  If you need help registering for a One Healthcare ID or have questions about existing access, please contact the UnitedHealthcare Web Support team help desk at 866-842-3278, option 1, 7 a.m.–11 p.m. CT, Monday–Friday.      Questions? We’re here to help   If we can further assist you, respond to this email.      Sincerely,  Estrellita “Nikki” Thomas  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-08 09:49:51', '2021-11-08 09:49:51'),
(52687, 11056, 43712, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Email received from : networkhelp@uhc.com   Sub : Secure Message from estrellita_thomas@uhc.com  Good Morning,     Thank you for contacting the Network Management Resource Team (NMRT) about the UnitedHealthcare credentialing and contracting process for medical health care professionals.     Please follow these steps to request to join our medical networks:     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Confirm you have access to the UnitedHealthcare Provider Portal: Our credentialing/contracting request tool is within our secure Provider Portal, and a One Healthcare ID is required to access the portal. If you don’t currently have access, you’ll need to set up an account.    Submit a request using OnboardPro: Once you have access to the portal, sign in and select the OnboardPro tile. The attached quick reference guide has instructions. For more information or additional assistance, please visit https://www.uhcprovider.com/en/resource-library/link-provider-self-service/onboard-pro.html.    One Healthcare ID assistance  If you need help registering for a One Healthcare ID or have questions about existing access, please contact the UnitedHealthcare Web Support team help desk at 866-842-3278, option 1, 7 a.m.–11 p.m. CT, Monday–Friday.      Questions? We’re here to help   If we can further assist you, respond to this email.      Sincerely,  Estrellita “Nikki” Thomas  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-08 09:50:27', '2021-11-08 09:50:27'),
(52688, 11056, 43712, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Secure Message from estrellita_thomas@uhc.com', NULL, NULL, '2021-11-09 12:23:08', '2021-11-09 12:23:08'),
(52689, 11056, 43712, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub : Secure Message from estrellita_thomas@uhc.com  Good afternoon!  Hope all is well with you. The CAQH has been updated and attested of the provider, Leticia. Kindly escalate the request for credentialing of the provider soon.  Please get back to me soon.  Thank you! Have a great day!', NULL, NULL, '2021-11-16 17:53:25', '2021-11-16 17:53:25'),
(52690, 11056, 43712, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from: networkhelp@uhc.com  Sub:  Secure Message from estrellita_thomas@uhc.com  Good Morning,  There is no escalation process for credentialing. Credentialing is a background check and the delay is not caused by UHC. If the information has been updated and attested our credentialing department will receive the information and move forward with the credentialing.  Please let us know if we can assist further via email.  Thank you, Estrellita “Nikki” Thomas UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-11-24 12:01:53', '2021-11-24 12:01:53'),
(52691, 11056, 43712, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Secure Message from j_mize@uhc.com', NULL, NULL, '2021-11-24 17:22:00', '2021-11-24 17:22:00'),
(52692, 11056, 43712, NULL, '2021-12-17 00:00:00.000', 'In Process', '	 Email sent to: networkhelp@uhc.com  Sub : Secure Message from estrellita_thomas@uhc.com Secure Message from j_mize@uhc.com   Good morning!  Hope all is well with you. Please provide me with the latest updates of the provider, Leticia Aleman-Listenbee.  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a great day!', NULL, NULL, '2021-12-10 17:00:55', '2021-12-10 17:00:55'),
(52693, 19067, 43712, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Query || Leticia Aleman-Listenbee || CBUC & GWMC || UHC ||    Hello,  Hope you\'re having a productive day.  I would like to know the enrollment status of the following provider.  Group Name	Coastal Bend Urgent Care Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County George West, TX 78022-3663  Kindly respond promptly.   Thanks & Regards, Ahmed, Hammad', NULL, NULL, '2021-12-22 16:42:40', '2021-12-22 16:42:40'),
(52694, 19067, 43712, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Query || Leticia Aleman-Listenbee || CBUC & GWMC || UHC ||   Hello, Please find the attachment. Form for Leticia Ann Aleman-Listenbee. I would like to enroll this provider. Thanks & Regards,Ahmed, Hammad', NULL, NULL, '2021-12-22 17:35:07', '2021-12-22 17:35:07'),
(52695, 19067, 43712, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Secure email received from: networkhelp@uhc.com  Subject: The contact information you requested on credentialing and contracting with UnitedHealthcare    Thank you for contacting the Network Management Resource Team. We will be glad to assist you with your inquiry. Leticia Aleman-Listenbee is not credentialed with United Healthcare. I have attached below the information needed to begin this process.  Hello,  Thank you for contacting the UnitedHealthcare Network Management Resource Team about the UnitedHealthcare credentialing and contracting process for medical health care professionals. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.   ·       Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested  ·       Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp  Questions? We’re here to help   If we can further assist you, please respond to this email.    Sincerely,  UnitedHealthcare Network Management Resource Team  *--SecureDelivery--*', NULL, NULL, '2021-12-23 13:32:30', '2021-12-23 13:32:30'),
(52696, 19067, 43712, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Application Submitted through Portal. See Attachment.', NULL, NULL, '2021-12-28 10:10:48', '2021-12-28 10:10:48'),
(52697, 19067, 43712, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Query || CBUC & GWMC || Leticia & Monica || UHC ||    Good Morning!  Hope you are doing really well.  I would like to know the enrollment status of the following Providers with United HealthCare.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Mocia Gonzalez	1871132811	504A Houston Street, Live Oak County, George West, TX 78022-3663 Leticia Aleman-Listenbee	1154999654	504A Houston Street, Live Oak County, George West, TX 78022-3663 Leticia Aleman-Listenbee	1154999654	301 S Hillside DR, STE 4, Beeville, TX 78102-5324  Waiting for your response.  Thanks & Regards, Hammad Ahmed. ', NULL, NULL, '2022-01-04 10:40:56', '2022-01-04 10:40:56'),
(52698, 19067, 43712, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Subject: Enrollment Query CBUC & GWMC Leticia & Monica UHC - [ref:_02646667:ref]   Hello,   Thank you for contacting the UnitedHealthcare Network Management Resource Team. In response to your request, I’m sending you the product roster showing the demographic information, lines of business and effective dates for MONICA GONZALEZ. Leticia Aleman-Listenbee is not in our system. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts. · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   · Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp     Questions? We’re here to help   If we can further assist you, please respond to this email.     Sincerely,  UnitedHealthcare Network Management Resource Team', NULL, NULL, '2022-01-05 13:27:14', '2022-01-05 13:27:14'),
(52699, 19067, 43712, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Application submitted through Portal. See Attachment.', NULL, NULL, '2022-01-05 14:04:30', '2022-01-05 14:04:30'),
(52700, 19067, 43712, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment Query || CBUC & GWMC || Leticia & Monica || UHC ||   Greetings!  Any updates on the following request?   Regards, Hammad Ahmed', NULL, NULL, '2022-01-12 14:49:55', '2022-01-12 14:49:55'),
(52701, 19067, 43712, NULL, '2022-01-20 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Subject: Re Enrollment Query CBUC & GWMC Leticia & Monica UHC - [ref:_02670638:ref]       Subject: The contact information you requested     Hello,     Thank you for contacting the UnitedHealthcare Network Management Resource Team. In response to your request, I’m sending you the product roster showing the demographic information, lines of business and effective dates for the health care professionals requested.    Leticia Aleman-Lisztenbee\'s credentialing was initiated 1/10/22. Please allow 3 weeks for processing.    Thank you', NULL, NULL, '2022-01-13 10:31:30', '2022-01-13 10:31:30'),
(52702, 19067, 43712, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: networkhelpresponse@27s8pfl30fqwgc1t1ivmnoq43eo15cildqeve2dnafevawdimx.5-jldwea4.na123.apex.salesforce.com  Subject: Re: Re Enrollment Query  CBUC & GWMC  Leticia & Monica  UHC - [ref:_02670638:ref]   Greetings!  Any updates on Leticia Aleman-Listenbee\'s credentialing process?  Don\'t hesitate to reach out if you need any document or information.   Regards, Hammad Ahmed.', NULL, NULL, '2022-01-26 13:55:09', '2022-01-26 13:55:09'),
(52703, 19067, 43712, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: natlcred_outreach@uhc.com  Subject: Request for Credentialing Information    Date: 3/15/2022  ATTN: LETICIA ALEMAN-LISTENBEE Email: cbuc@claimsmedinc.com  Provider: LETICIA ALEMAN-LISTENBEE MPIN: 7912501 OPID: sande  Re: URGENT ACTION NEEDED: Additional Information Needed to Complete Your Credentialing Review  Dear LETICIA ALEMAN-LISTENBEE:  Please send us the following required information within 3 days from the date on letter so that we can continue processing your application for credentialing as a UnitedHealthcare provider.  What information is needed?  Copy of your current professional liability insurance binder sheet Other _____________________________________________ Where should the information be sent? Please reply to this email with the required information. If you can’t reply to the email, please send a new email with the required information to natlcred_outreach@uhc.com. Please include this email with your reply to avoid delays in processing.  What if the deadline is missed? If we don’t receive the information by the deadline, your credentialing application will be closed. This means your request to join the UnitedHealthcare network, or to continue as a network provider, will be denied. If you’re already a participating provider, your participation in our network will end.  What happens next? We’ll contact you when we’ve completed our review of your credentialing application. If you haven’t heard from us within 45 days, please email us at Networkhelp@uhc.com. Include the health care professional’s full name, National Provider Identifier (NPI), Tax Identification Number.  Questions? We’re here to help. If you have any questions, please email us at Networkhelp@uhc.com. Include the health care professional’s full name, National Provider Identifier (NPI), Tax Identification Number and brief description of the request. A UnitedHealthcare representative will be in touch with you within two business days from when we receive your request. To learn more about joining the UnitedHealthcare network and about each step in the process, go to UHCprovider.com/join.  Sincerely,  Stephanie Anderson UnitedHealthcare National Credentialing Team _______________________________  Insurance coverage provided by or through UnitedHealthcare Insurance Company, All Savers Insurance Company, Oxford Health Insurance, Inc. or their affiliates. Health Plan coverage provided by UnitedHealthcare of Arizona, Inc., UHC of California DBA UnitedHealthcare of California, UnitedHealthcare Benefits Plan of California, UnitedHealthcare of Colorado, Inc., UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of Oregon, Inc., UnitedHealthcare of Texas, LLC, UnitedHealthcare Benefits of Texas, Inc., UnitedHealthcare of Utah, Inc. and UnitedHealthcare of Washington, Inc. or other affiliates. Oxford HMO products are underwritten by Oxford Health Plans (NJ), Inc. and Oxford Health Plans (CT), Inc. Administrative services provided by United HealthCare Services, Inc., OptumRx, OptumHealth Care Solutions, Inc., Oxford Health Plans LLC or their affiliates. Behavioral health products are provided by U.S. Behavioral Health Plan, California (USBHPC), United Behavioral Health (UBH) or its affiliates.  Doc#: PCA-3-013200-12042018_12182018 © 2018 United HealthCare Services, Inc.', NULL, NULL, '2022-03-15 09:55:40', '2022-03-15 09:55:40'),
