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
(38576, 11056, 29745, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : kavalos@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hello please,     provide providers specialty, phone/fax number effective date you will like.     Thanks;     Karen A  Have provided them with details', NULL, NULL, '2021-11-09 12:15:41', '2021-11-09 12:15:41'),
(38577, 11056, 29745, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon Karen!  Hope this email finds you well. Please find the information below which you have requested.   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 & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548           Ph # : 361-226-1126          fax no. : 361 542-4076 Mercedita Flynn (FNP)	1619166188          Ph # : 361-226-1126          fax no. : 361 542-4076 Monica Gonzalez (FNP)	1871132811          Ph # : 361-226-1126          fax no. : 361 542-4076  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:54:19', '2021-11-24 13:54:19'),
(38578, 11056, 29745, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:32:09', '2021-12-06 15:32:09'),
(38579, 11056, 29745, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub:  Enrollment Query - CBUC & GWMC - Galaxy Health  Enrollment Status Query - Galaxy Health - CBUC/GWMC   Is this eff date is for all of the providers or not? Provide me with welcome letters too.', NULL, NULL, '2021-12-17 14:25:40', '2021-12-17 14:25:40'),
(38580, 11056, 29745, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: Kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Enrollment Query - CBUC & GWMC - Galaxy Health   Good evening Karen!  Hope this email finds you well. Please list the highlighted location under the following provider as soon as possible. And also list all of the providers with both locations on your provider directory. I am unable to find the providers, I only found Mercedita Flynn. I have attached the SS for your concerns.    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 & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548              Unable to find provider on the directory Mercedita Flynn (FNP)	1619166188               Only Primary location is listed Monica Gonzalez (FNP)	1871132811              Unable to find provider on the directory  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-12-23 10:10:29', '2021-12-23 10:10:29'),
(38581, 19067, 29745, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Hello!  Hope you\'re doing well,  I would like to know the enrollment status of the following Providers & Groups with Galaxy Health.   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 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:24:27', '2021-12-30 13:24:27'),
(38582, 19067, 29745, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, kavalos@ghn-mci.com, dmarley@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Greetings!  You haven\'t responded yet.  Still waiting to get the updates about the previously mentioned request.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:28:34', '2022-01-09 22:28:34'),
(38583, 19067, 29745, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Good Morning!  Hope this email finds you well.  This is my SECOND REMINDER on the below mentioned request. Kindly look into this.  Kindly respond as per your convenience.   Regards, Hammad.', NULL, NULL, '2022-01-26 11:10:04', '2022-01-26 11:10:04'),
(38584, 19067, 29745, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email received from: kavalos@ghn-mci.com  Subject: RE: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||    Hello Ahmed;     There is no welcome letters this is not a personal agreement.', NULL, NULL, '2022-02-21 16:26:27', '2022-02-21 16:26:27'),
(38585, 20067, 29745, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Good Afternoon!  Hope you had a great weekend. I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  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 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663  Eagerly waiting to hear from you.  Thank you, ', NULL, NULL, '2022-03-07 16:56:10', '2022-03-07 16:56:10'),
(38586, 22077, 29745, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Hi,  I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Waiting to hear from you soon.  Thanks. Alex', NULL, NULL, '2022-04-13 14:25:57', '2022-04-13 14:25:57'),
(38587, 1006, 29746, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:01', '2021-05-10 15:27:01'),
(38588, 1005, 29746, NULL, '2021-06-15 00:00:00.000', 'On Hold', 'Awaiting Medicaid\'s approval confirmation.', NULL, NULL, '2021-06-07 17:34:32', '2021-06-07 17:34:32'),
(38589, 1006, 29746, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent following enrollment query @ AM.Austin@SuperiorHealthPlan.com & SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: Enrollment Query - CBUC/GWMC -  Superior Health/Ambetter  \"Hello,  I wanted to verify if the following group and providers were enrolled with Superior Healthplan & Ambetter under the mentioned addresses:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Katherine Paterson NPI# 1164776548  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Please get back to me as soon as you\'re able. Thank you. \"', NULL, NULL, '2021-06-09 09:49:38', '2021-06-09 09:49:38'),
(38590, 1006, 29746, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Approval confirmation:  Katherine Paterson: Eff: 06/01/2021  Ref# I57969070 ', NULL, NULL, '2021-06-29 16:42:48', '2021-06-29 16:42:48'),
(38591, 1006, 29747, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:01', '2021-05-10 15:27:01'),
(38592, 1006, 29747, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent provider addition request @ wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hello,  I hope you\'re doing well, we wanted to add the following provider under our group with the mentioned addresses: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264 Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324Secondary Address: 504A Houston Street, George West, TX 78022-3663 Provider Name: Katherine Paterson NPI# 1164776548  Please let me know what is required to proceed with this request, also our group is not showing up on the provider directory with either of the mentioned locations, please update that as well if possible.  Thank you. \"', NULL, NULL, '2021-06-08 15:12:06', '2021-06-08 15:12:06'),
(38593, 1006, 29747, NULL, '2021-07-05 00:00:00.000', 'In Process', 'We received the following response from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hi Brad,  Please see the attached credentialing documents that are required for providers to be added to our network.  Also, please see the screenshot from our directory. I’m not sure how you were searching for the group in our directory but per the credentialing documents, the locations have been listed as Beeville Medical Center and George West Medical Clinic in our directory since January 2021. (By clicking on the “advanced search” option, you can search by the group TIN and pull up all providers associated with that TIN.)  Feel free to contact me with any questions.  Thank you,   Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"  Forms were filled out and sent. Attached in providers task for reference.', NULL, NULL, '2021-06-28 17:12:17', '2021-06-28 17:12:17'),
(38594, 1006, 29747, NULL, '2021-08-05 00:00:00.000', 'In Process', 'We received the following update from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp   \"Hi Brad,  Please see the attached welcome letter and quick reference sheet. Feel free to contact me with any questions.\"  Replied with:  \"Hello DeeDee,   I appreciate the update, can you please let me know what is required to add the provider under our secondary address as well? Also, she is not showing up on the WorkWell provider directory. Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-07-29 12:32:03', '2021-07-29 12:32:03'),
(38595, 1006, 29747, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following reply from wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hi Brad,  In order to get a location added for a provider, we have to receive pages 6-7 of the TSCA with the provider’s practice site information listed.  As for the directory, it typically takes our vendor about three weeks to update the online directory with newly added providers and changes/ updates to provider records (i.e. adding/ removing practice sites, etc.)  Hope this helps!  Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"  Replied with:  \"Hello Dee Dee,   I appreciate the update, would this work out?  Thank you. \"', NULL, NULL, '2021-08-02 16:56:20', '2021-08-02 16:56:20'),
(38596, 1006, 29747, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Received update from wwtxcontracts@texasmutual.com:  \"Good morning,  Yes, those are the correct pages. She should be listed in our directory at both locations within the next few weeks.  Thank you,  Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"', NULL, NULL, '2021-08-03 09:21:56', '2021-08-03 09:21:56'),
(38597, 11056, 29747, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : wwtxcontracts@texasmutual.com  Sub : Enrollment Status Query - CBUC/GWMC - Texas Mutual Workers Comp  Good evening!  Hope all is well. Please inform me whenever the secondary location & provider mentioned below enrolled and listed under the Tax I.D. Please provide me with the latest updates soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  If you require any further information or documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 16:04:45', '2021-08-18 16:04:45'),
(38598, 11056, 29747, NULL, '2021-09-10 00:00:00.000', 'Approved', 'Email received from : wwtxcontracts@texasmutual.com  Sub : Enrollment Status Query - CBUC/GWMC - Texas Mutual Workers Comp  Hi Ahmed,   The provider is listed at both locations in our directory (see below). In the future, please utilize our online directory (https://www.viiad.com/tmi/public/main/Home) to check provider’s network status and practice locations. (The “advanced search” option allows you to search by TIN.)  Eff date is : 08/01/2021  Please see the attachment.', NULL, NULL, '2021-09-03 11:22:25', '2021-09-03 11:22:25'),
(38599, 1006, 29748, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:02', '2021-05-10 15:27:02'),
(38600, 1005, 29748, NULL, '2021-06-15 00:00:00.000', 'On Hold', 'Awaiting Cigna\'s approval.', NULL, NULL, '2021-06-07 17:33:37', '2021-06-07 17:33:37'),
(38601, 1006, 29748, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent enrollment request @ TXMAContracting@cigna.com:  Sub: Network Interest Form - CBUC/GWMC - Cigna Healthspring  \"Hello,   Please find the attached network interest form, do let me know if anything else is required to proceed with this request.  Thank you. \"', NULL, NULL, '2021-07-23 12:51:56', '2021-07-23 12:51:56'),
(38602, 11056, 29748, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : TXMAContracting@cigna.com  Sub :  Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status and the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 13:28:28', '2021-08-18 13:28:28'),
(38603, 11056, 29748, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com &  TXMAContracting@cigna.com  &  txgqproviderrelations@healthspring.com  Sub : Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  Good morning!  Hope you are doing well. Please provide me with the latest updates soon. I want to inquire about the enrollment status and the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 11:13:49', '2021-08-24 11:13:49'),
(38604, 11056, 29748, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com &  TXMAContracting@cigna.com  &  txgqproviderrelations@healthspring.com  Sub : Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  Good morning!  Hope this email finds you well. Please provide me with the latest updates soon. I am still waiting to get enrollment status and about the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know. Eagerly, waiting to hear back from you soon.  Thank you! Have a great week ahead!   Call didn\'t received. Left out the voice mail regarding the enrollment status', NULL, NULL, '2021-09-02 11:19:29', '2021-09-02 11:19:29'),
(38605, 11056, 29748, NULL, '2021-10-01 00:00:00.000', 'Not Eligible', '	 Email received from : lerensa.crain@careallies.com  Sub : Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  George West, Texas and Beeville, Texas are not in the Cigna MA medical plan service area.', NULL, NULL, '2021-09-24 13:07:44', '2021-09-24 13:07:44'),
(38606, 1006, 29749, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:02', '2021-05-10 15:27:02'),
(38607, 1006, 29749, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent following enrollment query @ providerdevelopment@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello,  We submitted an enrollment request last month for our group and wanted to get a status update on it, the group information is as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Please get back to me as soon as you\'re able to. Thank you. \"', NULL, NULL, '2021-06-08 16:15:35', '2021-06-08 16:15:35'),
(38608, 1006, 29749, NULL, '2021-07-02 00:00:00.000', 'In Process', 'The previous email was sent to an incorrect address, sent corrected email @ providerdevelopment@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello,    We submitted an enrollment request last month for our group and wanted to get a status update on it, the group information is as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Please get back to me as soon as you\'re able to.  Thank you.\"  ', NULL, NULL, '2021-06-25 17:05:36', '2021-06-25 17:05:36'),
(38609, 1006, 29749, NULL, '2021-07-21 00:00:00.000', 'In Process', 'Received following notification from email:  \"Your message to providerdevelopment@anci-care.com couldn\'t be delivered. The group providerdevelopment only accepts messages from people in its organization or on its allowed senders list, and your email address isn\'t on the list.\"  Sent corrected email @ ACS VIP Providers vipproviders@anci-care.com.', NULL, NULL, '2021-07-14 14:55:44', '2021-07-14 14:55:44'),
(38610, 1006, 29749, NULL, '2021-08-13 00:00:00.000', 'In Process', 'We received the following update from jmaligaya@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Good Morning,  I show that Coastal Bend Urgent Care, LLC And ACS are currently contracted since 7/20/2017. Records indicate that you are due for credentialing.  Please see the attached Re-credentialing Profile.  Best Regards,  Jennifer Maligaya | Sr. Provider Relations, ACS and MyDecision HealthSmart | Network Solutions Office: 405 241 4811 | Fax: 214 574 1121 Jennifer.maligaya@healthsmart.com | www.HealthSmart.com\"  Replied with:  \"Hello Jennifer,  Please find the attached information, do let me know if you need anything else.  Thank you. \"', NULL, NULL, '2021-08-06 15:12:17', '2021-08-06 15:12:17'),
(38611, 1006, 29749, NULL, '2021-08-23 00:00:00.000', 'In Process', 'Sent f/u email @ Jennifer MaligayaACS jmaligaya@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello Jennifer,  I hope you\'re doing well, I just wanted to check in on the status of enrollment for our group. Can you please get back to me on this?  Thank you.\"', NULL, NULL, '2021-08-16 16:07:33', '2021-08-16 16:07:33'),
(38612, 11056, 29749, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Coastal Bend Urgent Care is already contracted with ACS.     Recredentialing is complete just waiting on the approval meeting on 9/16.     No further action is necessary.  Claims are still being processing for this provider.     Jennifer Maligaya is no longer with ACS/HealthSmart.     Please continue to use VIPproviders@anci-care.com for updates.     New provider agreements please email me:  patti.davidson@healthsmart.com     Thank you,     Patti Davidson | Manager, Network Development  HealthSmart | Network Solutions  Office: 972 388 3091 | Fax: 214 574 1121  patti.davidson@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-08-23 17:10:41', '2021-08-23 17:10:41'),
(38613, 11056, 29749, NULL, '2021-09-11 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Good morning!  Hope all is well. Could you please provide me the enrollment updates,effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-03 14:25:45', '2021-09-03 14:25:45'),
(38614, 11056, 29749, NULL, '2021-09-21 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Good morning!  Hope all is well. Could you please provide me the enrollment updates, effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-14 14:30:01', '2021-09-14 14:30:01'),
(38615, 11056, 29749, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Coastal Bend Urgent Care is already contracted with ACS.  Recredentialing is complete just waiting on the approval meeting on 9/16.  No further action is necessary.  Claims are still being processing for this provider.    Thank you, Patti Davidson | Manager, Network Development HealthSmart | Network Solutions Office: 972 388 3091 | Fax: 214 574 1121 patti.davidson@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-09-27 10:34:18', '2021-09-27 10:34:18'),
(38616, 11056, 29749, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Hi.   The provider below is already contracted.  We are only recredentialing the site.     You will receive the recredentialing approval letter from our credentialing department after 2 weeks.', NULL, NULL, '2021-10-06 14:48:50', '2021-10-06 14:48:50'),
(38617, 11056, 29749, NULL, '2021-10-14 00:00:00.000', 'Approved', 'Ancillary contract has been completed.  There is no need of the providers to be credentialed.', NULL, NULL, '2021-10-07 10:56:17', '2021-10-07 10:56:17'),
(38618, 1006, 29750, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:02', '2021-05-10 15:27:02'),
(38619, 3040, 29750, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: providerservices@triwest.com   Subject:Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Triwest ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Triwest for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-07 13:00:17', '2021-06-07 13:00:17'),
(38620, 11056, 29750, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Triwest ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers with Triwest for our group under the below locations.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548    Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# : 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you! Have a blessed day!', NULL, NULL, '2021-06-24 13:12:08', '2021-06-24 13:12:08'),
(38621, 1006, 29750, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Hello,   I hope you\'re doing well, I wanted to get an update regarding the status of enrollment for our group and providers mentioned in the previous email.   Please get back to me as soon as possible.  Thank you.', NULL, NULL, '2021-07-13 17:28:10', '2021-07-13 17:28:10'),
(38622, 1006, 29750, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Spoke with the representative (Margo Rose, O: (916) 389-6334) ​and she said that the request is in-process and we should send an email to credentialing@triwest.com, sent f/u email.', NULL, NULL, '2021-07-26 16:06:17', '2021-07-26 16:06:17'),
(38623, 1006, 29750, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Sent f/u email @ credentialing@triwest.com:  Sub: Enrollment Status - CBUC/GWMC - Triwest  \"Hello,   We\'re still waiting on an update on this request. Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-08-03 16:13:32', '2021-08-03 16:13:32'),
(38624, 11056, 29750, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : 	credentialing@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening!  Hope this email finds you well. I wanted to get an update regarding the status of enrollment for our group and providers mentioned below:  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 16:15:25', '2021-08-18 16:15:25'),
(38625, 11056, 29750, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : credentialing@triwest.com, providerservices@triwest.com, jmonson@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening!  Hope this email finds you well. I am still waiting to get an update regarding the status of enrollment for our group and providers mentioned below. Please respond to me as soon as possible.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 10:41:33', '2021-08-24 10:41:33'),
(38626, 11056, 29750, NULL, '2021-09-11 00:00:00.000', 'In Process', 'Email sent to : jmonson@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening Jess!  Hope this email finds you well. Thank you so much for the prompt response. Please provide me with the welcome or approval letters for the below mentioned providers and practice as soon as possible.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-03 14:44:27', '2021-09-03 14:44:27'),
(38627, 11056, 29750, NULL, '2021-10-01 00:00:00.000', 'In Process', 'mail received from : mlarsen@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential  Good Morning,  The providers : Paterson, Katherine D  and Flynn, Mercedita N have been added for Aperture review as of 9/5/2021.  This credentialing process may take between 30-90 days and once approved you will receive an approval letter with contracted dates. If you have further questions please reach out to the email listed.   providerdataupdate@triwest.com  Thank you for caring for our nation’s veterans.  Michelle Larsen Provider Services mlarsen@Triwest.com 480-481-5549', NULL, NULL, '2021-09-24 14:52:06', '2021-09-24 14:52:06'),
(38628, 11056, 29750, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email received from : mlarsen@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential  Good Morning,  The providers : Paterson, Katherine D  and Flynn, Mercedita N have been added for Aperture review as of 9/5/2021.  This credentialing process may take between 30-90 days and once approved you will receive an approval letter with contracted dates. If you have further questions please reach out to the email listed.   providerdataupdate@triwest.com  Thank you for caring for our nation’s veterans.  Michelle Larsen Provider Services mlarsen@Triwest.com 480-481-5549', NULL, NULL, '2021-10-06 12:56:36', '2021-10-06 12:56:36'),
(38629, 11056, 29750, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email sent to : providerdataupdate@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good afternoon!  Hope this email finds you well. Please provide me with the latest updates regarding the providers and facility credentialing applications mentioned below under Tax I.D and both locations. And still waiting for the welcome letters for the providers.  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 Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811   If you have any questions or concerns or require any information or documents please let me know. Eagerly, waiting for the response.  Thank you! Have a great weekend!', NULL, NULL, '2021-10-14 15:55:21', '2021-10-14 15:55:21'),
(38630, 11056, 29750, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email received from : ccarroll@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest   TriWest Classification: Confidential   Talha,  I removed Michelle from the email as she is no longer in the same department.   We have both urgent cares loaded at the facility level as of 6/1/20 for CCN.  The providers below have credentialed but are in the process of being loaded.  You will receive the credentialing letter once completed.  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Provider is still in the cred process, pending with Aperture as of 9/5/21.  The credentialing process takes 30-90 days to complete.  Katherine Paterson  1164776548        Cecilia Carroll Direct Contract Manager TriWest Healthcare Alliance  O:  (623) 435-3343 F:  (866) 549-4618 ccarroll@triwest.com www.triwest.com', NULL, NULL, '2021-10-22 12:03:15', '2021-10-22 12:03:15'),
(38631, 11056, 29750, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from: ccarroll@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest   TriWest Classification: Confidential     Talha,     Reminder, Michelle is no longer in this department.      See below status of your urgent care and providers in question.     We have both urgent cares loaded at the facility level as of 6/1/20 for CCN.     The providers below have credentialed but are in the process of being loaded.  You will receive the credentialing letter once completed.  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Provider is still in the cred process, pending with Aperture as of 9/5/21.  The credentialing process takes 30-90 days to complete.  Katherine Paterson  1164776548              Cecilia Carroll  Direct Contract Manager  TriWest Healthcare Alliance  O:  (623) 435-3343  F:  (866) 549-4618  ccarroll@triwest.com  www.triwest.com', NULL, NULL, '2021-11-09 11:14:18', '2021-11-09 11:14:18'),
(38632, 11056, 29750, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from:  sbachman@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential     Julie,  Please process the provider in Pending status and provider the effective dates for all three providers.     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  Katherine Paterson  1164776548  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Sincerely,  Sandra Bachman  Team Lead, Provider Data Ops / TriWest Healthcare Alliance  P: 1 (855) 722-2838  F: (866) 589-7693  www.triwest.com', NULL, NULL, '2021-11-24 13:02:29', '2021-11-24 13:02:29'),
(38633, 11056, 29750, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  	jmiller@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest   Good morning Julie!  Hope this email finds you well. Please respond to this query at your earliest convenience. Provide us with the effective dates and welcome letters for all three providers soon.  Eagerly, waiting for your reply.  Thank you! Have a great day!', NULL, NULL, '2021-12-06 18:02:46', '2021-12-06 18:02:46'),
(38634, 11056, 29750, NULL, '2021-12-21 00:00:00.000', 'Approved', 'Email received from: jmonson@triwest.com & Credentialing@triwest.com & sdevi@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest  Talha,  Coastal Bend Urgent Care LLC, 301 S Hillside Dr, Ste 4 Beeville TX – 78102 and NPI: 1427509264 credentialed as of date 09/27/2019.  The location has been added. Effective 7/26/2021.  Here is the provider information that you have requested  Providers - Effective dates   Patterson – 10.15.21  Flynn – 9.29.21  Gonzalez – 10.5.21  Thank you.  Sailaja Devi Provider Credentialing Specialist TriWest Healthcare Alliance  Ph: (480) 530 4403 Fax: (866) 549-4610 Sdevi@triwest.com www.triwest.com', NULL, NULL, '2021-12-14 15:40:55', '2021-12-14 15:40:55'),
(38635, 1006, 29751, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:02', '2021-05-10 15:27:02'),
(38636, 1005, 29751, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes', NULL, NULL, '2021-06-01 14:20:01', '2021-06-01 14:20:01'),
(38637, 1006, 29762, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:03', '2021-05-10 15:27:03'),
(38638, 3040, 29762, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: providerservices@renaissancefamily.com   Subject:Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Renaissance Physicians ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Renaissance Physicians for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:35:31', '2021-06-07 12:35:31'),
(38639, 1006, 29762, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email to correct email address @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Request - CBUC/GWMC - Renaissance Physician  \"Hello,  I hope you\'re doing well, we want to enroll the following group and providers with Renaissance Physicians, please let me know what is required to complete this request, the information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson  Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-24 16:55:29', '2021-06-24 16:55:29'),
(38640, 1006, 29762, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Request - CBUC/GWMC - Renaissance Physician  \"Hello,   I wanted to get an update regarding the status of our request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:24:35', '2021-07-13 17:24:35'),
(38641, 11056, 29762, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : 	txgqproviderrelations@healthspring.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 13:00:37', '2021-08-18 13:00:37'),
(38642, 11056, 29762, NULL, '2021-09-01 00:00:00.000', 'In Process', 'Email sent to :  txgqproviderrelations@healthspring.com, joann.alanis@careallies.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  Good afternoon!  Hope you are doing well. I am still waiting to get an update regarding the enrollment status of the below mentioned practice and providers since july.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 14:43:54', '2021-08-24 14:43:54'),
(38643, 11056, 29762, NULL, '2021-09-02 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  These providers are not in the renaissance service area. We are only in the greater Houston area.     Thanks  Cresta', NULL, NULL, '2021-08-25 14:21:34', '2021-08-25 14:21:34'),
(38644, 1006, 29763, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:03', '2021-05-10 15:27:03'),
(38645, 1005, 29763, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Awaiting Molina\'s enrollment.', NULL, NULL, '2021-06-07 10:16:02', '2021-06-07 10:16:02'),
(38646, 1006, 29764, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38647, 3040, 29764, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: axhartma@texaschildrens.org   Subject:Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || TCHP ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers TCHP for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-07 12:41:01', '2021-06-07 12:41:01'),
(38648, 1006, 29764, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email @ TCHP CA Contract Admin tchpnetworkmanagement@texaschildrens.org:  Sub: Enrollment Request/Status - CBUC/GWMC - TCHP  \"Hello,   I hope you\'re doing well, we want to enroll the following group and providers with TCHP, please let me know what is required to complete this request, the information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson  Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-24 17:00:56', '2021-06-24 17:00:56'),
(38649, 1006, 29764, NULL, '2021-07-21 00:00:00.000', 'In Process', 'We received the following email from TCHP CA Contract Admin tchpnetworkmanagement@texaschildrens.org:  Sub: Enrollment Request/Status - CBUC/GWMC - TCHP  \"Please submit a letter of interest questionnaire with a w9. The application is on our website www.texaschildrenshealthplan.org *for providers\"  Replied with:  \"Hello,   Please find the attached LOI for our urgent care, do let me know if anything else is required to proceed.   Thank you. \"  The form is attached in group task for reference. ', NULL, NULL, '2021-07-14 12:47:39', '2021-07-14 12:47:39'),
(38650, 1006, 29764, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from jointchp@texaschildrens.org:  Sub: Letter of Interest Questionnaire - CBUC - TCHP  \"Thank you for your interest in our health plan’s network. Your LOI has been received and communication will be sent out to you once the review has been completed.\"', NULL, NULL, '2021-08-03 16:00:39', '2021-08-03 16:00:39'),
(38651, 11056, 29764, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : jointchp@texaschildrens.org  &  tchpnetworkmanagement@texaschildrens.org  Sub : Enrollment Status Query - CBUC/GWMC - TCHP  Good evening!  Hope all is well. I want to inquire about the enrollment status of the below mentioned practice and providers. Have my applications of the below mentioned providers been reviewed or not yet?  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 15:24:39', '2021-08-18 15:24:39');
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
(38652, 11056, 29764, NULL, '2021-09-01 00:00:00.000', 'In Process', 'Email received from : tchpnetworkmanagement@texaschildrens.org  Sub : Enrollment Status Query - CBUC/GWMC - TCHP  Hello,     I was able to find a submission of an LOI (attached) for provider Mercedita Flynn and a denial letter that was sent.  Please see attachments.     Let me know if you have any more questions  -Liz        Self Note  20210802037174969  Mercedita N Flynn', NULL, NULL, '2021-08-24 16:58:17', '2021-08-24 16:58:17'),
(38653, 11056, 29764, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : tchpnetworkmanagement@texaschildrens.org  Sub : Enrollment Status Query - CBUC/GWMC - TCHP   Good morning Liz!  Hope this email finds you well. We have confirmed the NPI of the provider Mercedita Flynn from TMHP & is also attested. Therefore, please consider this application. Please see the attachment below.  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-17 13:12:26', '2021-09-17 13:12:26'),
(38654, 11056, 29764, NULL, '2021-10-05 00:00:00.000', 'In Process', 'Email received from : tchpnetworkmanagement@texaschildrens.org  Sub : Enrollment Status Query - CBUC/GWMC - TCHP  Hello,  Thank you for your interest in our health plan’s network. Your LOI has been received and communication will be sent out to you once the review has been completed.   Thank you  Liz Ramirez Contract Specialist Texas Children’s Health Plan', NULL, NULL, '2021-09-28 09:46:25', '2021-09-28 09:46:25'),
(38655, 11056, 29764, NULL, '2021-10-14 00:00:00.000', 'Not Eligible', 'Email received from : tchpnetworkmanagement@texaschildrens.org & bxgupta@texaschildrens.org  Sub : Enrollment Status Query - CBUC/GWMC - TCHP  Group- Coastal Bend Urgent Care, LLC   Katherine Paterson         1164776548 Please see attached denial letter  20211001038052743     Mercedita Flynn               1619166188 Please see attached denial letter  20210930038036249     Monica Gonzalez             1871132811 Please see attached denial letter  20210930038036263   No TCHP does not work with BEE county. Our apologies.  You can also check yourself on website at texaschildrens.org yourself which county TCHP serves.', NULL, NULL, '2021-10-07 10:37:41', '2021-10-07 10:37:41'),
(38656, 1006, 29765, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38657, 1006, 29765, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent enrollment query @ CHC Contracting CHC.Contracting@communityhealthchoice.org:  Sub: Enrollment Query - CBUC/GWMC - Community Health Choice  \"Hello,  I wanted to verify if the following group and providers were enrolled with Community Health Choice or not? The group and provider information are as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Katherine Paterson NPI# 1164776548  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  I appreciate all the help, please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-08 16:48:07', '2021-06-08 16:48:07'),
(38658, 1006, 29765, NULL, '2021-07-02 00:00:00.000', 'In Process', 'Sent f/u email @ CHC Contracting CHC.Contracting@communityhealthchoice.org:  Sub: Enrollment Query - CBUC/GWMC - Community Health Choice  \"Hello,   I\'m still waiting for an update on this request, please get back to me as soon as possible as we\'re still waiting on this request.  Thank you!\"', NULL, NULL, '2021-06-25 17:13:14', '2021-06-25 17:13:14'),