(52704, 19067, 43712, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email sent to: natlcred_outreach@uhc.com  Subject: Request for Credentialing Information    Good Morning!  Hope this email finds you well. Attached is the COI for provider, Leticia Ann Aleman-Listenbee as per you requested.  Thanks,', NULL, NULL, '2022-03-15 09:56:22', '2022-03-15 09:56:22'),
(52705, 22077, 43712, NULL, '2022-04-21 00:00:00.000', 'In Process', 'Email sent to: natlcred_outreach@uhc.com  Subject: Re: Request for Credentialing Information  Hi,  Any update on the below-mentioned request?  Looking forward to your kind response. Have a great day!  Thanks & Regards, Alex.', NULL, NULL, '2022-04-14 09:45:01', '2022-04-14 09:45:01'),
(52706, 22077, 43712, NULL, '2022-05-04 00:00:00.000', 'In Process', 'Email sent to: stephanie_m_anderson@uhc.com  Subject: _Request for Credentialing Information  Hi,  Any updates on the previously mentioned request?  I am looking forward to your kind response.  Thanks & Regards.', NULL, NULL, '2022-04-27 10:57:19', '2022-04-27 10:57:19'),
(52707, 11056, 43713, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:48:16', '2021-10-29 14:48:16'),
(52708, 11056, 43713, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email sent to : efry@trpnppo.com & trpndataentry@trpnppo.com  Sub : Enrollment Query - CBUC & GWMC - TRPN  Good afternoon!  Hope this email finds you well. Kindly assist me with the enrollment procedure for the below-mentioned provider with UHC. Please guide me on how to proceed with the credentialing process for the provider with two locations.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654  Please respond to my query at your earliest convenience.  Thank You! Have a wonderful day!', NULL, NULL, '2021-10-29 14:49:33', '2021-10-29 14:49:33'),
(52709, 11056, 43713, NULL, '2021-11-15 00:00:00.000', 'In Process', 'Emai sent to: trpndataentry@trpnppo.com  Sub : Enrollment Query - CBUC & GWMC - TRPN  Good morning!  Hope all is well with you. Please find the attached form of the provider to be credentialed under the Tax I.D of the facility.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654   Kindly, also inform me whenever any documents or information is needed regarding the enrollment process.  Thank you! Have a great day!', NULL, NULL, '2021-11-08 12:00:33', '2021-11-08 12:00:33'),
(52710, 11056, 43713, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email sent to : trpndataentry@trpnppo.com  Sub : Enrollment Query - CBUC & GWMC - TRPN  Good morning!  Hope all is well with you. Any update on the credentialing process of the below-mentioned provider? Have u received the Provider Update form for the provider?  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654   Kindly, also inform me whenever any documents or information is needed regarding the enrollment process.  Thank you! Have a great day!', NULL, NULL, '2021-11-16 18:01:55', '2021-11-16 18:01:55'),
(52711, 11056, 43713, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to:  trpndataentry@trpnppo.com  Sub:  Re: Enrollment Query - CBUC & GWMC - TRPN  Good afternoon!     Hope this email finds you well. I am still waiting to get the latest updates for the provider. Please respond to me at your earliest convenience.     Thank you!', NULL, NULL, '2021-11-24 15:25:29', '2021-11-24 15:25:29'),
(52712, 11056, 43713, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email sent to:  jhorta@trpnppo.com  Sub: RE: Enrollment Query - CBUC & GWMC - TRPN  Good afternoon!     Hope this email finds you well. Please do provide me with the welcome letter for the provider and also list the provider in your directory.     Please get back to me with a welcome letter soon.     Thank you!  Have a wonderful day!', NULL, NULL, '2021-11-30 15:33:03', '2021-11-30 15:33:03'),
(52713, 11056, 43713, NULL, '2021-12-07 00:00:00.000', 'Approved', 'Email received from:  jhorta@trpnppo.com  Sub:  RE: Enrollment Query - CBUC & GWMC - TRPN  Hello,   LETICIA ALEMAN-LISTENBEE is now active in-network, effective 10/29/2021  Per request, the Welcome letter attached  Yes, both locations ……Primary & billing location: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324  Secondary location: 504A Houston Street, George West, TX 78022-3663 have been added as requested  Jorge  Horta TRPN Data Entry Three Rivers Provider Network  Phone: 619-934-9535 Fax: 619-934-9617 6970 O’Bannon Drive Las Vegas, NV 89117  trpndataentry@trpnppo.com www.trpnppo.com TRPNSecure', NULL, NULL, '2021-11-30 17:59:58', '2021-11-30 17:59:58'),
(52714, 10057, 43714, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:48:19', '2021-10-29 14:48:19'),
(52715, 10057, 43714, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:49:37', '2021-10-29 14:49:37');
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
(52716, 10057, 43714, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:08:42', '2021-11-16 11:08:42'),
(52717, 10057, 43714, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from debra_keck@uhc.com  Thank you for contacting the Network Management Resource Team . Credentialing for is reflecting as not credentialed for Nubia Benevides  New credentialing requests will need to be submitted online, either through the online RFP or OnBoard Pro. Onboard Pro is not yet available to all participating medical groups. To find out if the practice\'s TIN is eligible,  go to the Request for Participation (RFP) portal - https://ncc-optum.secure.force.com/rfp , after entering the practiceâ€™s TIN, youâ€™ll either be rerouted to Onboard Pro or the request will be completed through the online RFP.  A One Healthcare ID will be required to access the OnBoard Pro credentialing tool. To register or view a guide, please go to https://www.uhcprovider.com/en/new-user.html. Should the practice need assistance in registering for an Optum/One Healthcare ID or need assistance or status on updating their existing access, please contact the online/LINK help desk at (866)842-3278, option 1.   Please see attachment:', NULL, NULL, '2021-11-19 11:30:39', '2021-11-19 11:30:39'),
(52718, 10057, 43714, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:39:46', '2021-11-24 09:39:46'),
(52719, 10057, 43714, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:06:47', '2021-12-03 16:06:47'),
(52720, 10057, 43714, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Please find the attached form.  Thanks & Regards,', NULL, NULL, '2021-12-07 15:09:59', '2021-12-07 15:09:59'),
(52721, 10057, 43714, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:54:22', '2021-12-14 13:54:22'),
(52722, 10057, 43714, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com   Good morning,   Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded, effective date is 07/13/2021.  Nubia Benavides is currently not credentialed.  A provider must first meet criteria for credentialing before contracting can begin.  You can find complete information on our process and requirements on our Credentialing page:  https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp   Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 13:59:09', '2021-12-21 13:59:09'),
(52723, 10057, 43714, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:20', '2021-12-28 15:38:20'),
(52724, 20067, 43714, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:23:16', '2022-01-05 17:23:16'),
(52725, 20067, 43714, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:16', '2022-01-18 14:30:16'),
(52726, 20067, 43714, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:34', '2022-01-31 10:58:34'),
(52727, 20067, 43714, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:18', '2022-02-16 17:49:18'),
(52728, 20067, 43714, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email received from:  united_healthcare_provider_operations@uhc.com  Sub:  Secure Message from united_healthcare_provider_operations@uhc.com   Weâ€™ve reviewed the provider/group updates you requested on Dec 7, 2021 8:18:38 PM. Your request was assigned reference number PR-6354409.   While we were able to process your request, we werenâ€™t able to make all updates in our system.     Action May Be Needed Please see the attached report for details. Any provider/group updates marked as Incomplete in the Status column will have an explanation in the Comments column.   If comments indicate resubmission or missing information is needed, please resubmit your original request with all indicated information. If your original request covers multiple providers, your resubmission only needs to include the items marked Incomplete.  The original submission is attached for your reference.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*', NULL, NULL, '2022-03-10 15:45:54', '2022-03-10 15:45:54'),
(52729, 20067, 43714, NULL, '2022-03-24 00:00:00.000', 'Approved', 'Check Status through UHC provider Portal  Provider is Effective From 03/07/2022', NULL, NULL, '2022-03-17 15:46:22', '2022-03-17 15:46:22'),
(52730, 10057, 43715, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:48:29', '2021-10-29 14:48:29'),
(52731, 10057, 43715, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:49:29', '2021-10-29 14:49:29'),
(52732, 10057, 43715, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:08:35', '2021-11-16 11:08:35'),