(38659, 1006, 29765, NULL, '2021-07-21 00:00:00.000', 'Not Eligible', 'Received following rejection email from CHC Contracting CHC.Contracting@communityhealthchoice.org:  Sub: Enrollment Query - CBUC/GWMC - Community Health Choice  \"Good Morning Brad,  Please see attached letter and Service Area Map in reference to Coastal Bend Urgent Care’s application.  Thank you for your time and consideration.   Best Regards, Contracting Dept.\"  The denial letter is attached in the main group task for reference. ', NULL, NULL, '2021-07-14 14:58:49', '2021-07-14 14:58:49'),
(38660, 1006, 29766, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38661, 3040, 29766, NULL, '2021-06-14 00:00:00.000', 'Approved', 'Waiting for Aetna Approval ', NULL, NULL, '2021-06-07 10:43:10', '2021-06-07 10:43:10'),
(38662, 1006, 29767, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38663, 3040, 29767, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: providerservices@memorialhermann.org  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Memorial Hermann ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Memorial Hermann for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:13:46', '2021-06-07 12:13:46'),
(38664, 1006, 29767, NULL, '2021-07-01 00:00:00.000', 'In Process', 'We received the following reply from MH Health Provider Relations ProviderServices@memorialhermann.org:  Sub: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Memorial Hermann ||  \"Good Morning,  You will need to complete the Request for Application form online. You can do that by going here https://healthplan.memorialhermann.org/-/media/memorial-hermann/healthplan/files/providers/health-plan-request-to-participate.ashx?la=en&hash=27F819BE45E95E2EA8789FB1902B4D2F and completing the request to participate form online and forwarding to the email on the form.  Regards, Jo\"  The form is filled out and sent out to them and attached to the main group task for reference.   Sent to MHHP Contracting MHHPContracting@memorialhermann.org:  \"Hello,   Please find the attached network participation form for our group, please let me know if anything else is needed for this request.  Thank you!\"', NULL, NULL, '2021-06-24 16:49:43', '2021-06-24 16:49:43'),
(38665, 1006, 29767, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email @ MHHP Contracting MHHPContracting@memorialhermann.org  MH Health Provider Relations ProviderServices@memorialhermann.org:  Sub; Network Participation Form - CBUC/GWMC - Memorial Hermann  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers. Their information is as follows:  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\'', NULL, NULL, '2021-07-13 17:22:22', '2021-07-13 17:22:22'),
(38666, 1006, 29767, NULL, '2021-08-02 00:00:00.000', 'In Process', 'We received the following response from MHHP Contracting MHHPContracting@memorialhermann.org:  Sub: Memorial Hermann Health Plan Request to Participate  \"We are in receipt of Coastal Bend Urgent Care’s request to become a participating provider with Memorial Hermann Health Plans and need additional information to proceed with your request.  Please provide the following information:  List of services provided ·         Do you provide Virtual Health Services?  Current service area and/or list of locations List of all employed/contracted providers (if applicable) including NPs and PAs (please include individual NPIs) What age population is served? Please list 0-2 years of age; 2-18 years of age; 18+ years Where do you have privileges? Please list all Hospitals, Ambulatory Surgery Centers, etc. Link to website Current W-9 Current quality and outcomes data Any additional information you would like presented to the Network Access and Adequacy Committee   Your participation request will be presented at the next NAAC meeting following receipt of the additional information.\"  Responded to the queries.', NULL, NULL, '2021-07-26 13:19:41', '2021-07-26 13:19:41'),
(38667, 1006, 29767, NULL, '2021-08-23 00:00:00.000', 'Not Eligible', 'We received  the following denial notification from MHHPContracting@memorialhermann.org:  Sub: Memorial Hermann Health Plan Request to Participate  \"At this time, the cities listed below are out of our network area, and we do not contract out of network at this time. I am withdrawing your application for participation. If something changes in the near future, we will let you know. Please let me know if you have any questions.  Thank you. Camilla Paige\" ', NULL, NULL, '2021-08-16 11:04:25', '2021-08-16 11:04:25'),
(38668, 1006, 29769, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38669, 3040, 29769, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: david.balli@molinahealthcare.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Molina Health||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Molina Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:31:32', '2021-06-07 12:31:32'),
(38670, 1006, 29769, NULL, '2021-07-02 00:00:00.000', 'In Process', 'We received the following reply from MHTContractrequest mhtcontractrequest@molinahealthcare.com:  Sub: Attn: Contracting Team - CBUC/GWMC - Molina   \"Good Afternoon Mr. Adil Abbas  I am doing fine, how do are you doing?  I did research for Coastal Bend Urgent Care and it does not show up in our system.  I tried both the Tax id and Group NPI. Please complete this contract request form and return along with a current W-9 to fax number: 877-900-5655 Attn: Contracting Team or email form to: mhtcontractrequest@molinahealthcare.com  Please let me know if you need further information or assistances.  Thank you  David Balli Representative Provider Service  II Molina Healthcare of Texas, Inc. 4316 South McColl Road Edinburg, TX  78539 I Phone: (956) 532-5211 Righ tfax: (877) 900-8454 Email: david.balli@molinahealthcare.com\"  The form was filled out and sent to mhtcontractrequest@molinahealthcare.com, form is attached in the main group task for reference. ', NULL, NULL, '2021-06-25 12:42:54', '2021-06-25 12:42:54'),
(38671, 1006, 29769, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from MHTContractrequest MHTContractrequest@molinahealthcare.com:  Sub: Molina Provider Contract - Coastal Bend Urgent Care, LLC  \"Good Afternoon,  Happy Wednesday! Thank you again for your patience. Thank you for taking the first step to becoming a part of the Molina Healthcare Family. I have received your application for (Coastal Bend Urgent Care, LLC ) to contract under TAX ID number (81-1890349).  I am pleased to inform you that I have verified and placed your application in process and it is now with your designated coordinator.  Your designated coordinator will be your source of information for any questions you may have or for status checks. Every Coordinator services certain areas, based on the address information provided on the application; I have provided your Coordinators information.  Also, for an alternative route of provider/facility information, email TexasExpansionContracting@MolinaHealthcare.com  Please see your designated Coordinators information below: EL PASO, NUECES & TRAVIS Juliana Mata Juliana.Mata@molinahealthcare.com 888-562-5442 x200249   Have a wonderful day! Thank you, Tyhesha Price MHT| Provider Contracts Molina Healthcare of Texas, Inc. 1660 Westridge Circle N Irving, TX 75038 Mhtcontractrequest@Molinahealthcare.com\"', NULL, NULL, '2021-07-01 15:54:43', '2021-07-01 15:54:43'),
(38672, 1006, 29769, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from Juliana.Mata@molinahealthcare.com:  Sub: Molina Contract Packet - Coastal Bend Urgent Care LLC DBA Beeville Medical Clinic  \"Good afternoon,  Happy Monday!!  Hope you are doing well.  I am following up to my previous email. Please be advised unless all forms are returned, we will not be able to continue contracting process.  any assistance will be greatly appreciated.  Thank you in advance  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'  (888) 562-5442 ext 200249\"  Replied with the requested information:  \"Hello Juliana,   I apologize for the delay, here\'s the requested information hopefully it suffices. We also have a secondary location and the address is as follows: 504A Houston Street, George West, TX 78022-3663  Do let me know if anything else is required to proceed.\"', NULL, NULL, '2021-08-03 14:06:13', '2021-08-03 14:06:13'),
(38673, 1006, 29769, NULL, '2021-08-12 00:00:00.000', 'In Process', 'We received the following email Juliana.Mata@molinahealthcare.com:  Sub: Molina Contract Packet - Coastal Bend Urgent Care LLC DBA Beeville Medical Clinic  \"Good afternoon,  Happy Tuesday!!  Hope you are doing well.  Thank you for your assistance filling out forms.  Could you please assist with correction needed in claim sample?  Box 33 we are missing pay to name  could you please update and submit back to me?  For secondary location, could you please fill out a credentialing application?  Please see attached.  Once information is received back, we will be able to continue  Juliana Mata | Associate Specialist Provider Contracts Molina Healthcare Of Texas Molina Healthcare Of Texas, Inc Juliana.Mata@Molinahealthcare.com 1660 Westridge Circle N. Irving, TX 75038 \'  (888) 562-5442 ext 200249\"  Responded with the requested information:  \"Hello,   Please find the requested documents attached. Do let me know if anything else is needed.  Thank you. \"', NULL, NULL, '2021-08-05 16:01:18', '2021-08-05 16:01:18'),
(38674, 11056, 29769, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Good evening!  Hope all is well. Please provide me with the latest updates of the enrollment status of following providers & practice and the secondary location too. Kindly also update me about the applications and forms submitted to you regarding enrollment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Furthermore,if documents and information is needed please let me know. Please don\'t hesitate to contact me directly.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 15:50:29', '2021-08-18 15:50:29'),
(38675, 11056, 29769, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Good morning,  Happy Thursday!!  Hope you are doing well.  Per information on our system, service location  301 S. Hillside Drive is in process  of credentialing.  Service location 504  A  Houston Street, we are missing a contract request form, could you please fill out form and submit back to me at your earliest convenience?  Individual providers are not contracted under Urgent Care Facility.  Molina contracts facility directly.     Hope this information helps.  Thank you        Juliana Mata | Associate Specialist Provider Contracts  Molina Healthcare Of Texas  Molina Healthcare Of Texas, Inc  Juliana.Mata@Molinahealthcare.com  1660 Westridge Circle N.  Irving, TX 75038  \'  (888) 562-5442 ext 200249', NULL, NULL, '2021-08-24 14:03:24', '2021-08-24 14:03:24'),
(38676, 11056, 29769, NULL, '2021-09-11 00:00:00.000', 'In Process', 'Email sent to : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Good morning!  Hope all is well. Here is the filled contract request form for the secondary service location 504-A, Houston Street. Please see the attachment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Furthermore, if any additional information is required please let me know. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-03 15:05:33', '2021-09-03 15:05:33'),
(38677, 11056, 29769, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email received from : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Thank you again for your patience. Thank you for taking the first step to becoming a part of the Molina Healthcare Family. I have received your application for Coastal Bend Urgent Care LLC to contract under TAX ID number 81-1890349.  I am pleased to inform you that I have verified and placed your application in process and it is now with your designated coordinator.  Your designated coordinator will be your source of information for any questions you may have or for status checks. Every Coordinator services certain areas, based on the address information provided on the application; I have provided your Coordinators information.  Also, for an alternative route of provider/facility information, email TexasExpansionContracting@MolinaHealthcare.com  Please see your designated Coordinators information below:  EL PASO, NUECES & TRAVIS Juliana Mata Juliana.Mata@molinahealthcare.com   888-562-5442 x200249', NULL, NULL, '2021-09-24 11:46:26', '2021-09-24 11:46:26'),
(38678, 11056, 29769, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email sent to : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Good morning!  Hope this email finds you well. Please provide me with the updates on the credentialing of  the facility mentioned below with Molina Health under the Tax ID with both locations listed below.  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  If you need any information or documents related to this please let me know. Waiting for your reply.  Thank you! Have a great weekend!', NULL, NULL, '2021-10-06 12:37:36', '2021-10-06 12:37:36'),
(38679, 11056, 29769, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email received from : Juliana.Mata@molinahealthcare.com  Sub  : Enrollment Status Query - CBUC/GWMC - Molina Health  Good  afternoon,  Happy Wednesday!!  Hope you are doing well.  per information on   our system,  both facilities are in process for credentialing.  Once credentialing process is complete, we will go ahead and forward contract to be loaded  into network billing system.  thank you  for your patience', NULL, NULL, '2021-10-14 15:48:30', '2021-10-14 15:48:30'),
(38680, 11056, 29769, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email received from : Juliana.Mata@molinahealthcare.com  Sub : Enrollment Status Query - CBUC/GWMC - Molina Health  Good afternoon,  Happy Tuesday!!  Hope you are doing well.  Per information on our system, both facilities are credential complete, we are waiting on execution from plan\'s president.  Once PSA is executed,  we will go ahead and forward contract to be loaded into network billing system,  this process might take 30-45 days.', NULL, NULL, '2021-10-22 10:21:35', '2021-10-22 10:21:35'),
(38681, 11056, 29769, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email sent to: Juliana.Mata@molinahealthcare.com  Sub: Enrollment Status Query - CBUC/GWMC - Molina Health  Good morning Juliana!  Hope you had a great week yet. Please let us know about the execution of the Plan\'s President. Has the PSA been executed yet or not? Is that loaded into your billing system?  Eagerly, waiting to hear back from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-11-09 14:11:23', '2021-11-09 14:11:23'),
(38682, 11056, 29769, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from: Juliana.Mata@molinahealthcare.com  Sub: Enrollment Status Query - CBUC/GWMC - Molina Health  Good afternoon,  Happy Friday!!  Hope you are doing well.  Per information on our system, both locations are in process of being loaded into the network billing system, this process might take 30-45 days.  Thank you for your patience', NULL, NULL, '2021-11-24 12:13:33', '2021-11-24 12:13:33'),
(38683, 11056, 29769, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Juliana.Mata@molinahealthcare.com  Sub: Enrollment Status Query - CBUC/GWMC - Molina Health  Good morning!  Hope this email finds you well.  Thank you for the update and prompt response. Try to escalate the loading process and let it be completed before the time period.  Have a wonderful day!', NULL, NULL, '2021-12-06 17:01:44', '2021-12-06 17:01:44'),
(38684, 11056, 29769, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email received from: Juliana.Mata@molinahealthcare.com  Sub: Enrollment Status Query - CBUC/GWMC - Molina Health   Good morning,  Happy Friday!!  Hope you are doing well.  per information on our system, service location 301 S. Hillside Drive is loaded into network billing system with effective date 12/15/2021.  Please see attached for welcome letter.  2nd service location is in process of being loaded into network billing system.  thank you for your patience.     Thank you     Juliana Mata | Associate Specialist Provider Contracts', NULL, NULL, '2021-12-21 17:28:44', '2021-12-21 17:28:44'),
(38685, 19067, 29769, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: Juliana.Mata@molinahealthcare.com  Subject: Enrollment Query || Providers & Group || GWMC || Molina Health ||    Good Morning!  Hope you are having a productive day.  I would like to know the enrollment status of the following Providers and Group.   Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Monica Gonzalez	1871132811	504A Houston Street, Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	504A Houston Street, Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	504A Houston Street, Live Oak County, George West, TX 78022-3663  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 12:01:38', '2022-01-04 12:01:38'),
(38686, 19067, 29769, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email received from: Juliana.Mata@molinahealthcare.com  Subject: Enrollment Query || Providers & Group || GWMC || Molina Health ||    Good afternoon,  Happy Monday!!  Hope you are doing well. per information on our system, TIN 81-1890349 is loaded into network billing system with effective date 12/15/2021.  Since contract on file is for urgent care clinic, we will not be able to link individual providers to group.  Facility is contracted already.  Should you have any additional questions, please reach out to your provider service representative directly at MHTXProviderServices@MolinaHealthCare.Com.  Thank you in advance, hope you have a great day.     Thank you     Juliana Mata | Associate Specialist Provider Contracts  Molina Healthcare Of Texas  Molina Healthcare Of Texas, Inc  Juliana.Mata@Molinahealthcare.com  1660 Westridge Circle N.  Irving, TX 75038  \'  (972)346-0603', NULL, NULL, '2022-01-11 13:10:43', '2022-01-11 13:10:43'),
(38687, 19067, 29769, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: Juliana.Mata@molinahealthcare.com  Subject: Re: Enrollment Query || Providers & Group || GWMC || Molina Health ||   Greetings!  Can you please confirm the location, it is 504A Houston Street, Live Oak County, George West, TX 78022.   Regards, Hammad.', NULL, NULL, '2022-01-26 15:05:02', '2022-01-26 15:05:02'),
(38688, 19067, 29769, NULL, '2022-02-22 00:00:00.000', 'Approved', 'Received the following email from: Juliana.Mata@molinahealthcare.com  Subject: RE: Enrollment Query || Providers & Group || GWMC || Molina Health ||   Good afternoon,  Happy Monday!!  Hope you are doing well. per information on our system, TIN 81-1890349 is loaded into network billing system with effective date 12/15/2021.  Since contract on file is for urgent care clinic, we will not be able to link individual providers to group.  Facility is contracted already.  Should you have any additional questions, please reach out to your provider service representative directly at MHTXProviderServices@MolinaHealthCare.Com.  Thank you in advance, hope you have a great day.     Thank you     Juliana Mata | Associate Specialist Provider Contracts  Molina Healthcare Of Texas  Molina Healthcare Of Texas, Inc  Juliana.Mata@Molinahealthcare.com  1660 Westridge Circle N.  Irving, TX 75038  \'  (972)346-0603', NULL, NULL, '2022-02-15 13:13:07', '2022-02-15 13:13:07'),
(38689, 1006, 29770, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38690, 3040, 29770, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Galaxy Health ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Galaxy Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 10:47:26', '2021-06-07 10:47:26'),
(38691, 1006, 29770, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent a f/u email @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,    We wish to enroll the following group and providers with Galaxy Health, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible regarding how we should proceed.  Thank you!\"', NULL, NULL, '2021-06-24 15:40:14', '2021-06-24 15:40:14'),
(38692, 1006, 29770, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email to Daniel Marley dmarley@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,   I wanted to get an update on this request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:05:26', '2021-07-13 17:05:26'),
(38693, 11056, 29770, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 12:42:26', '2021-08-18 12:42:26'),
(38694, 11056, 29770, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com,  contracting@ghn-mci.com &  providers@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# : 1619166188  Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 10:29:22', '2021-08-24 10:29:22'),
(38695, 11056, 29770, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Ahmed,     After review, I show a personal agreement for Dr. Mercedita Flynn effective 7-1-2021. I do not show Katherine Paterson as participating under the information you provided.     Thanks,     Daniel M.  Contract Specialist  Galaxy Health Network  (P) 800-975-3322 X 1124 (F) 1-800-645-0154', NULL, NULL, '2021-09-01 13:37:31', '2021-09-01 13:37:31'),
(38696, 11056, 29770, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good morning!  Hope this email finds you well. Could you provide me with a signed copy of that agreement of the provider Dr. Mercedita Flynn? And inform me the procedure by which the provider Katherine Paterson shows as participating under the Group TIN.  If you need any documents or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-09-17 14:50:17', '2021-09-17 14:50:17'),
(38697, 11056, 29770, NULL, '2021-10-06 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hi Ahmed,  I am sorry, however, the below statement that Dr. Flynn is under a personal agreement shows to be incorrect. I show this provider, Dr. Flynn  is under a group agreement.  To confirm I do not show Katherine Paterson as presently participating with Galaxy under the Coastal Bend Urgent Care Group agreement. If the group wishes to add Katherine Paterson to their existing agreement then please see the attached.  If your company wishes a copy of the group agreement you will need to fax written authorization signed by an authorized signatory of the CBUS group stating your company Claims Med Inc is representing the group and that Galaxy is authorized to send you a copy of their agreement. That can be faxed to 817-633-5729.   Further, I show that the same information above on how to obtain a copy of the group agreement was sent to Mr. Brad Peterson who is with you company and he may already have a copy of the group agreement.', NULL, NULL, '2021-09-29 12:52:40', '2021-09-29 12:52:40'),
(38698, 11056, 29770, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good afternoon Daniel!  Hope this email finds you well. Here is the filled Physician agreement form for the provider Katherine Paterson, to add her with Galaxy under the Coastal Bend Urgent Care Group agreement. Please see the attachment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-10-07 15:05:40', '2021-10-07 15:05:40'),
(38699, 11056, 29770, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope this email finds you well.  Please provide us with the latest updates regarding the following providers under the below mentioned practice with Galaxy health as soon as possible.  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 Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a great day!', NULL, NULL, '2021-10-18 16:45:59', '2021-10-18 16:45:59'),
(38700, 11056, 29770, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : kavalos@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hello please,     provide providers specialty, phone/fax number effective date you will like.     Thanks;     Karen A  Have provided them with details', NULL, NULL, '2021-11-09 12:15:35', '2021-11-09 12:15:35'),
(38701, 11056, 29770, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon Karen!  Hope this email finds you well. Please find the information below which you have requested.   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 & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548           Ph # : 361-226-1126          fax no. : 361 542-4076 Mercedita Flynn (FNP)	1619166188          Ph # : 361-226-1126          fax no. : 361 542-4076 Monica Gonzalez (FNP)	1871132811          Ph # : 361-226-1126          fax no. : 361 542-4076  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:54:14', '2021-11-24 13:54:14'),
(38702, 11056, 29770, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:32:04', '2021-12-06 15:32:04'),
(38703, 11056, 29770, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub:  Enrollment Query - CBUC & GWMC - Galaxy Health  Enrollment Status Query - Galaxy Health - CBUC/GWMC   Is this eff date is for all of the providers or not? Provide me with welcome letters too.', NULL, NULL, '2021-12-17 14:25:47', '2021-12-17 14:25:47'),
(38704, 11056, 29770, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: Kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Enrollment Query - CBUC & GWMC - Galaxy Health   Good evening Karen!  Hope this email finds you well. Please list the highlighted location under the following provider as soon as possible. And also list all of the providers with both locations on your provider directory. I am unable to find the providers, I only found Mercedita Flynn. I have attached the SS for your concerns.    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 & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548              Unable to find provider on the directory Mercedita Flynn (FNP)	1619166188               Only Primary location is listed Monica Gonzalez (FNP)	1871132811              Unable to find provider on the directory  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-12-23 10:10:25', '2021-12-23 10:10:25'),
(38705, 19067, 29770, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Hello!  Hope you\'re doing well,  I would like to know the enrollment status of the following Providers & Groups with Galaxy Health.   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 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:24:54', '2021-12-30 13:24:54'),
(38706, 19067, 29770, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, kavalos@ghn-mci.com, dmarley@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Greetings!  You haven\'t responded yet.  Still waiting to get the updates about the previously mentioned request.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:28:28', '2022-01-09 22:28:28'),
(38707, 19067, 29770, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Good Morning!  Hope this email finds you well.  This is my SECOND REMINDER on the below mentioned request. Kindly look into this.  Kindly respond as per your convenience.   Regards, Hammad.', NULL, NULL, '2022-01-26 11:10:30', '2022-01-26 11:10:30'),
(38708, 19067, 29770, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email received from: kavalos@ghn-mci.com  Subject: RE: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||    Hello Ahmed;     There is no welcome letters this is not a personal agreement.', NULL, NULL, '2022-02-21 16:27:17', '2022-02-21 16:27:17'),
(38709, 20067, 29770, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Good Afternoon!  Hope you had a great weekend. I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  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 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663  Eagerly waiting to hear from you.  Thank you, ', NULL, NULL, '2022-03-07 16:56:04', '2022-03-07 16:56:04'),
(38710, 22077, 29770, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Hi,  I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Waiting to hear from you soon.  Thanks. Alex', NULL, NULL, '2022-04-13 14:23:58', '2022-04-13 14:23:58'),
(38711, 1006, 29771, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:12', '2021-05-10 15:27:12'),
(38712, 1005, 29771, NULL, '2021-06-15 00:00:00.000', 'On Hold', 'Awaiting Medicaid\'s approval confirmation.', NULL, NULL, '2021-06-07 17:34:28', '2021-06-07 17:34:28'),
(38713, 1006, 29771, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent following enrollment query @ AM.Austin@SuperiorHealthPlan.com & SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: Enrollment Query - CBUC/GWMC -  Superior Health/Ambetter  \"Hello,  I wanted to verify if the following group and providers were enrolled with Superior Healthplan & Ambetter under the mentioned addresses:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Katherine Paterson NPI# 1164776548  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Please get back to me as soon as you\'re able. Thank you. \"', NULL, NULL, '2021-06-09 09:49:33', '2021-06-09 09:49:33'),
(38714, 1006, 29771, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent f/u email @ Account Management - Corpus Christi AM.CorpusChristi@superiorhealthplan.com:  Sub: Group Contract Query - CBUC/GWMC - Ambetter  \"Hello,   I hope you\'re doing well, I wanted to verify if the following group was enrolled with Superior & Ambetter and what the effective date was for the group contract. The group information is as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264 TIN# 81-1890349  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-29 16:29:11', '2021-06-29 16:29:11'),
(38715, 1006, 29771, NULL, '2021-08-13 00:00:00.000', 'In Process', 'Location addition request initiated for Mercedita, will update task accordingly. ', NULL, NULL, '2021-08-06 13:03:42', '2021-08-06 13:03:42'),
(38716, 1006, 29771, NULL, '2021-08-23 00:00:00.000', 'In Process', 'We received the following response :  \"Hello, please see link below to add provider to existing group:  https://www.superiorhealthplan.com/providers/become-a-provider/Add-New-Provider.html  Thank you, Deidra Hernandez Provider Account Manager cid:image002.jpg@01D4921D.61E12940 Toll-Free: 1-800-656-4817 Option 1, then Option 3 Fax: 1-866-683-5630 AM.Houston@SuperiorHealthPlan.com | SuperiorHealthPlan.com\"  Sent requested, attached for reference.', NULL, NULL, '2021-08-16 15:52:26', '2021-08-16 15:52:26'),
(38717, 11056, 29771, NULL, '2021-09-27 00:00:00.000', 'In Process', 'Call Rep : Yesenia P  Status : Application is closed & discontinued on 8-2-2021. Because of not submitting documents since the end of June.  Interaction code : 59315  Contact no : 800-656-4817  Another Application has been submitted. ', NULL, NULL, '2021-09-20 09:46:41', '2021-09-20 09:46:41'),
(38718, 11056, 29771, NULL, '2021-10-01 00:00:00.000', 'In Process', '[Secure] 59576 - Secondary Location Addition needed - CBUC / GWMC - Ambetter', NULL, NULL, '2021-09-24 13:29:43', '2021-09-24 13:29:43'),
(38719, 11056, 29771, NULL, '2021-10-06 00:00:00.000', 'In Process', 'Rep. : Yesenia P  Status:    Mercedita flynn = is in processing & reviewing.  Monica = is in credentialing. Received on 09/28/2021 It will take 100 days.  Secondary location has been listed under the group Tax ID.  Ref : 60964  Contact no : 800-656-4817', NULL, NULL, '2021-09-29 16:06:20', '2021-09-29 16:06:20'),
(38720, 11056, 29771, NULL, '2021-10-06 00:00:00.000', 'In Process', 'REF # 60964 _ MERCEDITA FLYNN_NPI_1619166188', NULL, NULL, '2021-09-29 16:13:56', '2021-09-29 16:13:56'),
(38721, 11056, 29771, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : Credentialing@superiorhealthplan.com  Sub : Enrollment Query - CBUC & GWMC - AMBETTER  Good morning!  Hope you are doing well. Please update me with the enrollment status of below mentioned providers at your earliest opportunity..  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 Mercedita Flynn 	1619166188 : for secondary location Monica Gonzalez  	1871132811 : for both locations   If you need any documents or information feel free to contact me.  Thank you!', NULL, NULL, '2021-10-07 13:36:12', '2021-10-07 13:36:12'),
(38722, 11056, 29771, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email received from : Credentialing@superiorhealthplan.com  Sub : Enrollment Query - CBUC & GWMC - AMBETTER  Good afternoon,             I am able to locate the following information per the status request below for the providers:  1619166188 - Re-credential date will be 07/31/2022.  1871132811 -I currently show the file is in progress and has not been completed at this time, the credentialing specialist will contact you directly if there is any missing/incomplete information.  Thank you,   Credentialing Department | Superior Health Plan 5900 E. Ben White Blvd | Austin, TX 78741 Phone: 800-820-5686 |Fax: 866-702-4831 Credentialing@superiorhealthplan.com', NULL, NULL, '2021-10-14 16:14:26', '2021-10-14 16:14:26'),
(38723, 11056, 29771, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email sent to : Credentialing@superiorhealthplan.com>  Sub : Enrollment Query - CBUC & GWMC - AMBETTER  Good afternoon!  Hope this email finds you well. Please respond to the below at your earliest convenience.   TIN - 81-1890349 1619166188 - Are both locations listed under this NPI and also, please do provide the welcome letter.  1871132811 - Please provide the latest updates on this NPI.  Waiting to hear from you soon.  Thank you! Take Care!', NULL, NULL, '2021-10-22 12:30:27', '2021-10-22 12:30:27');
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
(38724, 11056, 29771, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email sent to : Credentialing@superiorhealthplan.com>  Sub : Enrollment Query - CBUC & GWMC - AMBETTER  Good afternoon!  Hope this email finds you well. Please respond to the below at your earliest convenience.   TIN - 81-1890349 1619166188 - Are both locations listed under this NPI and also, please do provide the welcome letter.  1871132811 - Please provide the latest updates on this NPI.  Waiting to hear from you soon.  Thank you! Take Care!', NULL, NULL, '2021-10-22 12:32:34', '2021-10-22 12:32:34'),
(38725, 11056, 29771, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from: Credentialing@superiorhealthplan.com  Sub: Enrollment Query - CBUC & GWMC - AMBETTER  Good morning,              1619166188 -Please contact your account manager for assistance in obtaining the welcome letter. I have attached the providers approval letter from credentialing team. Please go to https://www.superiorhealthplan.com/ , for providers, and find my account manager, to locate your account manager. Your Account Manager can better assist you with your question and direct your request to the correct Department.      1871132811-I am currently reflecting that this provider is awaiting approval by the medical director. If all goes well, the anticipated effective date will be 12/01/2021', NULL, NULL, '2021-11-09 16:35:36', '2021-11-09 16:35:36'),
(38726, 11056, 29771, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to:  Credentialing@superiorhealthplan.com  Sub:   Enrollment Query - CBUC & GWMC - AMBETTER  Good afternoon!  Hope you are doing well. I want to get the latest updates regarding the enrollment process of the following provider under 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 Monica Gonzalez  	1871132811   If you have any questions or concerns feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:31:46', '2021-11-24 13:31:46'),
(38727, 11056, 29771, NULL, '2021-12-17 00:00:00.000', 'Approved', '	 Email received from: Credentialing@superiorhealthplan.com  Sub: Enrollment Query - CBUC & GWMC - AMBETTER  Good Afternoon,              I am able to locate the following information per the status request below for the provider:  The provider credentialing was completed on the effective date is 02/01/2021 and the re-credential date is 01/01/2024.  Provider\'s second location has been updated.  Ref# I57969070  Please see the attachment  All providers have been added to the secondary location as well.', NULL, NULL, '2021-12-10 12:25:04', '2021-12-10 12:25:04'),