(52733, 10057, 43715, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from debra_keck@uhc.com  Thank you for contacting the Network Management Resource Team . Credentialing for is reflecting as not credentialed for Nubia Benevides  New credentialing requests will need to be submitted online, either through the online RFP or OnBoard Pro. Onboard Pro is not yet available to all participating medical groups. To find out if the practice\'s TIN is eligible,  go to the Request for Participation (RFP) portal - https://ncc-optum.secure.force.com/rfp , after entering the practiceâ€™s TIN, youâ€™ll either be rerouted to Onboard Pro or the request will be completed through the online RFP.  A One Healthcare ID will be required to access the OnBoard Pro credentialing tool. To register or view a guide, please go to https://www.uhcprovider.com/en/new-user.html. Should the practice need assistance in registering for an Optum/One Healthcare ID or need assistance or status on updating their existing access, please contact the online/LINK help desk at (866)842-3278, option 1.   Please see attachment:', NULL, NULL, '2021-11-19 11:30:28', '2021-11-19 11:30:28'),
(52734, 10057, 43715, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:39:41', '2021-11-24 09:39:41'),
(52735, 10057, 43715, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:06:42', '2021-12-03 16:06:42'),
(52736, 10057, 43715, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Please find the attached form.  Thanks & Regards,', NULL, NULL, '2021-12-07 15:09:50', '2021-12-07 15:09:50'),
(52737, 10057, 43715, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:54:16', '2021-12-14 13:54:16'),
(52738, 10057, 43715, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com   Good morning,   Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded, effective date is 07/13/2021.  Nubia Benavides is currently not credentialed.  A provider must first meet criteria for credentialing before contracting can begin.  You can find complete information on our process and requirements on our Credentialing page:  https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp   Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 13:59:04', '2021-12-21 13:59:04'),
(52739, 10057, 43715, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:14', '2021-12-28 15:38:14'),
(52740, 20067, 43715, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:23:05', '2022-01-05 17:23:05'),
(52741, 20067, 43715, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:08', '2022-01-18 14:30:08'),
(52742, 20067, 43715, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:28', '2022-01-31 10:58:28'),
(52743, 20067, 43715, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:11', '2022-02-16 17:49:11'),
(52744, 20067, 43715, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email received from:  united_healthcare_provider_operations@uhc.com  Sub:  Secure Message from united_healthcare_provider_operations@uhc.com   Weâ€™ve reviewed the provider/group updates you requested on Dec 7, 2021 8:18:38 PM. Your request was assigned reference number PR-6354409.   While we were able to process your request, we werenâ€™t able to make all updates in our system.     Action May Be Needed Please see the attached report for details. Any provider/group updates marked as Incomplete in the Status column will have an explanation in the Comments column.   If comments indicate resubmission or missing information is needed, please resubmit your original request with all indicated information. If your original request covers multiple providers, your resubmission only needs to include the items marked Incomplete.  The original submission is attached for your reference.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*', NULL, NULL, '2022-03-10 15:45:48', '2022-03-10 15:45:48'),
(52745, 20067, 43715, NULL, '2022-03-24 00:00:00.000', 'Approved', 'Check Status through UHC provider Portal  Provider is Effective From 03/07/2022', NULL, NULL, '2022-03-17 15:45:37', '2022-03-17 15:45:37'),
(52746, 10057, 43716, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:48:41', '2021-10-29 14:48:41'),
(52747, 10057, 43716, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in UHC for our group under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 14:49:22', '2021-10-29 14:49:22'),
(52748, 10057, 43716, NULL, '2021-11-23 00:00:00.000', 'Initiated', 'Email Sent To : networkhelp@uhc.com  Sub : RE: Secure Message from jennifer_r_bready@uhc.com  Hello,  Hope this email finds you well. Could you please help me out to get the  latest updates on credentialing request for below mentioned providers  under TIN for all three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations)	 Tax ID	81-5123542	  Group NPI	1518404631	 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496	 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248	 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX  78501-1166	  Provider Name		NPI Edna Michi		1992293906 Nubia Benavides		1801371935 Wert, Jeniece K		1659919702  Your earliest response will be highly appreciated.  Thanks & Regards Steve Albert', NULL, NULL, '2021-11-16 11:08:23', '2021-11-16 11:08:23'),
(52749, 10057, 43716, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from debra_keck@uhc.com  Thank you for contacting the Network Management Resource Team . Credentialing for is reflecting as not credentialed for Nubia Benevides  New credentialing requests will need to be submitted online, either through the online RFP or OnBoard Pro. Onboard Pro is not yet available to all participating medical groups. To find out if the practice\'s TIN is eligible,  go to the Request for Participation (RFP) portal - https://ncc-optum.secure.force.com/rfp , after entering the practiceâ€™s TIN, youâ€™ll either be rerouted to Onboard Pro or the request will be completed through the online RFP.  A One Healthcare ID will be required to access the OnBoard Pro credentialing tool. To register or view a guide, please go to https://www.uhcprovider.com/en/new-user.html. Should the practice need assistance in registering for an Optum/One Healthcare ID or need assistance or status on updating their existing access, please contact the online/LINK help desk at (866)842-3278, option 1.   Please see attachment:', NULL, NULL, '2021-11-19 11:30:08', '2021-11-19 11:30:08'),
(52750, 10057, 43716, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub: Secure Message from robin_joplin@uhc.com  Good Afternoon,  Thank you for contacting United HealthCare regarding adding a new practitioner to your existing Medical Group Participation Agreement.   There are two ways you can submit your request:                  a. For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html).  This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).                  b. If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.   You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  Please follow the steps below. I do not see a pending request to add the provider to the Tax ID.  Questions? We’re here to help Please respond to this email if you need further assistance.  Sincerely, UnitedHealthcare Network Management Resource Team  Robin Joplin UnitedHealthcare  Network Management Resource Team (NMRT) ', NULL, NULL, '2021-11-24 09:39:32', '2021-11-24 09:39:32'),
(52751, 10057, 43716, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hello,  Hope this email finds you well. I\'m writing this email to check the status for the below mentioned request.  Please revert back to me as soon as you get a chance.  Thanks & Regards,', NULL, NULL, '2021-12-03 16:06:34', '2021-12-03 16:06:34'),
(52752, 10057, 43716, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Please find the attached form.  Thanks & Regards,', NULL, NULL, '2021-12-07 15:09:42', '2021-12-07 15:09:42'),
(52753, 10057, 43716, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com  Good afternoon,  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry.  We have verified that credentialing for Edna Michi is showing as current and active.  Linkage to TIN 815123542/contract loading is currently in process under reference number PR-6356670, initiated 12/08/2021. Turnaround time for contract loading is 30-45 days.  Additionally, once contracts have been loaded for Edna Michi, this information is now in your LINK/My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1). Please see the attached handout for more information.  Sincerely,  UnitedHealthcare Network Management Resource Team  Jennifer Bready UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-14 13:54:10', '2021-12-14 13:54:10'),
(52754, 10057, 43716, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Received From : networkhelp@uhc.com  Sub : Secure Message from jennifer_r_bready@uhc.com   Good morning,   Jeniece Wert is currently credentialed and linked to TIN 815123542 with contracts loaded, effective date is 07/13/2021.  Nubia Benavides is currently not credentialed.  A provider must first meet criteria for credentialing before contracting can begin.  You can find complete information on our process and requirements on our Credentialing page:  https://www.uhcprovider.com/content/provider/en/resource-library/Join-Our-Network.html?CID=none For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts: https://www.uhcprovider.com/en/resource-library/Join-Our-Network/join-get-started.html  · Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested   Submit your request through the RFP portal at  https://ncc-optum.secure.force.com/rfp   Jennifer Bready UnitedHealthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-12-21 13:58:56', '2021-12-21 13:58:56'),
(52755, 10057, 43716, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : networkhelp@uhc.com & hpdemo@uhc.com  Sub : Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Greetings!  Hope this email finds you in good health. I\'m writing this email to get the latest update on below mentioned providers enrollment status.  Forms were submitted the 1st week of December. Please revert back to me as soon as possible.  Regards,', NULL, NULL, '2021-12-28 15:38:08', '2021-12-28 15:38:08'),
(52756, 20067, 43716, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||   Good afternoon,  Hope you are doing well. I would like to know the enrollment status of the below-mentioned providers. If any provider is enrolled kindly send me their welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:22:53', '2022-01-05 17:22:53'),
(52757, 20067, 43716, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Sub:  Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Good Afternoon!  Hope you are doing great. any update on the previous request?  your Early response will be highly appreciated  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-18 14:30:01', '2022-01-18 14:30:01'),