(38728, 1006, 29772, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38729, 1006, 29772, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent provider addition request @ wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hello,  I hope you\'re doing well, we wanted to add the following provider under our group with the mentioned addresses: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264 Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324Secondary Address: 504A Houston Street, George West, TX 78022-3663 Provider Name: Katherine Paterson NPI# 1164776548  Please let me know what is required to proceed with this request, also our group is not showing up on the provider directory with either of the mentioned locations, please update that as well if possible.  Thank you. \"', NULL, NULL, '2021-06-08 15:12:11', '2021-06-08 15:12:11'),
(38730, 1006, 29772, NULL, '2021-07-05 00:00:00.000', 'In Process', 'We received the following response from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hi Brad,  Please see the attached credentialing documents that are required for providers to be added to our network.  Also, please see the screenshot from our directory. I’m not sure how you were searching for the group in our directory but per the credentialing documents, the locations have been listed as Beeville Medical Center and George West Medical Clinic in our directory since January 2021. (By clicking on the “advanced search” option, you can search by the group TIN and pull up all providers associated with that TIN.)  Feel free to contact me with any questions.  Thank you,   Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"  Forms were filled out and sent. Attached in providers task for reference.', NULL, NULL, '2021-06-28 17:12:12', '2021-06-28 17:12:12'),
(38731, 1006, 29772, NULL, '2021-08-05 00:00:00.000', 'In Process', 'We received the following update from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp   \"Hi Brad,  Please see the attached welcome letter and quick reference sheet. Feel free to contact me with any questions.\"  Replied with:  \"Hello DeeDee,   I appreciate the update, can you please let me know what is required to add the provider under our secondary address as well? Also, she is not showing up on the WorkWell provider directory. Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-07-29 12:32:08', '2021-07-29 12:32:08'),
(38732, 11056, 29772, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : wwtxcontracts@texasmutual.com  Sub : Enrollment Status Query - CBUC/GWMC - Texas Mutual Workers Comp  Good evening!  Hope all is well. Please inform me whenever the secondary location & provider mentioned below enrolled and listed under the Tax I.D. Please provide me with the latest updates soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  If you require any further information or documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 16:04:21', '2021-08-18 16:04:21'),
(38733, 11056, 29772, NULL, '2021-09-27 00:00:00.000', 'Approved', 'Call Rep. : Dee Dee   Eff date : 01/01/2021  Contact no. : 844-867-2338  Ref code : Dee Dee  Also see the Attachment.', NULL, NULL, '2021-09-20 10:59:46', '2021-09-20 10:59:46'),
(38734, 1006, 29773, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38735, 1005, 29773, NULL, '2021-06-15 00:00:00.000', 'On Hold', 'Awaiting Cigna\'s approval.', NULL, NULL, '2021-06-07 17:33:33', '2021-06-07 17:33:33'),
(38736, 1006, 29773, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent enrollment request @ TXMAContracting@cigna.com:  Sub: Network Interest Form - CBUC/GWMC - Cigna Healthspring  \"Hello,   Please find the attached network interest form, do let me know if anything else is required to proceed with this request.  Thank you. \"', NULL, NULL, '2021-07-23 12:51:52', '2021-07-23 12:51:52'),
(38737, 11056, 29773, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : TXMAContracting@cigna.com  Sub :  Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status and the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 13:28:04', '2021-08-18 13:28:04'),
(38738, 11056, 29773, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com &  TXMAContracting@cigna.com  &  txgqproviderrelations@healthspring.com  Sub :   Good morning!  Hope you are doing well. Please provide me with the latest updates soon. I want to inquire about the enrollment status and the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know. Waiting for your response.  Thank you! Have a great week ahead! ', NULL, NULL, '2021-08-24 11:13:15', '2021-08-24 11:13:15'),
(38739, 11056, 29773, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email sent to : JENNIFER.PEREZ@cigna.com &  TXMAContracting@cigna.com  &  txgqproviderrelations@healthspring.com  Sub : Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  Good morning!  Hope this email finds you well. Please provide me with the latest updates soon. I am still waiting to get enrollment status and about the Network interest forms which have been submitted on 23rd of July,2021 of the below mentioned practice and providers :  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know. Eagerly, waiting to hear back from you soon.  Thank you! Have a great week ahead!   Call didn\'t received. Left out the voice mail regarding the enrollment status', NULL, NULL, '2021-09-02 11:18:27', '2021-09-02 11:18:27'),
(38740, 11056, 29773, NULL, '2021-10-01 00:00:00.000', 'Not Eligible', '	 Email received from : lerensa.crain@careallies.com  Sub : Enrollment Status Updates - CBUC/GWMC - Cigna Healthspring  George West, Texas and Beeville, Texas are not in the Cigna MA medical plan service area.', NULL, NULL, '2021-09-24 13:07:36', '2021-09-24 13:07:36'),
(38741, 1006, 29774, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38742, 1006, 29774, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent following enrollment query @ providerdevelopment@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello,  We submitted an enrollment request last month for our group and wanted to get a status update on it, the group information is as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Please get back to me as soon as you\'re able to. Thank you. \"', NULL, NULL, '2021-06-08 16:15:30', '2021-06-08 16:15:30'),
(38743, 1006, 29774, NULL, '2021-07-02 00:00:00.000', 'In Process', 'The previous email was sent to an incorrect address, sent corrected email @ providerdevelopment@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello,    We submitted an enrollment request last month for our group and wanted to get a status update on it, the group information is as follows:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Please get back to me as soon as you\'re able to.  Thank you.\"  ', NULL, NULL, '2021-06-25 17:05:13', '2021-06-25 17:05:13'),
(38744, 1006, 29774, NULL, '2021-07-21 00:00:00.000', 'In Process', 'Received following notification from email:  \"Your message to providerdevelopment@anci-care.com couldn\'t be delivered. The group providerdevelopment only accepts messages from people in its organization or on its allowed senders list, and your email address isn\'t on the list.\"  Sent corrected email @ ACS VIP Providers vipproviders@anci-care.com.', NULL, NULL, '2021-07-14 14:55:29', '2021-07-14 14:55:29'),
(38745, 1006, 29774, NULL, '2021-08-13 00:00:00.000', 'In Process', 'We received the following update from jmaligaya@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Good Morning,  I show that Coastal Bend Urgent Care, LLC And ACS are currently contracted since 7/20/2017. Records indicate that you are due for credentialing.  Please see the attached Re-credentialing Profile.  Best Regards,  Jennifer Maligaya | Sr. Provider Relations, ACS and MyDecision HealthSmart | Network Solutions Office: 405 241 4811 | Fax: 214 574 1121 Jennifer.maligaya@healthsmart.com | www.HealthSmart.com\"  Replied with:  \"Hello Jennifer,  Please find the attached information, do let me know if you need anything else.  Thank you. \"', NULL, NULL, '2021-08-06 15:12:11', '2021-08-06 15:12:11'),
(38746, 1006, 29774, NULL, '2021-08-23 00:00:00.000', 'In Process', 'Sent f/u email @ Jennifer MaligayaACS jmaligaya@anci-care.com:  Sub: Enrollment Query - CBUC/GWMC - Anci-Care  \"Hello Jennifer,  I hope you\'re doing well, I just wanted to check in on the status of enrollment for our group. Can you please get back to me on this?  Thank you.\"', NULL, NULL, '2021-08-16 16:07:30', '2021-08-16 16:07:30'),
(38747, 11056, 29774, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Coastal Bend Urgent Care is already contracted with ACS.     Recredentialing is complete just waiting on the approval meeting on 9/16.     No further action is necessary.  Claims are still being processing for this provider.     Jennifer Maligaya is no longer with ACS/HealthSmart.     Please continue to use VIPproviders@anci-care.com for updates.     New provider agreements please email me:  patti.davidson@healthsmart.com     Thank you,     Patti Davidson | Manager, Network Development  HealthSmart | Network Solutions  Office: 972 388 3091 | Fax: 214 574 1121  patti.davidson@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-08-23 17:10:46', '2021-08-23 17:10:46'),
(38748, 11056, 29774, NULL, '2021-09-11 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Good morning!  Hope all is well. Could you please provide me the enrollment updates,effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-03 14:25:40', '2021-09-03 14:25:40'),
(38749, 11056, 29774, NULL, '2021-09-21 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Good morning!  Hope all is well. Could you please provide me the enrollment updates, effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-14 14:29:53', '2021-09-14 14:29:53'),
(38750, 11056, 29774, NULL, '2021-09-21 00:00:00.000', 'In Process', 'Email sent to : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Good morning!  Hope all is well. Could you please provide me the enrollment updates, effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-09-14 14:29:54', '2021-09-14 14:29:54'),
(38751, 11056, 29774, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Coastal Bend Urgent Care is already contracted with ACS.  Recredentialing is complete just waiting on the approval meeting on 9/16.  No further action is necessary.  Claims are still being processing for this provider.    Thank you, Patti Davidson | Manager, Network Development HealthSmart | Network Solutions Office: 972 388 3091 | Fax: 214 574 1121 patti.davidson@healthsmart.com | www.HealthSmart.com', NULL, NULL, '2021-09-27 10:34:08', '2021-09-27 10:34:08'),
(38752, 11056, 29774, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email received from : pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Hi.   The provider below is already contracted.  We are only recredentialing the site.     You will receive the recredentialing approval letter from our credentialing department after 2 weeks.', NULL, NULL, '2021-10-06 14:48:39', '2021-10-06 14:48:39'),
(38753, 11056, 29774, NULL, '2021-10-14 00:00:00.000', 'Approved', 'Email received from : Betsy.Eggleston@healthsmart.com & pdavidson@anci-care.com  Sub : Re: Enrollment Query - CBUC/GWMC - Anci-Care  Hi.   Coastal Bend Urgent Care is already contracted with ACS.  Recredentialing is complete.  Both locations are loaded.  This was only a recredentialing provider update.  The facilities can see patients since this was already contracted. No further action is necessary.  Claims are still being processing for this provider.  Your provider agreement effective date is 7/20/2017.  The recredentialing date does not change the provider agreement effective date.   Please see the attachment.', NULL, NULL, '2021-10-07 10:54:15', '2021-10-07 10:54:15'),
(38754, 1006, 29775, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38755, 3040, 29775, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: providerservices@triwest.com   Subject:Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Triwest ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Triwest for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-07 13:00:20', '2021-06-07 13:00:20'),
(38756, 11056, 29775, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Email sent to : providerservices@triwest.com  Sub : Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Triwest ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers with Triwest for our group under the below locations.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548    Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# : 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you! Have a blessed day!', NULL, NULL, '2021-06-24 13:12:22', '2021-06-24 13:12:22'),
(38757, 1006, 29775, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Hello,   I hope you\'re doing well, I wanted to get an update regarding the status of enrollment for our group and providers mentioned in the previous email.   Please get back to me as soon as possible.  Thank you.', NULL, NULL, '2021-07-13 17:27:57', '2021-07-13 17:27:57'),
(38758, 1006, 29775, NULL, '2021-08-02 00:00:00.000', 'In Process', 'Spoke with the representative (Margo Rose, O: (916) 389-6334) ​and she said that the request is in-process and we should send an email to credentialing@triwest.com, sent f/u email.', NULL, NULL, '2021-07-26 16:06:24', '2021-07-26 16:06:24'),
(38759, 1006, 29775, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Sent f/u email @ credentialing@triwest.com:  Sub: Enrollment Status - CBUC/GWMC - Triwest  \"Hello,   We\'re still waiting on an update on this request. Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-08-03 16:13:24', '2021-08-03 16:13:24'),
(38760, 11056, 29775, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : 	credentialing@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening!  Hope this email finds you well. I wanted to get an update regarding the status of enrollment for our group and providers mentioned below:  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 16:14:12', '2021-08-18 16:14:12'),
(38761, 11056, 29775, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : credentialing@triwest.com, providerservices@triwest.com, jmonson@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening!  Hope this email finds you well. I am still waiting to get an update regarding the status of enrollment for our group and providers mentioned below. Please respond to me as soon as possible.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 10:41:26', '2021-08-24 10:41:26'),
(38762, 11056, 29775, NULL, '2021-09-11 00:00:00.000', 'In Process', 'Email sent to : jmonson@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good evening Jess!  Hope this email finds you well. Thank you so much for the prompt response. Please provide me with the welcome or approval letters for the below mentioned providers and practice as soon as possible.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324 Secondary Practice Address: 504A Houston Street George West , TX 78022-3663  Provider Details: Provider 1: Provider Name : Paterson, Katherine D Provider NPI# : 1164776548   Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# :1619166188  Provider 3:   Provider Name: Gonzalez, Monica Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-03 14:44:22', '2021-09-03 14:44:22'),
(38763, 11056, 29775, NULL, '2021-10-01 00:00:00.000', 'In Process', 'mail received from : mlarsen@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential  Good Morning,  The providers : Paterson, Katherine D  and Flynn, Mercedita N have been added for Aperture review as of 9/5/2021.  This credentialing process may take between 30-90 days and once approved you will receive an approval letter with contracted dates. If you have further questions please reach out to the email listed.   providerdataupdate@triwest.com  Thank you for caring for our nation’s veterans.  Michelle Larsen Provider Services mlarsen@Triwest.com 480-481-5549', NULL, NULL, '2021-09-24 14:51:59', '2021-09-24 14:51:59'),
(38764, 11056, 29775, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email received from : mlarsen@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential  Good Morning,  The providers : Paterson, Katherine D  and Flynn, Mercedita N have been added for Aperture review as of 9/5/2021.  This credentialing process may take between 30-90 days and once approved you will receive an approval letter with contracted dates. If you have further questions please reach out to the email listed.   providerdataupdate@triwest.com  Thank you for caring for our nation’s veterans.  Michelle Larsen Provider Services mlarsen@Triwest.com 480-481-5549', NULL, NULL, '2021-10-06 12:57:00', '2021-10-06 12:57:00'),
(38765, 11056, 29775, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email sent to : providerdataupdate@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest  Good afternoon!  Hope this email finds you well. Please provide me with the latest updates regarding the providers and facility credentialing applications mentioned below under Tax I.D and both locations. And still waiting for the welcome letters for the providers.  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 Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811   If you have any questions or concerns or require any information or documents please let me know. Eagerly, waiting for the response.  Thank you! Have a great weekend!', NULL, NULL, '2021-10-14 15:55:15', '2021-10-14 15:55:15'),
(38766, 11056, 29775, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email received from : ccarroll@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest   TriWest Classification: Confidential   Talha,  I removed Michelle from the email as she is no longer in the same department.   We have both urgent cares loaded at the facility level as of 6/1/20 for CCN.  The providers below have credentialed but are in the process of being loaded.  You will receive the credentialing letter once completed.  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Provider is still in the cred process, pending with Aperture as of 9/5/21.  The credentialing process takes 30-90 days to complete.  Katherine Paterson  1164776548        Cecilia Carroll Direct Contract Manager TriWest Healthcare Alliance  O:  (623) 435-3343 F:  (866) 549-4618 ccarroll@triwest.com www.triwest.com', NULL, NULL, '2021-10-22 12:03:09', '2021-10-22 12:03:09'),
(38767, 11056, 29775, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from: ccarroll@triwest.com  Sub : Enrollment Status Query - CBUC & GWMC - Triwest   TriWest Classification: Confidential     Talha,     Reminder, Michelle is no longer in this department.      See below status of your urgent care and providers in question.     We have both urgent cares loaded at the facility level as of 6/1/20 for CCN.     The providers below have credentialed but are in the process of being loaded.  You will receive the credentialing letter once completed.  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Provider is still in the cred process, pending with Aperture as of 9/5/21.  The credentialing process takes 30-90 days to complete.  Katherine Paterson  1164776548              Cecilia Carroll  Direct Contract Manager  TriWest Healthcare Alliance  O:  (623) 435-3343  F:  (866) 549-4618  ccarroll@triwest.com  www.triwest.com', NULL, NULL, '2021-11-09 11:14:25', '2021-11-09 11:14:25'),
(38768, 11056, 29775, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from:  sbachman@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest  TriWest Classification: Confidential     Julie,  Please process the provider in Pending status and provider the effective dates for all three providers.     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  Katherine Paterson  1164776548  Mercedita Flynn  1619166188  Monica Gonzalez  1871132811     Sincerely,  Sandra Bachman  Team Lead, Provider Data Ops / TriWest Healthcare Alliance  P: 1 (855) 722-2838  F: (866) 589-7693  www.triwest.com', NULL, NULL, '2021-11-24 13:02:24', '2021-11-24 13:02:24'),
(38769, 11056, 29775, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  	jmiller@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest   Good morning Julie!  Hope this email finds you well. Please respond to this query at your earliest convenience. Provide us with the effective dates and welcome letters for all three providers soon.  Eagerly, waiting for your reply.  Thank you! Have a great day!', NULL, NULL, '2021-12-06 18:02:36', '2021-12-06 18:02:36'),
(38770, 11056, 29775, NULL, '2021-12-21 00:00:00.000', 'Approved', 'Email received from: jmonson@triwest.com & Credentialing@triwest.com & sdevi@triwest.com  Sub: Enrollment Status Query - CBUC & GWMC - Triwest  Talha,  Coastal Bend Urgent Care LLC, 301 S Hillside Dr, Ste 4 Beeville TX – 78102 and NPI: 1427509264 credentialed as of date 09/27/2019.  The location has been added. Effective 7/26/2021.  Here is the provider information that you have requested  Providers - Effective dates   Patterson – 10.15.21  Flynn – 9.29.21  Gonzalez – 10.5.21  Thank you.  Sailaja Devi Provider Credentialing Specialist TriWest Healthcare Alliance  Ph: (480) 530 4403 Fax: (866) 549-4610 Sdevi@triwest.com www.triwest.com', NULL, NULL, '2021-12-14 15:40:40', '2021-12-14 15:40:40'),
(38771, 1006, 29776, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38772, 1005, 29776, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes', NULL, NULL, '2021-06-01 14:20:38', '2021-06-01 14:20:38'),
(38773, 1006, 29782, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38774, 3040, 29782, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: providerservices@renaissancefamily.com   Subject:Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Renaissance Physicians ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Renaissance Physicians for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:35:35', '2021-06-07 12:35:35'),
(38775, 1006, 29782, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email to correct email address @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Request - CBUC/GWMC - Renaissance Physician  \"Hello,  I hope you\'re doing well, we want to enroll the following group and providers with Renaissance Physicians, please let me know what is required to complete this request, the information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson  Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-24 16:55:24', '2021-06-24 16:55:24'),
(38776, 1006, 29782, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email @ txgqproviderrelations@healthspring.com:  Sub: Enrollment Request - CBUC/GWMC - Renaissance Physician  \"Hello,   I wanted to get an update regarding the status of our request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:24:31', '2021-07-13 17:24:31'),
(38777, 11056, 29782, NULL, '2021-08-25 00:00:00.000', 'In Process', '	 Email sent to : 	txgqproviderrelations@healthspring.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 13:00:59', '2021-08-18 13:00:59'),
(38778, 11056, 29782, NULL, '2021-09-01 00:00:00.000', 'In Process', 'Email sent to :  txgqproviderrelations@healthspring.com, joann.alanis@careallies.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  Good afternoon!  Hope you are doing well. I am still waiting to get an update regarding the enrollment status of the below mentioned practice and providers since july.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 14:43:12', '2021-08-24 14:43:12'),
(38779, 11056, 29782, NULL, '2021-09-02 00:00:00.000', 'Not Eligible', 'Email received from : cresta.smith@careallies.com  Sub : Enrollment Status Query - Renaissance Physicians - CBUC/GWMC  These providers are not in the renaissance service area. We are only in the greater Houston area.     Thanks  Cresta', NULL, NULL, '2021-08-25 14:21:28', '2021-08-25 14:21:28'),
(38780, 1006, 29783, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-10 15:27:13', '2021-05-10 15:27:13'),
(38781, 1005, 29783, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Awaiting Molina\'s enrollment.', NULL, NULL, '2021-06-07 10:15:54', '2021-06-07 10:15:54'),
(38782, 1005, 29783, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'Awaiting Molina\'s enrollment.', NULL, NULL, '2021-06-07 10:15:55', '2021-06-07 10:15:55'),
(38783, 1019, 29784, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 14:07:57', '2021-05-11 14:07:57'),
(38784, 1019, 29784, NULL, '2021-05-19 00:00:00.000', 'Initiated', 'Sent the following email to  contracting_dept@elpasohealth.com SUB: Enrollment Query || Tameka Birts || MBS || EL Paso  Hello, We have attached the Contracting application for our provider with EL Paso Health.  Let me know if anything else is required.   Thank you,', NULL, NULL, '2021-05-12 13:30:48', '2021-05-12 13:30:48'),
(38785, 1019, 29784, NULL, '2021-05-21 00:00:00.000', 'In Process', 'Received the following email from gdelossantos@elpasohealth.com SUB: Enrollment Query || Tameka Birts || MBS || EL Paso  Hello Alex,  Hope you are doing good and this email finds you well.  Thank you for submitted the demo form for the provider, but we are also needing a W-9.  If you could please forward me a copy of the W-9, I will be able to update the provider information.  Let me know if there are any questions, thank you.   Gabriel De Los Santos CONTRACTING & CREDENTIALING REPRESENTATIVE  915-298-7198 EXT. 1128 gdelossantos@elpasohealth.com 1145 Westmoreland Drive El Paso, TX 79925 elpasohealth.com', NULL, NULL, '2021-05-14 13:18:23', '2021-05-14 13:18:23'),
(38786, 1019, 29784, NULL, '2021-05-21 00:00:00.000', 'In Process', 'Sent the following email to gdelossantos@elpasohealth.com  Hello Gabriel, Hope you are doing good. I have attached the W9 form as requested, Let me know if something else is required.     Thank you,', NULL, NULL, '2021-05-14 13:19:20', '2021-05-14 13:19:20'),
(38787, 1019, 29784, NULL, '2021-06-15 00:00:00.000', 'In Process', 'Sent the following email to gdelossantos@elpasohealth.com  Good Afternoon Gabriel,  Hope you are doing good, I want enrollment status for the following provider as her application is in process for a while now.  Tameka Birts NPI: 1508211079  Regards, Alex', NULL, NULL, '2021-06-07 14:33:07', '2021-06-07 14:33:07'),
(38788, 1019, 29784, NULL, '2021-06-29 00:00:00.000', 'In Process', 'Sent the following email to gdelossantos@elpasohealth.com  Good Afternoon Gabriel,Hope you are doing good, I want enrollment status for the following provider as her application is in process for a while now. Tameka Birts NPI: 1508211079 Regards, Alex', NULL, NULL, '2021-06-15 13:35:21', '2021-06-15 13:35:21'),
(38789, 1019, 29784, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Received the following email from gdelossantos@elpasohealth.com Hello Alex,     The provider has been added to the EPH Network for the Preferred Administrators program only effective 05/01/2021.  For the STAR Medicaid and CHIP programs, we are unable to add the provider, as the providers TPI is under the TMHP Excluded List of providers.  Let me know if there are any questions please let me know, thank you.     FYI, do you have claims for an El Paso Health member?  If so, what are the DOS of your claims.', NULL, NULL, '2021-07-20 08:22:36', '2021-07-20 08:22:36'),
(38790, 1019, 29784, NULL, '2021-12-07 00:00:00.000', 'Approved', 'Received the following email from EL Paso, Eff date 05/01/2021, attached is the email confirmation  Hello Alex,     The provider has been added to the EPH Network for the Preferred Administrators program only effective 05/01/2021.  For the STAR Medicaid and CHIP programs, we are unable to add the provider, as the providers TPI is under the TMHP Excluded List of providers.  Let me know if there are any questions please let me know, thank you.     FYI, do you have claims for an El Paso Health member?  If so, what are the DOS of your claims.', NULL, NULL, '2021-11-30 17:49:27', '2021-11-30 17:49:27'),
(38791, 3040, 29785, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:00', '2021-05-11 15:22:00'),
(38792, 3040, 29785, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:24:47', '2021-05-11 15:24:47'),
(38793, 3040, 29786, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:00', '2021-05-11 15:22:00'),
(38794, 3040, 29786, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:24:57', '2021-05-11 15:24:57'),
(38795, 3040, 29787, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:00', '2021-05-11 15:22:00'),
(38796, 3040, 29787, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:02', '2021-05-11 15:25:02'),
(38797, 3040, 29788, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:00', '2021-05-11 15:22:00'),
(38798, 3040, 29788, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:06', '2021-05-11 15:25:06'),
(38799, 3040, 29789, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:00', '2021-05-11 15:22:00'),
(38800, 3040, 29789, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:11', '2021-05-11 15:25:11'),
(38801, 3040, 29790, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38802, 3040, 29790, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:17', '2021-05-11 15:25:17'),
(38803, 3040, 29791, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38804, 3040, 29791, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:22', '2021-05-11 15:25:22'),
(38805, 3040, 29792, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38806, 3040, 29792, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:26', '2021-05-11 15:25:26'),
(38807, 3040, 29793, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38808, 3040, 29793, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:32', '2021-05-11 15:25:32'),
(38809, 3040, 29794, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38810, 3040, 29794, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:36', '2021-05-11 15:25:36'),
(38811, 3040, 29795, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38812, 3040, 29795, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:41', '2021-05-11 15:25:41'),
(38813, 3040, 29796, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38814, 3040, 29796, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:45', '2021-05-11 15:25:45'),
(38815, 3040, 29797, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38816, 3040, 29797, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:51', '2021-05-11 15:25:51'),
(38817, 3040, 29798, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38818, 3040, 29798, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:25:56', '2021-05-11 15:25:56'),
(38819, 3040, 29799, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:01', '2021-05-11 15:22:01'),
(38820, 3040, 29799, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:26:01', '2021-05-11 15:26:01'),
(38821, 3040, 29800, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:22:09', '2021-05-11 15:22:09'),
(38822, 3040, 29800, NULL, '2021-05-18 00:00:00.000', 'Not Eligible', 'Paramount does not cover Texas as it is an Ohio only plan, please find attached link for reference: https://www.paramounthealthcare.com/news/paramount-advantage-service-area-changes ', NULL, NULL, '2021-05-11 15:26:08', '2021-05-11 15:26:08'),
(38823, 3040, 29801, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:21', '2021-05-11 15:34:21');
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
(38824, 3040, 29801, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:36:29', '2021-05-11 15:36:29'),
(38825, 3040, 29801, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:46', '2021-06-01 17:18:46'),
(38826, 3040, 29801, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:23', '2021-06-07 14:13:23'),
(38827, 3040, 29801, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:32', '2021-07-13 09:36:32'),
(38828, 11056, 29801, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:33:25', '2021-08-04 14:33:25'),
(38829, 3040, 29801, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:57', '2021-08-17 14:19:57'),
(38830, 12062, 29801, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:55:12', '2021-09-22 14:55:12'),
(38831, 12062, 29801, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:12:03', '2021-09-24 09:12:03'),
(38832, 10057, 29801, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:46', '2021-10-29 08:48:46'),
(38833, 10057, 29801, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:11:28', '2021-11-02 09:11:28'),
(38834, 10057, 29801, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:55:03', '2021-11-15 14:55:03'),
(38835, 10057, 29801, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:55', '2021-11-30 11:33:55'),
(38836, 10057, 29801, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:11:07', '2021-12-06 17:11:07'),
(38837, 10057, 29801, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:23:06', '2021-12-13 12:23:06'),
(38838, 10057, 29801, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:44', '2021-12-20 09:56:44'),
(38839, 10057, 29801, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:59:27', '2021-12-20 09:59:27'),
(38840, 10057, 29801, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:56', '2021-12-28 11:48:56'),
(38841, 19067, 29801, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:56', '2022-01-04 13:46:56'),
(38842, 20067, 29801, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:23', '2022-01-19 13:35:23'),
(38843, 20067, 29801, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:21:29', '2022-01-21 14:21:29'),
(38844, 3040, 29802, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:21', '2021-05-11 15:34:21'),
(38845, 3040, 29802, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:36:34', '2021-05-11 15:36:34'),
(38846, 3040, 29802, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:01', '2021-06-01 17:18:01'),
(38847, 3040, 29802, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:27', '2021-06-07 14:13:27'),
(38848, 3040, 29802, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:31', '2021-07-13 09:36:31'),
(38849, 11056, 29802, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:33:08', '2021-08-04 14:33:08'),
(38850, 3040, 29802, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:56', '2021-08-17 14:19:56'),
(38851, 12062, 29802, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:54:56', '2021-09-22 14:54:56'),
(38852, 12062, 29802, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:11:48', '2021-09-24 09:11:48'),
(38853, 10057, 29802, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:40', '2021-10-29 08:48:40'),
(38854, 10057, 29802, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:11:16', '2021-11-02 09:11:16'),
(38855, 10057, 29802, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:56', '2021-11-15 14:54:56'),
(38856, 10057, 29802, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:49', '2021-11-30 11:33:49'),
(38857, 10057, 29802, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:11:01', '2021-12-06 17:11:01'),
(38858, 10057, 29802, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:23:00', '2021-12-13 12:23:00'),
(38859, 10057, 29802, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:37', '2021-12-20 09:56:37'),
(38860, 10057, 29802, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:59:19', '2021-12-20 09:59:19'),
(38861, 10057, 29802, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:50', '2021-12-28 11:48:50'),
(38862, 19067, 29802, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:51', '2022-01-04 13:46:51'),