(52758, 20067, 43716, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email received from: networkhelpresponse@uhc.com  Sub: Re Enrollment Request Valley Med Urgent Care PLLC Providers UHC - [ref:_02679437:ref]  Thank you for contacting Network Help. Nubia Olivama Benavides is currently not credentialed. You can find complete information on our process and requirements on our Credentialing page. For assistance with credentialing and contracting for facilities and other specialty providers, refer to these contacts.     Update CAQH application: Make sure the health care professional’s Council for Affordable Quality Healthcare (CAQH) application is up-to-date and attested    Submit your request through the RFP portal at https://ncc-optum.secure.force.com/rfp    Credentialing for Edna Michi is showing as current and active. However, provider is not currently linked to TIN 815123542. There are two ways you can submit your request:  For faster processing, submit a change request using our Link App called My Practice Profile (https://www.uhcprovider.com/en/demographics-profiles-attestation/link-my-practice-profile.html). This process will enable you to check your status online. If you have further questions regarding this system, please feel free to contact the LINK help desk (866-842-3278, option 1).  If you don’t have access to My Practice Profile, then complete the attached form for each practitioner and send via email to hpdemo@uhc.com.  You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours (please double check spam/junk folder), please resubmit due to technical error. Please do not CC anyone on your request. This can cause an error and it may not be received.  ﻿Sincerely,  UnitedHealthcare Network Management Resource Team  ', NULL, NULL, '2022-01-31 10:58:21', '2022-01-31 10:58:21'),
(52759, 20067, 43716, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: UnitedHealthcare Provider Operations\' via Abdur Rauf Practices  Sub: We Received Your My Practice Profile Request – GL000002165468   Thanks for using My Practice Profile to submit demographic updates to your care provider data. We\'re processing your request. Your request number is GL000002165468  How to Check the Status of Your Updates To access My Practice Profile, sign in to the UnitedHealthcare Provider Portal by clicking on the Sign In button in the top right corner of UHCprovider.com. Next select Practice Management at the top of the dashboard and then My Practice Profile. Click My Practice Profile in the top left corner and choose Transaction Status. Click on GL000002165468 from the list on the main page or type GL000002165468 in the search bar to see the details of your request. Learn More Want to learn more about using My Practice Profile to view, update and attest to the care provider demographic information UnitedHealthcare members see for your organization? Go to UHCprovider.com/mpp for more information, a self-paced user guide and training.  We\'re Here to Help If you have questions about using My Practice Profile, please contact UnitedHealthcare Web Support at ProviderTechSupport@uhc.com or 866-842-3278, option 1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday. For all other questions, please call Provider Services at 877-842-3210. Thank you. ', NULL, NULL, '2022-02-16 17:49:05', '2022-02-16 17:49:05'),
(52760, 20067, 43716, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email received from:  united_healthcare_provider_operations@uhc.com  Sub:  Secure Message from united_healthcare_provider_operations@uhc.com   Weâ€™ve reviewed the provider/group updates you requested on Dec 7, 2021 8:18:38 PM. Your request was assigned reference number PR-6354409.   While we were able to process your request, we werenâ€™t able to make all updates in our system.     Action May Be Needed Please see the attached report for details. Any provider/group updates marked as Incomplete in the Status column will have an explanation in the Comments column.   If comments indicate resubmission or missing information is needed, please resubmit your original request with all indicated information. If your original request covers multiple providers, your resubmission only needs to include the items marked Incomplete.  The original submission is attached for your reference.  If you have questions or need further assistance, please contact your Network Account Manager.  Thank you.  UnitedHealthcare Provider Operations  *--SecureDelivery--*', NULL, NULL, '2022-03-10 15:45:41', '2022-03-10 15:45:41'),
(52761, 22077, 43716, NULL, '2022-04-15 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: 	Re: Enrollment Request || Valley Med Urgent Care PLLC || Providers || UHC ||  Hi,  I would like to get an update on the provider Nubia Olivama Benavides  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935  Thanks', NULL, NULL, '2022-04-08 15:10:18', '2022-04-08 15:10:18'),
(52762, 10057, 43717, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:02', '2021-10-29 14:57:02'),
(52763, 10057, 43717, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:01:29', '2021-10-29 15:01:29'),
(52764, 10057, 43717, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:42:03', '2021-11-16 09:42:03'),
(52765, 10057, 43717, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:45:45', '2021-11-17 10:45:45'),
(52766, 11056, 43718, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:12', '2021-10-29 14:57:12'),
(52767, 11056, 43718, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com>  Sub : Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope this email finds you well. Kindly assist me with the enrollment procedure for the below-mentioned provider with Health Smart . Please guide me on how to proceed with the credentialing process for the provider with two locations.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654  Please respond to my query at your earliest convenience.  Thank You! Have a wonderful day!', NULL, NULL, '2021-10-29 14:58:33', '2021-10-29 14:58:33'),
(52768, 11056, 43718, NULL, '2021-11-15 00:00:00.000', 'Initiated', 'Email received from : mdiprsupport@healthsmart.com  Sub : Enrollment Query - CBUC & GWMC - Health Smart  Hi,  We are returning your application due to the missing information listed below.  * SSN # * Current state license * Current certificate of Insurance * Explain gaps in Work History * Explain gaps in Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Name of Supervising Physician  * Credentialing Application form / State Replica * CAQH is not Updated  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  Thanks. HealthSmart Provider Relations.   Documents have been provided and CAQH has been updated and attested too.', NULL, NULL, '2021-11-08 13:25:38', '2021-11-08 13:25:38'),
(52769, 11056, 43718, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub : Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope all is well with you. Please find the attached CAQH Access form for the provider, Leticia Aleman-Listenbee. The CAQH has been updated and attested. Health smart is authorized to the CAQH application also.  If any corrections or any document is required please let me know.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-17 12:51:40', '2021-11-17 12:51:40'),
(52770, 11056, 43718, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub:  Enrollment Query - CBUC & GWMC - Health Smart  Hi,  We are returning your application due to missing information listed below.  * SSN # * Current state license * Current certificate of Insurance * Explain gaps in Work History * Explain gaps in Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Credentialing Application form / State Replica * CAQH is still not Updated  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  Thanks. HealthSmart Provider Relations.', NULL, NULL, '2021-11-24 10:27:27', '2021-11-24 10:27:27'),
(52771, 11056, 43718, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub:  Enrollment Query - CBUC & GWMC - Health Smart  Good morning!  Hope this email finds you well. I have again attested the CAQH of the provider, Leticia Aleman-Listenbee. Please see the attached Screenshots for your reference, related to the CAQH attestation issue.  If you have some more questions or issues feel free to contact me. I\'ll try my best to figure that out for you.  Thank you! Have a nice day!', NULL, NULL, '2021-12-03 15:43:08', '2021-12-03 15:43:08'),
(52772, 11056, 43718, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Good morning!  Hope this email finds you well. Kindly, provide updates on the credentialing application of the provider, Leticia Aleman-Listenbee.  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, '2021-12-17 15:54:54', '2021-12-17 15:54:54');
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
(52773, 11056, 43718, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Hi,  Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents, should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-12-20 16:50:28', '2021-12-20 16:50:28'),
(52774, 11056, 43718, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope you are having a wonderful day. Any latest updates on the credentialing process of the provider, Leticia Akeman-Listenbee.   If you require any documents or information please let me know.   Thank you! Have a blessed day!', NULL, NULL, '2021-12-22 11:05:17', '2021-12-22 11:05:17'),
(52775, 19067, 43718, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||    Hello!  Hope you\'re doing well.  I would like to know the enrollment status of the following provider and if the provider is enrolled provide us with the Welcome pack.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad', NULL, NULL, '2021-12-30 13:39:33', '2021-12-30 13:39:33'),
(52776, 19067, 43718, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad. ', NULL, NULL, '2022-01-03 09:48:21', '2022-01-03 09:48:21'),
(52777, 19067, 43718, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 09:50:11', '2022-01-03 09:50:11'),
(52778, 19067, 43718, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||    Hi,  Please send the list of providers affected by this update,  Provider Name Provider NPI #  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-03 09:52:53', '2022-01-03 09:52:53'),
(52779, 19067, 43718, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Re: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good Morning!  I hope you enjoyed the holidays and having a great new year!  I would like to know the enrollment status of the following Group.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663  Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811 Leticia Ann Aleman-Listenbee	1154999654 Frank Dehnsich	1952376345 Jennifer Tudor	1720455835    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 10:01:07', '2022-01-03 10:01:07'),
(52780, 19067, 43718, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Katherine D Paterson, NP   02/01/2022   Mercedita Nening Flynn, NP   09/01/2017   Monica D Gonzalez, NP   10/01/2021   Frank Raymond Dehnisch, Jr, MD   09/01/2017   Jennifer Marrie Tudor, NP   09/01/2017    02- Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-05 11:52:05', '2022-01-05 11:52:05'),
(52781, 19067, 43718, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||   Hi,  Provider \"Aleman-Listenbee, Leticia A NP\" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.     Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-06 10:02:24', '2022-01-06 10:02:24'),
(52782, 19067, 43718, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Re: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||  Greetings!  Any updates on mentioned request?  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-12 13:43:29', '2022-01-12 13:43:29'),
(52783, 19067, 43718, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||   Hi,  Provider \"Aleman-Listenbee, Leticia A NP\" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.     Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-26 11:16:26', '2022-01-26 11:16:26'),
(52784, 20067, 43718, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Sub: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good evening!  Hope you had a great weekend. Can you please help me out with the credentialing status of the listed provider under both locations?  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663   Thank you, Syed Ahad.', NULL, NULL, '2022-03-07 17:05:55', '2022-03-07 17:05:55'),
(52785, 22077, 43718, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: 	Re: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||  Hi,  Any updates on the request mentioned previously?  Thanks. ', NULL, NULL, '2022-04-13 14:36:33', '2022-04-13 14:36:33'),
(52786, 19067, 43718, NULL, '2022-04-25 00:00:00.000', 'Approved', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  Provider \"Letecia Aleman-Listenbee, NP\" is effective \"03/01/2022\".  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  (Document ID: 3517835)  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-04-18 15:13:03', '2022-04-18 15:13:03'),
(52787, 10057, 43719, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:19', '2021-10-29 14:57:19'),
(52788, 10057, 43719, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:01:22', '2021-10-29 15:01:22'),
(52789, 10057, 43719, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:41:58', '2021-11-16 09:41:58'),
(52790, 10057, 43719, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:45:20', '2021-11-17 10:45:20'),
(52791, 11056, 43720, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:22', '2021-10-29 14:57:22'),
(52792, 11056, 43720, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com>  Sub : Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope this email finds you well. Kindly assist me with the enrollment procedure for the below-mentioned provider with Health Smart . Please guide me on how to proceed with the credentialing process for the provider with two locations.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Leticia Aleman-Listenbee  1154999654  Please respond to my query at your earliest convenience.  Thank You! Have a wonderful day!', NULL, NULL, '2021-10-29 14:58:18', '2021-10-29 14:58:18'),
(52793, 11056, 43720, NULL, '2021-11-16 00:00:00.000', 'Initiated', 'Email received from : mdiprsupport@healthsmart.com  Sub : Enrollment Query - CBUC & GWMC - Health Smart  Hi,  We are returning your application due to the missing information listed below.  * SSN # * Current state license * Current certificate of Insurance * Explain gaps in Work History * Explain gaps in Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Name of Supervising Physician  * Credentialing Application form / State Replica * CAQH is not Updated  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  Thanks. HealthSmart Provider Relations.   Documents have been provided and CAQH has been updated and attested too.', NULL, NULL, '2021-11-09 12:46:14', '2021-11-09 12:46:14'),
(52794, 11056, 43720, NULL, '2021-11-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub : Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope all is well with you. Please find the attached CAQH Access form for the provider, Leticia Aleman-Listenbee. The CAQH has been updated and attested. Health smart is authorized to the CAQH application also.  If any corrections or any document is required please let me know.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-17 12:51:21', '2021-11-17 12:51:21'),
(52795, 11056, 43720, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub:  Enrollment Query - CBUC & GWMC - Health Smart  Hi,  We are returning your application due to missing information listed below.  * SSN # * Current state license * Current certificate of Insurance * Explain gaps in Work History * Explain gaps in Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Credentialing Application form / State Replica * CAQH is still not Updated  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  Thanks. HealthSmart Provider Relations.', NULL, NULL, '2021-11-24 10:27:04', '2021-11-24 10:27:04'),
(52796, 11056, 43720, NULL, '2021-12-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub:  Enrollment Query - CBUC & GWMC - Health Smart  Good morning!  Hope this email finds you well. I have again attested the CAQH of the provider, Leticia Aleman-Listenbee. Please see the attached Screenshots for your reference, related to the CAQH attestation issue.  If you have some more questions or issues feel free to contact me. I\'ll try my best to figure that out for you.  Thank you! Have a nice day!', NULL, NULL, '2021-12-03 15:42:40', '2021-12-03 15:42:40'),
(52797, 11056, 43720, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Good morning!  Hope this email finds you well. Kindly, provide updates on the credentialing application of the provider, Leticia Aleman-Listenbee.  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, '2021-12-17 15:54:39', '2021-12-17 15:54:39'),
(52798, 11056, 43720, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Hi,  Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents, should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-12-20 16:50:12', '2021-12-20 16:50:12'),
(52799, 11056, 43720, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query - CBUC & GWMC - Health Smart   Good afternoon!  Hope you are having a wonderful day. Any latest updates on the credentialing process of the provider, Leticia Akeman-Listenbee.   If you require any documents or information please let me know.   Thank you! Have a blessed day! ', NULL, NULL, '2021-12-22 11:03:55', '2021-12-22 11:03:55'),
(52800, 19067, 43720, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||    Hello!  Hope you\'re doing well.  I would like to know the enrollment status of the following provider and if the provider is enrolled provide us with the Welcome pack.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad', NULL, NULL, '2021-12-30 13:39:46', '2021-12-30 13:39:46'),
(52801, 19067, 43720, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad. ', NULL, NULL, '2022-01-03 09:48:15', '2022-01-03 09:48:15'),
(52802, 19067, 43720, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||    Hi,  Please send the list of providers affected by this update,  Provider Name Provider NPI #  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-03 09:52:39', '2022-01-03 09:52:39'),
(52803, 19067, 43720, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Re: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good Morning!  I hope you enjoyed the holidays and having a great new year!  I would like to know the enrollment status of the following Group.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663  Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811 Leticia Ann Aleman-Listenbee	1154999654 Frank Dehnsich	1952376345 Jennifer Tudor	1720455835    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 10:01:00', '2022-01-03 10:01:00'),
(52804, 19067, 43720, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Katherine D Paterson, NP   02/01/2022   Mercedita Nening Flynn, NP   09/01/2017   Monica D Gonzalez, NP   10/01/2021   Frank Raymond Dehnisch, Jr, MD   09/01/2017   Jennifer Marrie Tudor, NP   09/01/2017    02- Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-05 11:52:09', '2022-01-05 11:52:09'),
(52805, 19067, 43720, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||   Hi,  Provider \"Aleman-Listenbee, Leticia A NP\" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.     Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-06 10:02:27', '2022-01-06 10:02:27'),
(52806, 19067, 43720, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Re: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||  Greetings!  Any updates on mentioned request?  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-12 13:43:34', '2022-01-12 13:43:34'),
(52807, 19067, 43720, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||   Hi,  Provider \"Aleman-Listenbee, Leticia A NP\" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.     Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-26 11:16:42', '2022-01-26 11:16:42'),
(52808, 20067, 43720, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Sub: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good evening!  Hope you had a great weekend. Can you please help me out with the credentialing status of the listed provider under both locations?  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663   Thank you, Syed Ahad.', NULL, NULL, '2022-03-07 17:05:47', '2022-03-07 17:05:47'),
(52809, 22077, 43720, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: 	Re: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||  Hi,  Any updates on the request mentioned previously?  Thanks. ', NULL, NULL, '2022-04-13 14:36:46', '2022-04-13 14:36:46'),
(52810, 19067, 43720, NULL, '2022-04-25 00:00:00.000', 'Approved', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  Provider \"Letecia Aleman-Listenbee, NP\" is effective \"03/01/2022\".  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com.  (Document ID: 3517835)  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-04-18 15:13:01', '2022-04-18 15:13:01'),
(52811, 10057, 43721, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:32', '2021-10-29 14:57:32'),
(52812, 10057, 43721, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:01:15', '2021-10-29 15:01:15'),
(52813, 10057, 43721, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:41:51', '2021-11-16 09:41:51'),
(52814, 10057, 43721, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:44:43', '2021-11-17 10:44:43'),
(52815, 10057, 43722, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:57:48', '2021-10-29 14:57:48'),
(52816, 10057, 43722, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:01:06', '2021-10-29 15:01:06'),
(52817, 10057, 43722, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:41:46', '2021-11-16 09:41:46'),
(52818, 10057, 43722, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:48:45', '2021-11-17 10:48:45'),
(52819, 10057, 43723, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:58:01', '2021-10-29 14:58:01'),