(38863, 20067, 29802, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:30', '2022-01-19 13:35:30'),
(38864, 20067, 29802, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:20:57', '2022-01-21 14:20:57'),
(38865, 3040, 29803, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:21', '2021-05-11 15:34:21'),
(38866, 3040, 29803, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:36:38', '2021-05-11 15:36:38'),
(38867, 3040, 29803, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:24', '2021-06-01 17:18:24'),
(38868, 3040, 29803, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:31', '2021-06-07 14:13:31'),
(38869, 3040, 29803, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:30', '2021-07-13 09:36:30'),
(38870, 11056, 29803, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:31:51', '2021-08-04 14:31:51'),
(38871, 3040, 29803, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:56', '2021-08-17 14:19:56'),
(38872, 12062, 29803, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:54:41', '2021-09-22 14:54:41'),
(38873, 12062, 29803, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:11:33', '2021-09-24 09:11:33'),
(38874, 10057, 29803, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:34', '2021-10-29 08:48:34'),
(38875, 10057, 29803, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:11:04', '2021-11-02 09:11:04'),
(38876, 10057, 29803, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:49', '2021-11-15 14:54:49'),
(38877, 10057, 29803, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:42', '2021-11-30 11:33:42'),
(38878, 10057, 29803, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:55', '2021-12-06 17:10:55'),
(38879, 10057, 29803, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:54', '2021-12-13 12:22:54'),
(38880, 10057, 29803, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:31', '2021-12-20 09:56:31'),
(38881, 10057, 29803, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:59:12', '2021-12-20 09:59:12'),
(38882, 10057, 29803, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:44', '2021-12-28 11:48:44'),
(38883, 19067, 29803, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:45', '2022-01-04 13:46:45'),
(38884, 20067, 29803, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:36', '2022-01-19 13:35:36'),
(38885, 20067, 29803, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:20:24', '2022-01-21 14:20:24'),
(38886, 3040, 29804, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:21', '2021-05-11 15:34:21'),
(38887, 3040, 29804, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:36:43', '2021-05-11 15:36:43'),
(38888, 3040, 29804, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:28', '2021-06-01 17:18:28'),
(38889, 3040, 29804, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:35', '2021-06-07 14:13:35'),
(38890, 3040, 29804, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:30', '2021-07-13 09:36:30'),
(38891, 11056, 29804, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:31:41', '2021-08-04 14:31:41');
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
(38892, 3040, 29804, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:55', '2021-08-17 14:19:55'),
(38893, 12062, 29804, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:54:26', '2021-09-22 14:54:26'),
(38894, 12062, 29804, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:11:18', '2021-09-24 09:11:18'),
(38895, 10057, 29804, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:28', '2021-10-29 08:48:28'),
(38896, 10057, 29804, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:10:52', '2021-11-02 09:10:52'),
(38897, 10057, 29804, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:43', '2021-11-15 14:54:43'),
(38898, 10057, 29804, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:36', '2021-11-30 11:33:36'),
(38899, 10057, 29804, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:48', '2021-12-06 17:10:48'),
(38900, 10057, 29804, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:48', '2021-12-13 12:22:48'),
(38901, 10057, 29804, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:25', '2021-12-20 09:56:25'),
(38902, 10057, 29804, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:59:04', '2021-12-20 09:59:04'),
(38903, 10057, 29804, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:38', '2021-12-28 11:48:38'),
(38904, 19067, 29804, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:39', '2022-01-04 13:46:39'),
(38905, 20067, 29804, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:42', '2022-01-19 13:35:42'),
(38906, 20067, 29804, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:19:50', '2022-01-21 14:19:50'),
(38907, 3040, 29805, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:21', '2021-05-11 15:34:21'),
(38908, 3040, 29805, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:02', '2021-05-11 15:37:02'),
(38909, 3040, 29805, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:32', '2021-06-01 17:18:32'),
(38910, 3040, 29805, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:38', '2021-06-07 14:13:38'),
(38911, 3040, 29805, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:29', '2021-07-13 09:36:29'),
(38912, 11056, 29805, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:32:13', '2021-08-04 14:32:13'),
(38913, 3040, 29805, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:55', '2021-08-17 14:19:55'),
(38914, 12062, 29805, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:54:13', '2021-09-22 14:54:13'),
(38915, 12062, 29805, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:11:01', '2021-09-24 09:11:01'),
(38916, 10057, 29805, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:22', '2021-10-29 08:48:22'),
(38917, 10057, 29805, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:10:41', '2021-11-02 09:10:41'),
(38918, 10057, 29805, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:36', '2021-11-15 14:54:36'),
(38919, 10057, 29805, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:30', '2021-11-30 11:33:30'),
(38920, 10057, 29805, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:38', '2021-12-06 17:10:38'),
(38921, 10057, 29805, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:41', '2021-12-13 12:22:41'),
(38922, 10057, 29805, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:19', '2021-12-20 09:56:19'),
(38923, 10057, 29805, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:56', '2021-12-20 09:58:56'),
(38924, 10057, 29805, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:30', '2021-12-28 11:48:30'),
(38925, 19067, 29805, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:32', '2022-01-04 13:46:32'),
(38926, 20067, 29805, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:48', '2022-01-19 13:35:48'),
(38927, 20067, 29805, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:19:13', '2022-01-21 14:19:13'),
(38928, 3040, 29806, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(38929, 3040, 29806, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:06', '2021-05-11 15:37:06'),
(38930, 3040, 29806, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:38', '2021-06-01 17:18:38'),
(38931, 3040, 29806, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:42', '2021-06-07 14:13:42'),
(38932, 3040, 29806, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:28', '2021-07-13 09:36:28'),
(38933, 11056, 29806, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:32:46', '2021-08-04 14:32:46'),
(38934, 3040, 29806, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:54', '2021-08-17 14:19:54'),
(38935, 12062, 29806, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:54:01', '2021-09-22 14:54:01'),
(38936, 12062, 29806, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:10:44', '2021-09-24 09:10:44'),
(38937, 10057, 29806, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:15', '2021-10-29 08:48:15'),
(38938, 10057, 29806, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:10:28', '2021-11-02 09:10:28'),
(38939, 10057, 29806, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:29', '2021-11-15 14:54:29'),
(38940, 10057, 29806, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:23', '2021-11-30 11:33:23'),
(38941, 10057, 29806, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:32', '2021-12-06 17:10:32'),
(38942, 10057, 29806, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:35', '2021-12-13 12:22:35'),
(38943, 10057, 29806, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:14', '2021-12-20 09:56:14'),
(38944, 10057, 29806, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:48', '2021-12-20 09:58:48'),
(38945, 10057, 29806, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:25', '2021-12-28 11:48:25'),
(38946, 19067, 29806, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:27', '2022-01-04 13:46:27'),
(38947, 20067, 29806, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:35:55', '2022-01-19 13:35:55'),
(38948, 20067, 29806, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:18:35', '2022-01-21 14:18:35'),
(38949, 3040, 29807, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(38950, 3040, 29807, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:10', '2021-05-11 15:37:10'),
(38951, 3040, 29807, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:50', '2021-06-01 17:18:50'),
(38952, 3040, 29807, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:45', '2021-06-07 14:13:45'),
(38953, 3040, 29807, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:27', '2021-07-13 09:36:27'),
(38954, 11056, 29807, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:31:15', '2021-08-04 14:31:15'),
(38955, 3040, 29807, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:54', '2021-08-17 14:19:54'),
(38956, 12062, 29807, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:53:43', '2021-09-22 14:53:43'),
(38957, 12062, 29807, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:10:30', '2021-09-24 09:10:30'),
(38958, 10057, 29807, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:10', '2021-10-29 08:48:10'),
(38959, 10057, 29807, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:10:12', '2021-11-02 09:10:12'),
(38960, 10057, 29807, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:23', '2021-11-15 14:54:23'),
(38961, 10057, 29807, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:16', '2021-11-30 11:33:16'),
(38962, 10057, 29807, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:26', '2021-12-06 17:10:26');
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
(38963, 10057, 29807, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:28', '2021-12-13 12:22:28'),
(38964, 10057, 29807, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:08', '2021-12-20 09:56:08'),
(38965, 10057, 29807, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:38', '2021-12-20 09:58:38'),
(38966, 10057, 29807, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:19', '2021-12-28 11:48:19'),
(38967, 19067, 29807, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:22', '2022-01-04 13:46:22'),
(38968, 20067, 29807, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:00', '2022-01-19 13:36:00'),
(38969, 20067, 29807, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:18:01', '2022-01-21 14:18:01'),
(38970, 3040, 29808, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(38971, 3040, 29808, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:15', '2021-05-11 15:37:15'),
(38972, 3040, 29808, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:54', '2021-06-01 17:18:54'),
(38973, 3040, 29808, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:48', '2021-06-07 14:13:48'),
(38974, 3040, 29808, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:27', '2021-07-13 09:36:27'),
(38975, 11056, 29808, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:30:59', '2021-08-04 14:30:59'),
(38976, 3040, 29808, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:53', '2021-08-17 14:19:53'),
(38977, 12062, 29808, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:53:30', '2021-09-22 14:53:30'),
(38978, 12062, 29808, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:10:09', '2021-09-24 09:10:09'),
(38979, 10057, 29808, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:48:03', '2021-10-29 08:48:03'),
(38980, 10057, 29808, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:10:01', '2021-11-02 09:10:01'),
(38981, 10057, 29808, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:17', '2021-11-15 14:54:17'),
(38982, 10057, 29808, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:10', '2021-11-30 11:33:10'),
(38983, 10057, 29808, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:20', '2021-12-06 17:10:20'),
(38984, 10057, 29808, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:22', '2021-12-13 12:22:22'),
(38985, 10057, 29808, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:56:03', '2021-12-20 09:56:03'),
(38986, 10057, 29808, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:29', '2021-12-20 09:58:29'),
(38987, 10057, 29808, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:13', '2021-12-28 11:48:13'),
(38988, 19067, 29808, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:17', '2022-01-04 13:46:17'),
(38989, 20067, 29808, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:06', '2022-01-19 13:36:06'),
(38990, 20067, 29808, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:17:02', '2022-01-21 14:17:02'),
(38991, 3040, 29809, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(38992, 3040, 29809, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:20', '2021-05-11 15:37:20'),
(38993, 3040, 29809, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:58', '2021-06-01 17:18:58'),
(38994, 3040, 29809, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:52', '2021-06-07 14:13:52'),
(38995, 3040, 29809, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:26', '2021-07-13 09:36:26'),
(38996, 11056, 29809, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:30:16', '2021-08-04 14:30:16'),
(38997, 3040, 29809, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:52', '2021-08-17 14:19:52'),
(38998, 12062, 29809, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:53:17', '2021-09-22 14:53:17'),
(38999, 12062, 29809, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:09:54', '2021-09-24 09:09:54'),
(39000, 10057, 29809, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:49:21', '2021-10-29 08:49:21'),
(39001, 10057, 29809, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:09:52', '2021-11-02 09:09:52'),
(39002, 10057, 29809, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:10', '2021-11-15 14:54:10'),
(39003, 10057, 29809, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:33:04', '2021-11-30 11:33:04'),
(39004, 10057, 29809, NULL, '2021-12-21 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-14 09:46:34', '2021-12-14 09:46:34'),
(39005, 10057, 29809, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:58', '2021-12-20 09:55:58'),
(39006, 10057, 29809, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:21', '2021-12-20 09:58:21'),
(39007, 10057, 29809, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:06', '2021-12-28 11:48:06'),
(39008, 19067, 29809, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:12', '2022-01-04 13:46:12'),
(39009, 20067, 29809, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:12', '2022-01-19 13:36:12'),
(39010, 20067, 29809, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:16:29', '2022-01-21 14:16:29'),
(39011, 3040, 29810, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(39012, 3040, 29810, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:24', '2021-05-11 15:37:24'),
(39013, 3040, 29810, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:02', '2021-06-01 17:19:02'),
(39014, 3040, 29810, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:56', '2021-06-07 14:13:56'),
(39015, 3040, 29810, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:25', '2021-07-13 09:36:25'),
(39016, 11056, 29810, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:30:07', '2021-08-04 14:30:07'),
(39017, 3040, 29810, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:52', '2021-08-17 14:19:52'),
(39018, 12062, 29810, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:53:01', '2021-09-22 14:53:01'),
(39019, 12062, 29810, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:09:37', '2021-09-24 09:09:37'),
(39020, 10057, 29810, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:39', '2021-10-29 08:47:39'),
(39021, 10057, 29810, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:09:39', '2021-11-02 09:09:39'),
(39022, 10057, 29810, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:54:03', '2021-11-15 14:54:03'),
(39023, 10057, 29810, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:58', '2021-11-30 11:32:58'),
(39024, 10057, 29810, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:13', '2021-12-06 17:10:13'),
(39025, 10057, 29810, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:17', '2021-12-13 12:22:17'),
(39026, 10057, 29810, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:52', '2021-12-20 09:55:52'),
(39027, 10057, 29810, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:48:00', '2021-12-28 11:48:00'),
(39028, 19067, 29810, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:07', '2022-01-04 13:46:07'),
(39029, 20067, 29810, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:18', '2022-01-19 13:36:18'),
(39030, 20067, 29810, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:15:38', '2022-01-21 14:15:38'),
(39031, 3040, 29811, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22');
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
(39032, 3040, 29811, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:28', '2021-05-11 15:37:28'),
(39033, 3040, 29811, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:05', '2021-06-01 17:19:05'),