(52820, 10057, 43723, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:00:59', '2021-10-29 15:00:59'),
(52821, 10057, 43723, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:41:40', '2021-11-16 09:41:40'),
(52822, 10057, 43723, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:49:15', '2021-11-17 10:49:15'),
(52823, 10057, 43724, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 14:58:11', '2021-10-29 14:58:11'),
(52824, 10057, 43724, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : Elizabeth Fry efry@trpnppo.com, trpndataentry@trpnppo.com, ccampos@trpnppo.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in TRPN for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Also, please feel free to revert if you need any other information. Have a great day!  Thanks & Regards, ', NULL, NULL, '2021-10-29 15:00:42', '2021-10-29 15:00:42'),
(52825, 10057, 43724, NULL, '2021-11-23 00:00:00.000', 'In Process', 'Email Sent To : trpndataentry@trpnppo.com, ccampos@trpnppo.com & efry@trpnppo.com  Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Good Morning,  Hope this email finds you well. Please help me out to get the latest enrollment status for below mentioned providers under TIN including all given locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Edna Michi	1992293906 Nubia Benavides	1801371935 Juan Hernandez	1225617558  Your earliest response will be highly appreciated. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-11-16 09:41:33', '2021-11-16 09:41:33'),
(52826, 10057, 43724, NULL, '2021-11-24 00:00:00.000', 'Approved', 'Email Received From : trpndataentry@trpnppo.com  Sub : RE: Enrollment Status || Valley Med Urgent Care PLLC || Providers || TRPN ||  Provider Juan Hernandez is Active, effective date 07/23/2021,  Provider Nubia Benavides is Active, effective date 10/29/2021,  Provider Edna Michi is Active, effective date 10/29/2021,  Carlos Campos  Data Entry Department Supervisor Three Rivers Provider Network 6970 O’Bannon Drive Las Vegas, NV 89117 P: 619.869.8940', NULL, NULL, '2021-11-17 10:52:29', '2021-11-17 10:52:29'),
(52827, 10057, 43725, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:03:58', '2021-10-29 15:03:58'),
(52828, 10057, 43725, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:10:14', '2021-10-29 15:10:14'),
(52829, 10057, 43725, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:30:15', '2021-11-09 11:30:15'),
(52830, 10057, 43725, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:30:56', '2021-11-09 11:30:56'),
(52831, 10057, 43725, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:48:05', '2021-11-30 13:48:05'),
(52832, 10057, 43725, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:47:24', '2021-12-07 11:47:24'),
(52833, 10057, 43725, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:38', '2021-12-16 11:53:38'),
(52834, 10057, 43725, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:58:13', '2021-12-22 10:58:13'),
(52835, 10057, 43725, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:32', '2021-12-29 11:33:32'),
(52836, 20067, 43725, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:20:57', '2022-01-05 14:20:57'),
(52837, 20067, 43725, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:39:42', '2022-01-10 09:39:42'),
(52838, 20067, 43725, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:35:00', '2022-01-18 12:35:00'),
(52839, 20067, 43725, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:45', '2022-02-04 11:54:45'),
(52840, 20067, 43725, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:17:38', '2022-02-16 14:17:38'),
(52841, 10057, 43726, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:04:10', '2021-10-29 15:04:10'),
(52842, 10057, 43726, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:10:08', '2021-10-29 15:10:08'),
(52843, 10057, 43726, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:30:10', '2021-11-09 11:30:10'),
(52844, 10057, 43726, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:30:46', '2021-11-09 11:30:46'),
(52845, 10057, 43726, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:47:59', '2021-11-30 13:47:59'),
(52846, 10057, 43726, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:47:16', '2021-12-07 11:47:16'),
(52847, 10057, 43726, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:32', '2021-12-16 11:53:32'),
(52848, 10057, 43726, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:58:06', '2021-12-22 10:58:06'),
(52849, 10057, 43726, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:27', '2021-12-29 11:33:27'),
(52850, 20067, 43726, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:20:39', '2022-01-05 14:20:39'),
(52851, 20067, 43726, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:39:34', '2022-01-10 09:39:34'),
(52852, 20067, 43726, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:34:47', '2022-01-18 12:34:47'),
(52853, 20067, 43726, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:39', '2022-02-04 11:54:39'),
(52854, 20067, 43726, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:17:24', '2022-02-16 14:17:24'),
(52855, 10057, 43727, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:04:23', '2021-10-29 15:04:23'),
(52856, 10057, 43727, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:10:01', '2021-10-29 15:10:01'),
(52857, 10057, 43727, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:30:03', '2021-11-09 11:30:03'),
(52858, 10057, 43727, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:30:37', '2021-11-09 11:30:37'),
(52859, 10057, 43727, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:47:53', '2021-11-30 13:47:53');
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
(52860, 10057, 43727, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:47:07', '2021-12-07 11:47:07'),
(52861, 10057, 43727, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:27', '2021-12-16 11:53:27'),
(52862, 10057, 43727, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:58:00', '2021-12-22 10:58:00'),
(52863, 10057, 43727, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:22', '2021-12-29 11:33:22'),
(52864, 20067, 43727, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:20:23', '2022-01-05 14:20:23'),
(52865, 20067, 43727, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:39:26', '2022-01-10 09:39:26'),
(52866, 20067, 43727, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:34:41', '2022-01-18 12:34:41'),
(52867, 20067, 43727, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:31', '2022-02-04 11:54:31'),
(52868, 20067, 43727, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:15:58', '2022-02-16 14:15:58'),
(52869, 10057, 43728, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:04:35', '2021-10-29 15:04:35'),
(52870, 10057, 43728, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:09:54', '2021-10-29 15:09:54'),
(52871, 10057, 43728, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:19:06', '2021-11-09 11:19:06'),
(52872, 10057, 43728, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:21:30', '2021-11-09 11:21:30'),
(52873, 10057, 43728, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Fw: Provider Application – Michi  Hi,  We are returning your application due to missing information listed below. The provider application form does not have the tin \'\'81-5123542\'\' on it. Please review the attached Application Review Form and forward the missing information within the next 5 days.  Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-11-12 13:37:33', '2021-11-12 13:37:33'),
(52874, 10057, 43728, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Re: Provider Application – Michi  Greetings!  Thank you for reaching out. Please find the updated Application. Also Ednas CAQH has been updated.  If you require any further details, please let me know. Have a great weekend ahead!  Regards, Steve Albert', NULL, NULL, '2021-11-12 13:42:35', '2021-11-12 13:42:35'),
(52875, 10057, 43728, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:47:46', '2021-11-30 13:47:46'),
(52876, 10057, 43728, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:46:58', '2021-12-07 11:46:58'),
(52877, 10057, 43728, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:21', '2021-12-16 11:53:21'),
(52878, 10057, 43728, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:57:55', '2021-12-22 10:57:55'),
(52879, 10057, 43728, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:17', '2021-12-29 11:33:17'),
(52880, 20067, 43728, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:20:04', '2022-01-05 14:20:04'),
(52881, 20067, 43728, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:39:17', '2022-01-10 09:39:17'),
(52882, 20067, 43728, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:34:35', '2022-01-18 12:34:35'),
(52883, 20067, 43728, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:25', '2022-02-04 11:54:25'),
(52884, 20067, 43728, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:26:02', '2022-02-16 14:26:02'),
(52885, 10057, 43729, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:04:46', '2021-10-29 15:04:46'),
(52886, 10057, 43729, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:09:48', '2021-10-29 15:09:48'),
(52887, 10057, 43729, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:18:35', '2021-11-09 11:18:35'),
(52888, 10057, 43729, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:21:24', '2021-11-09 11:21:24'),
(52889, 10057, 43729, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Fw: Provider Application – Michi  Hi,  We are returning your application due to missing information listed below. The provider application form does not have the tin \'\'81-5123542\'\' on it. Please review the attached Application Review Form and forward the missing information within the next 5 days.  Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-11-12 13:37:27', '2021-11-12 13:37:27'),
(52890, 10057, 43729, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Re: Provider Application – Michi  Greetings!  Thank you for reaching out. Please find the updated Application. Also Ednas CAQH has been updated.  If you require any further details, please let me know. Have a great weekend ahead!  Regards, Steve Albert', NULL, NULL, '2021-11-12 13:42:25', '2021-11-12 13:42:25'),
(52891, 10057, 43729, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:47:39', '2021-11-30 13:47:39'),
(52892, 10057, 43729, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:46:50', '2021-12-07 11:46:50'),
(52893, 10057, 43729, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:16', '2021-12-16 11:53:16'),
(52894, 10057, 43729, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:57:51', '2021-12-22 10:57:51'),
(52895, 10057, 43729, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:11', '2021-12-29 11:33:11'),
(52896, 20067, 43729, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:19:49', '2022-01-05 14:19:49'),
(52897, 20067, 43729, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:39:09', '2022-01-10 09:39:09'),
(52898, 20067, 43729, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:34:29', '2022-01-18 12:34:29'),
(52899, 20067, 43729, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:17', '2022-02-04 11:54:17'),
(52900, 20067, 43729, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:25:46', '2022-02-16 14:25:46'),
(52901, 10057, 43730, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-10-29 15:04:56', '2021-10-29 15:04:56'),
(52902, 10057, 43730, NULL, '2021-11-05 00:00:00.000', 'Initiated', 'Email Sent To : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,  Hope this email finds you well. I wanted to enroll the below mentioned providers in Health Smart for our group under the below locations. Kindly help me out with the procedure.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Please feel free to revert if you need any other information. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 15:09:41', '2021-10-29 15:09:41'),
(52903, 10057, 43730, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email Received From : pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello, Please use the link below and select from the dropdown for your request.  https://www.healthsmart.com/Service-Centers/Provider-Center/Join-Our-Network  Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 11:19:44', '2021-11-09 11:19:44'),
(52904, 10057, 43730, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Service Centers // Provider Center  Thank You For Your Submission  Your form has been submitted! For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.  Please see attachment:', NULL, NULL, '2021-11-09 11:21:11', '2021-11-09 11:21:11'),
(52905, 10057, 43730, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Fw: Provider Application – Michi  Hi,  We are returning your application due to missing information listed below. The provider application form does not have the tin \'\'81-5123542\'\' on it. Please review the attached Application Review Form and forward the missing information within the next 5 days.  Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-11-12 13:37:43', '2021-11-12 13:37:43'),
(52906, 10057, 43730, NULL, '2021-11-19 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Re: Provider Application – Michi  Greetings!  Thank you for reaching out. Please find the updated Application. Also Ednas CAQH has been updated.  If you require any further details, please let me know. Have a great weekend ahead!  Regards, Steve Albert', NULL, NULL, '2021-11-12 13:41:31', '2021-11-12 13:41:31'),
(52907, 10057, 43730, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com & pr.south@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hello,  Can I get the latest updates on the below mentioned request.  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:47:32', '2021-11-30 13:47:32'),
(52908, 10057, 43730, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *     Provider \"MICHI, EDNA D PA\" is currently in the credentialing process.  *     The application for \"Benavides, Nubia O NP\" has been forwarded to credentialing. Please follow up in 30 days for a status.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2021-12-07 11:46:37', '2021-12-07 11:46:37'),
(52909, 10057, 43730, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Thank you for the update. Have a great day!  Regards,', NULL, NULL, '2021-12-16 11:53:07', '2021-12-16 11:53:07'),
(52910, 10057, 43730, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Please check previous comments.  Need to Follow-up in next 15 days.', NULL, NULL, '2021-12-22 10:57:45', '2021-12-22 10:57:45'),
(52911, 10057, 43730, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : mdiprsupport@healthsmart.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Greetings!  Any update on the below request?  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-29 11:33:06', '2021-12-29 11:33:06'),
(52912, 20067, 43730, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Edna Michi	1992293906 Nubia Olivama Benavides	1801371935   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 14:19:31', '2022-01-05 14:19:31'),
(52913, 20067, 43730, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from:  mdiprsupport@healthsmart.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Hi,  Please review the following details.  *  Provider \"Nubia Olivama Benavides, NP\" will be effective on \"02/01/2022\".  *   Provider \"Michi, Edna D PA\" is currently in credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations', NULL, NULL, '2022-01-10 09:38:45', '2022-01-10 09:38:45'),
(52914, 20067, 43730, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com   Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Morning!  Hope all is well with you. Can you provide me with the welcome letter of Provider Nubia Olivama Benavides, and what is the current enrollment status of Provider Edna Michi?  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-18 12:34:21', '2022-01-18 12:34:21'),
(52915, 20067, 43730, NULL, '2022-02-11 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||   Good Morning!  Hope this email finds you in good health. Kindly provide me with the welcome kit for both providers.  Thank you,', NULL, NULL, '2022-02-04 11:54:05', '2022-02-04 11:54:05'),
(52916, 20067, 43730, NULL, '2022-02-23 00:00:00.000', 'Approved', 'Email received from: pr.south@healthsmart.com  Sub: Enrollment Query || Valley Med Urgent Care PLLC || Providers || Health Smart ||  Good Afternoon,                   Please see the attached for Welcome letters for both providers MICHI, EDNA D  & BENAVIDES, NUBIA O.        Valesia Glenn |Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2022-02-16 14:25:32', '2022-02-16 14:25:32'),
(52917, 10057, 44682, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-11-01 13:26:19', '2021-11-01 13:26:19'),
(52918, 10057, 44682, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Tricare. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 13:42:47', '2021-11-01 13:42:47'),
(52919, 10057, 44682, NULL, '2021-12-08 00:00:00.000', 'Initiated', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Hello,  Could you please update me with the process to enroll the following providers under the TIN and locations.  Kindly get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-01 16:29:17', '2021-12-01 16:29:17'),
(52920, 10057, 44682, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Received From : trenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good afternoon, sir.  An email was sent to you on 11/1/21 advising what is needed to credentialing the providers:  I would need the above information sent to me by email on each provider so I can submit to my credentialing team to process.   Thank you, Jacque Trenz', NULL, NULL, '2021-12-08 11:12:46', '2021-12-08 11:12:46'),
(52921, 10057, 44682, NULL, '2021-12-21 00:00:00.000', 'In Process', '	 Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Hello Jacque,  Thank you for reaching out. Please find the attached documents for your reference. Let me know once you get any update.  Regards,', NULL, NULL, '2021-12-14 13:35:12', '2021-12-14 13:35:12'),
(52922, 10057, 44682, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Dear Sir:  The attachments do not have a credentialing application.  The attachments include a “certification” application.  We cannot use a certification application to credential a provider.  Please see the correct form attached above.  You can use either the Texas Standardized Credentialing Application (TSCA) or the Humana Military credentialing application.   Just complete one, NOT both.  The TSCA can also be found on the Texas Dept of Insurance website also.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 13:34:17', '2021-12-21 13:34:17'),
(52923, 10057, 44682, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Thank you for reaching out. Please find the attached forms as requested.  Let me know the update.  Thanks & Regards,', NULL, NULL, '2021-12-29 15:57:42', '2021-12-29 15:57:42'),
(52924, 20067, 44682, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations. If any provider is enrolled kindly send me the welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906 Garcia Homero	1730564857 Wert Jeniece	1659919702 Juan Hernandez	1225617558   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:09:28', '2022-01-05 17:09:28'),
(52925, 20067, 44682, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Morning Jacqueline!  Hope all is well with you. Can you please provide me with the welcome kits for:  Homero Garcia NPI 1730564857 Teresa Saavedra NPI 1255676151  And also, I would like to know the enrollment status of the mentioned providers.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan hernandez	1225617558 jeniece Wert	1659919702 Nubia Olivama Benavides	1801371935 Edna Michi	1992293906  Thanks & regards, Syed Ahad ', NULL, NULL, '2022-01-18 14:09:08', '2022-01-18 14:09:08'),
(52926, 20067, 44682, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Morning Jacqueline!  Hope all is well with you. Can you please provide me with the welcome kits for:  Homero Garcia NPI 1730564857 Teresa Saavedra NPI 1255676151  And also, I would like to know the enrollment status of the mentioned providers.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan hernandez	1225617558 jeniece Wert	1659919702 Nubia Olivama Benavides	1801371935 Edna Michi	1992293906  Thanks & regards, Syed Ahad', NULL, NULL, '2022-01-31 11:07:44', '2022-01-31 11:07:44'),
(52927, 20067, 44682, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good afternoon,     TRICARE does not send Welcome Kits or Letters.     Thank you,  Jacque Trenz  Health System Consultant  Humana Military TRICARE', NULL, NULL, '2022-02-16 17:29:57', '2022-02-16 17:29:57'),
(52928, 20067, 44682, NULL, '2022-03-09 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Evening!  Hope this email finds you in good condition. I would like to know the enrollment status of the below-listed providers.  Group Name	Normandy Urgent Care Center Tax ID	27-0796429 Group NPI	1407171077 Provider Name	NPI	Location Nubia Benavides	1801371935	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Nubia Benavides	1801371935	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Nubia Benavides	1801371935	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Edna Michi	1992293906	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Edna Michi	1992293906	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Edna Michi	1992293906	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Juan Hernandez	1225617558	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Juan Hernandez	1225617558	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Juan Hernandez	1225617558	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Jeniece Wert	1659919702	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Jeniece Wert	1659919702	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Thank you,', NULL, NULL, '2022-03-02 17:05:58', '2022-03-02 17:05:58'),
(52929, 20067, 44682, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Secure Email received from: jtrenz@humana.com   Sub: RE: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare  Good afternoon –     1)  Nubia Benavides  -   There is a discrepancy with this providers’ name in the TRICARE system.  In our system, the name is showing as    Please use the attached form to submit a name update/correction.  Be sure to check the box at the top which states “Update Solo Practitioner Name”.  This needs to be corrected before credentialing can be completed. Please fax completed form to 608-221-7535.     2) Edna Michi – Please complete the 2nd attachment (Provider Roster).  On the first spreadsheet tab, include all information of the three locations.  On the second tab for Professional Info, please complete with all information on the professional provider. This will add the provider to the 3 locations.  Once complete, please email this form to HGBProviderRosters@humana.com.     3)  Juan Hernandez – There is a discrepancy with this providers’ name in the TRICARE system.  In our system, the name is showing as    Please follow the same instructions for the form as with #1, Nubia Benavides.     4)  Jeniece Wert – Provider profile is complete.   101 E Expressway 83, Ste 170, McAllen Texas – Effective date 1/31/2022  800 E Alton Gloor, Brownsville TX – Effective date 1/31/2022.     Thank you,  Jacque Trenz', NULL, NULL, '2022-03-10 15:15:38', '2022-03-10 15:15:38'),
(52930, 20067, 44682, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email sent to: HGBProviderRosters@humana.com  Sub: Provider Roster || Edna Michi || VMUC || Tricare  Good Afternoon!  Attached is the roster for Edna Michi.  Thank you', NULL, NULL, '2022-03-10 15:26:01', '2022-03-10 15:26:01'),
(52931, 20067, 44682, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email received from: HGBProviderRosters@humana.com  Sub: Automatic reply: Provider Roster || Edna Michi || VMUC || Tricare  Thank you for your roster submission!  Roster updates will be processed within 30 days of receipt and status responses that include loaded data and effective dates will be delivered upon completion.  Please note roster updates must include at minimum the following data elements in order for updates to be processed:  Name, NPI or SSN, Gender, Address, Specialty, Location or Practice Name, Phone Number, and Fax Number. Incomplete records will not be processed and will not be viewable on the online provider directory.  The use of Humana Military’s standard roster template is highly encouraged and will result in more efficient processing times.  The use of other formats requires significant manual processing and slower load times.     Humana Military Team', NULL, NULL, '2022-03-10 15:35:22', '2022-03-10 15:35:22'),
(52932, 10057, 44683, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-11-01 13:26:33', '2021-11-01 13:26:33'),
(52933, 10057, 44683, NULL, '2021-11-08 00:00:00.000', 'Initiated', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good Afternoon!  Hope this email finds you well. Please assist me with the enrollment procedure for the below-mentioned providers with Tricare. Also guide me on how to proceed with the credentialing process for the provider with three locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Michi, Edna D	1992293906 Benavides, Nubia Olivama	1801371935  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-11-01 13:42:41', '2021-11-01 13:42:41'),
(52934, 10057, 44683, NULL, '2021-12-08 00:00:00.000', 'Initiated', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Hello,  Could you please update me with the process to enroll the following providers under the TIN and locations.  Kindly get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-01 16:29:11', '2021-12-01 16:29:11'),
(52935, 10057, 44683, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email Received From : trenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good afternoon, sir.  An email was sent to you on 11/1/21 advising what is needed to credentialing the providers:  I would need the above information sent to me by email on each provider so I can submit to my credentialing team to process.   Thank you, Jacque Trenz', NULL, NULL, '2021-12-08 11:12:40', '2021-12-08 11:12:40'),
(52936, 10057, 44683, NULL, '2021-12-21 00:00:00.000', 'In Process', '	 Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Hello Jacque,  Thank you for reaching out. Please find the attached documents for your reference. Let me know once you get any update.  Regards,', NULL, NULL, '2021-12-14 13:35:06', '2021-12-14 13:35:06'),
(52937, 10057, 44683, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email Received From : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Dear Sir:  The attachments do not have a credentialing application.  The attachments include a “certification” application.  We cannot use a certification application to credential a provider.  Please see the correct form attached above.  You can use either the Texas Standardized Credentialing Application (TSCA) or the Humana Military credentialing application.   Just complete one, NOT both.  The TSCA can also be found on the Texas Dept of Insurance website also.  Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-12-21 13:34:09', '2021-12-21 13:34:09'),
(52938, 10057, 44683, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email Sent To : jtrenz@humana.com  Sub : Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Thank you for reaching out. Please find the attached forms as requested.  Let me know the update.  Thanks & Regards,', NULL, NULL, '2021-12-29 15:57:32', '2021-12-29 15:57:32'),
(52939, 20067, 44683, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Subject: Enrollment Query || Valley Med Urgent Care PLLC || Provider || Tricare ||  Good afternoon,  Hope you are doing well. I want to know the enrollment status of the below-mentioned providers under these locations. If any provider is enrolled kindly send me the welcome letter.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Nubia Olivama Benavides	1801371935 Edna Michi	1992293906 Garcia Homero	1730564857 Wert Jeniece	1659919702 Juan Hernandez	1225617558   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-05 17:09:15', '2022-01-05 17:09:15'),
(52940, 20067, 44683, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Morning Jacqueline!  Hope all is well with you. Can you please provide me with the welcome kits for:  Homero Garcia NPI 1730564857 Teresa Saavedra NPI 1255676151  And also, I would like to know the enrollment status of the mentioned providers.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan hernandez	1225617558 jeniece Wert	1659919702 Nubia Olivama Benavides	1801371935 Edna Michi	1992293906  Thanks & regards, Syed Ahad ', NULL, NULL, '2022-01-18 14:09:02', '2022-01-18 14:09:02'),
(52941, 20067, 44683, NULL, '2022-02-07 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Morning Jacqueline!  Hope all is well with you. Can you please provide me with the welcome kits for:  Homero Garcia NPI 1730564857 Teresa Saavedra NPI 1255676151  And also, I would like to know the enrollment status of the mentioned providers.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan hernandez	1225617558 jeniece Wert	1659919702 Nubia Olivama Benavides	1801371935 Edna Michi	1992293906  Thanks & regards, Syed Ahad', NULL, NULL, '2022-01-31 11:07:38', '2022-01-31 11:07:38'),
(52942, 20067, 44683, NULL, '2022-02-23 00:00:00.000', 'In Process', 'Email received from: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good afternoon,     TRICARE does not send Welcome Kits or Letters.     Thank you,  Jacque Trenz  Health System Consultant  Humana Military TRICARE', NULL, NULL, '2022-02-16 17:29:50', '2022-02-16 17:29:50'),
(52943, 20067, 44683, NULL, '2022-03-09 00:00:00.000', 'In Process', 'Email sent to: jtrenz@humana.com  Sub: Re: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare   Good Evening!  Hope this email finds you in good condition. I would like to know the enrollment status of the below-listed providers.  Group Name	Normandy Urgent Care Center Tax ID	27-0796429 Group NPI	1407171077 Provider Name	NPI	Location Nubia Benavides	1801371935	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Nubia Benavides	1801371935	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Nubia Benavides	1801371935	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Edna Michi	1992293906	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Edna Michi	1992293906	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Edna Michi	1992293906	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Juan Hernandez	1225617558	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Juan Hernandez	1225617558	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Juan Hernandez	1225617558	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Jeniece Wert	1659919702	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Jeniece Wert	1659919702	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Thank you,', NULL, NULL, '2022-03-02 17:05:53', '2022-03-02 17:05:53'),
(52944, 20067, 44683, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Secure Email received from: jtrenz@humana.com   Sub: RE: Enrollment Status Query - Valley Med Urgent Care PLLC - Tricare  Good afternoon –     1)  Nubia Benavides  -   There is a discrepancy with this providers’ name in the TRICARE system.  In our system, the name is showing as    Please use the attached form to submit a name update/correction.  Be sure to check the box at the top which states “Update Solo Practitioner Name”.  This needs to be corrected before credentialing can be completed. Please fax completed form to 608-221-7535.     2) Edna Michi – Please complete the 2nd attachment (Provider Roster).  On the first spreadsheet tab, include all information of the three locations.  On the second tab for Professional Info, please complete with all information on the professional provider. This will add the provider to the 3 locations.  Once complete, please email this form to HGBProviderRosters@humana.com.     3)  Juan Hernandez – There is a discrepancy with this providers’ name in the TRICARE system.  In our system, the name is showing as    Please follow the same instructions for the form as with #1, Nubia Benavides.     4)  Jeniece Wert – Provider profile is complete.   101 E Expressway 83, Ste 170, McAllen Texas – Effective date 1/31/2022  800 E Alton Gloor, Brownsville TX – Effective date 1/31/2022.     Thank you,  Jacque Trenz', NULL, NULL, '2022-03-10 15:14:14', '2022-03-10 15:14:14'),
(52945, 20067, 44683, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email sent to: HGBProviderRosters@humana.com  Sub: Provider Roster || Edna Michi || VMUC || Tricare  Good Afternoon!  Attached is the roster for Edna Michi.  Thank you', NULL, NULL, '2022-03-10 15:25:54', '2022-03-10 15:25:54');