(39034, 3040, 29811, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:13:59', '2021-06-07 14:13:59'),
(39035, 3040, 29811, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:25', '2021-07-13 09:36:25'),
(39036, 11056, 29811, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:29:58', '2021-08-04 14:29:58'),
(39037, 3040, 29811, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:51', '2021-08-17 14:19:51'),
(39038, 12062, 29811, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:52:46', '2021-09-22 14:52:46'),
(39039, 12062, 29811, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:09:20', '2021-09-24 09:09:20'),
(39040, 10057, 29811, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:31', '2021-10-29 08:47:31'),
(39041, 10057, 29811, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:09:27', '2021-11-02 09:09:27'),
(39042, 10057, 29811, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:58', '2021-11-15 14:53:58'),
(39043, 10057, 29811, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:51', '2021-11-30 11:32:51'),
(39044, 10057, 29811, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:06', '2021-12-06 17:10:06'),
(39045, 10057, 29811, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:11', '2021-12-13 12:22:11'),
(39046, 10057, 29811, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:45', '2021-12-20 09:55:45'),
(39047, 10057, 29811, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:54', '2021-12-28 11:47:54'),
(39048, 19067, 29811, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:46:02', '2022-01-04 13:46:02'),
(39049, 20067, 29811, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:25', '2022-01-19 13:36:25'),
(39050, 20067, 29811, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:15:05', '2022-01-21 14:15:05'),
(39051, 3040, 29812, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(39052, 3040, 29812, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:32', '2021-05-11 15:37:32'),
(39053, 3040, 29812, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:09', '2021-06-01 17:19:09'),
(39054, 3040, 29812, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:14:03', '2021-06-07 14:14:03'),
(39055, 3040, 29812, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:24', '2021-07-13 09:36:24'),
(39056, 11056, 29812, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:29:49', '2021-08-04 14:29:49'),
(39057, 3040, 29812, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:51', '2021-08-17 14:19:51'),
(39058, 12062, 29812, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:52:31', '2021-09-22 14:52:31'),
(39059, 12062, 29812, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:09:05', '2021-09-24 09:09:05'),
(39060, 10057, 29812, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:24', '2021-10-29 08:47:24'),
(39061, 10057, 29812, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:09:14', '2021-11-02 09:09:14'),
(39062, 10057, 29812, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:52', '2021-11-15 14:53:52'),
(39063, 10057, 29812, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:45', '2021-11-30 11:32:45'),
(39064, 10057, 29812, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:10:00', '2021-12-06 17:10:00'),
(39065, 10057, 29812, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:22:05', '2021-12-13 12:22:05'),
(39066, 10057, 29812, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:37', '2021-12-20 09:55:37'),
(39067, 10057, 29812, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:47', '2021-12-28 11:47:47'),
(39068, 19067, 29812, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:45:57', '2022-01-04 13:45:57'),
(39069, 20067, 29812, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:30', '2022-01-19 13:36:30'),
(39070, 20067, 29812, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:14:22', '2022-01-21 14:14:22'),
(39071, 3040, 29813, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(39072, 3040, 29813, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:37', '2021-05-11 15:37:37'),
(39073, 3040, 29813, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:13', '2021-06-01 17:19:13'),
(39074, 3040, 29813, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:14:07', '2021-06-07 14:14:07'),
(39075, 3040, 29813, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:23', '2021-07-13 09:36:23'),
(39076, 11056, 29813, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:29:38', '2021-08-04 14:29:38'),
(39077, 3040, 29813, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:51', '2021-08-17 14:19:51'),
(39078, 12062, 29813, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:52:16', '2021-09-22 14:52:16'),
(39079, 12062, 29813, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:08:24', '2021-09-24 09:08:24'),
(39080, 10057, 29813, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:17', '2021-10-29 08:47:17'),
(39081, 10057, 29813, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:09:03', '2021-11-02 09:09:03'),
(39082, 10057, 29813, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:36', '2021-11-15 14:53:36'),
(39083, 10057, 29813, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:37', '2021-11-30 11:32:37'),
(39084, 10057, 29813, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:09:54', '2021-12-06 17:09:54'),
(39085, 10057, 29813, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:21:58', '2021-12-13 12:21:58'),
(39086, 10057, 29813, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:28', '2021-12-20 09:55:28'),
(39087, 10057, 29813, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:41', '2021-12-28 11:47:41'),
(39088, 19067, 29813, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:45:52', '2022-01-04 13:45:52'),
(39089, 20067, 29813, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:44', '2022-01-19 13:36:44'),
(39090, 20067, 29813, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:13:37', '2022-01-21 14:13:37'),
(39091, 3040, 29814, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(39092, 3040, 29814, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:42', '2021-05-11 15:37:42'),
(39093, 3040, 29814, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:16', '2021-06-01 17:19:16'),
(39094, 3040, 29814, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:20', '2021-06-01 17:19:20'),
(39095, 3040, 29814, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:14:10', '2021-06-07 14:14:10'),
(39096, 3040, 29814, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:22', '2021-07-13 09:36:22'),
(39097, 11056, 29814, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:27:13', '2021-08-04 14:27:13'),
(39098, 3040, 29814, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:50', '2021-08-17 14:19:50');
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
(39099, 12062, 29814, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:52:00', '2021-09-22 14:52:00'),
(39100, 12062, 29814, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:08:03', '2021-09-24 09:08:03'),
(39101, 10057, 29814, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:09', '2021-10-29 08:47:09'),
(39102, 10057, 29814, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:08:49', '2021-11-02 09:08:49'),
(39103, 10057, 29814, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:30', '2021-11-15 14:53:30'),
(39104, 10057, 29814, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:31', '2021-11-30 11:32:31'),
(39105, 10057, 29814, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:09:49', '2021-12-06 17:09:49'),
(39106, 10057, 29814, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:21:52', '2021-12-13 12:21:52'),
(39107, 10057, 29814, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:18', '2021-12-20 09:55:18'),
(39108, 10057, 29814, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:13', '2021-12-20 09:58:13'),
(39109, 10057, 29814, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:33', '2021-12-28 11:47:33'),
(39110, 19067, 29814, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:45:46', '2022-01-04 13:45:46'),
(39111, 20067, 29814, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:36:56', '2022-01-19 13:36:56'),
(39112, 20067, 29814, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:12:47', '2022-01-21 14:12:47'),
(39113, 3040, 29815, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:22', '2021-05-11 15:34:22'),
(39114, 3040, 29815, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:46', '2021-05-11 15:37:46'),
(39115, 3040, 29815, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:19:24', '2021-06-01 17:19:24'),
(39116, 3040, 29815, NULL, '2021-06-14 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task. ', NULL, NULL, '2021-06-07 14:14:14', '2021-06-07 14:14:14'),
(39117, 3040, 29815, NULL, '2021-07-20 00:00:00.000', 'Not Eligible', 'Provider no longer working ', NULL, NULL, '2021-07-13 09:34:21', '2021-07-13 09:34:21'),
(39118, 12062, 29815, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:51:12', '2021-09-22 14:51:12'),
(39119, 12062, 29815, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:07:40', '2021-09-24 09:07:40'),
(39120, 10057, 29815, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:47:03', '2021-10-29 08:47:03'),
(39121, 10057, 29815, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:08:32', '2021-11-02 09:08:32'),
(39122, 10057, 29815, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:25', '2021-11-15 14:53:25'),
(39123, 10057, 29815, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:24', '2021-11-30 11:32:24'),
(39124, 10057, 29815, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:09:43', '2021-12-06 17:09:43'),
(39125, 10057, 29815, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:21:45', '2021-12-13 12:21:45'),
(39126, 10057, 29815, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:11', '2021-12-20 09:55:11'),
(39127, 10057, 29815, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:58:05', '2021-12-20 09:58:05'),
(39128, 10057, 29815, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:28', '2021-12-28 11:47:28'),
(39129, 19067, 29815, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:45:36', '2022-01-04 13:45:36'),
(39130, 20067, 29815, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:37:02', '2022-01-19 13:37:02'),
(39131, 20067, 29815, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:12:09', '2022-01-21 14:12:09'),
(39132, 3040, 29816, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-11 15:34:29', '2021-05-11 15:34:29'),
(39133, 3040, 29816, NULL, '2021-05-18 00:00:00.000', 'In Process', 'Email sent to: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Christus Health Plan for our group Columbus Urgent Care under the below location.  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-11 15:37:51', '2021-05-11 15:37:51'),
(39134, 3040, 29816, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email rcvd from: michal.simms@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || US FAMILY HEALTH PLAN ||  Hello Adil,  For participation in the USFHP plan, the attached forms need to be completed for each individual in the group then submitted to CHP.networkdevelopment@christushealth.org..  Please forward your requests to our department mailbox at CHP.networkdevelopment@christushealth.org for proper assignment and tracking.  Thank you, Michal  Ms. Michal Simms Network Contractor Senior Nueces Region CHRISTUS Health Plan US Family Health Plan www.christushealthplan.org www.usfhp.com', NULL, NULL, '2021-06-01 17:18:42', '2021-06-01 17:18:42'),
(39135, 3040, 29816, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. Please find the attached prospective group from as per your previous email requested. We wish to enroll as an ancillary facility, we will be billing under the group NPI with individuals rendering NPI on the claims, is that fine?  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-07 14:11:57', '2021-06-07 14:11:57'),
(39136, 3040, 29816, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Email rcvd from: hunter.barrett@christushealth.org  Subject: RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  If the individual providers NPIs are on the claims then it would need to be a group contract. If it would only be the group NPI we would be able to execute an Ancillary agreement. Hope that makes sense.  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health 919 Hidden Ridge | Irving, Texas 75038 (o) 469.282.3113 www.christushealth.org', NULL, NULL, '2021-06-24 08:34:03', '2021-06-24 08:34:03'),
(39137, 3040, 29816, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Yes we need to do the group contract. Can you please advise what you need from my side for a group contract?   Waiting for your reply.   Thank you  ', NULL, NULL, '2021-06-24 08:34:33', '2021-06-24 08:34:33'),
(39138, 3040, 29816, NULL, '2021-07-01 00:00:00.000', 'On Hold', 'We sent the ancillary contract request for the group. For more details please see the group task.  ', NULL, NULL, '2021-06-24 08:42:02', '2021-06-24 08:42:02'),
(39139, 3040, 29816, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Email sent to: CHP.NetworkDevelopment@christushealth.org  Subject: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello,   Hope you are doing well. Please find attached the prospective provider form for the below mentioned providers to enroll in Christus Health plan in our group Columbus Urgent Care PA under the below locations.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name:  Joseph, Molly Provider NPI# 1396380077  Provider 16:   Provider Name:  John, Jeny Provider NPI# 1073019493  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-07-13 09:36:22', '2021-07-13 09:36:22'),
(39140, 11056, 29816, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Email received from : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Would the provider bill as an Urgent Care/Ancillary?     Thanks,     Hunter Barrett  Network Contracting  CHRISTUS Health Plan  CHRISTUS Health  919 Hidden Ridge | Irving, Texas 75038  (o) 469.282.3113  www.christushealth.org    Replied :   Hello Hunter,   No, we are doing a group contract under the facility.   Thank you.', NULL, NULL, '2021-08-04 14:29:24', '2021-08-04 14:29:24'),
(39141, 3040, 29816, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: hunter.barrett@christushealth.org  Subject: Re: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hello Hunter,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Christus Health plan in our group under the below location.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Practice Address: 926 Walnut St, Columbus , TX 78934-2215  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-08-17 14:19:47', '2021-08-17 14:19:47'),
(39142, 12062, 29816, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Sent a follow up mail as below;  To:hunter.barrett@christushealth.org Subject:RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Hi Barrett,  Hope You are doing well !  I want to inquire about about the subject case, please advise if there is any further proceedings.   ', NULL, NULL, '2021-09-22 14:46:51', '2021-09-22 14:46:51'),
(39143, 12062, 29816, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Replied to an atatched email received ;  To:hunter.barrett@christushealth.org Subject :RE: Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Dear Barrett,  Thanks for you acknowledgement.   Can you check and advise any estimated time from now to which the provider must get enrolled? ', NULL, NULL, '2021-09-24 09:07:19', '2021-09-24 09:07:19'),
(39144, 10057, 29816, NULL, '2021-11-05 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org, CHP.NetworkDevelopment@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope you are doing well. Please let me know the updated status for below mentioned providers under the location TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-29 08:46:57', '2021-10-29 08:46:57'),
(39145, 10057, 29816, NULL, '2021-12-09 00:00:00.000', 'In Process', 'Email Received From : hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Please reach out to our credentialing team directly for updates. I sent them the contract 3 months ago and they typically take 6 months to get the new application. Please allow them that 6 months.  CHRISTUS.HP.Credentialing CHRISTUS.HP.Credentialing@christushealth.org  Thanks,  Hunter Barrett Network Contracting CHRISTUS Health Plan CHRISTUS Health', NULL, NULL, '2021-11-02 09:08:20', '2021-11-02 09:08:20'),
(39146, 10057, 29816, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Michal,  Hope you are doing good!  Can you please help me out with the query of our providers, we have sent their applications back in April, but still didn\'t have any update. I have attached our group roster, please get back to me at your earliest convenience.  Regards, Alex', NULL, NULL, '2021-11-15 14:53:18', '2021-11-15 14:53:18'),
(39147, 10057, 29816, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Received From : michal.simms@christushealth.org  Sub : Enrollment Query - CUCC  Hello Alex,  Our department email address is CHP.NetworkDevelopment@CHRISTUSHealth.org.  Please send your requests to that mailbox so that the requests are sent to the correct person handling a territory.  I do not see Columbus Urgent Care PA in our system.  Has the request been submitted to the department mailbox?  I do not handle Columbus, Texas region.  Thanks, Michal  CLAIMS MED PERSONNEL:  PLEASE DIRECT YOUR CONTRACTING INQUIRES TO CHP.NetworkDevelopment@CHRISTUSHealth.org', NULL, NULL, '2021-11-30 11:32:18', '2021-11-30 11:32:18'),
(39148, 10057, 29816, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : hunter.barrett@christushealth.org & CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Thank you for your response. Have a great day.  Regards,', NULL, NULL, '2021-12-06 17:09:37', '2021-12-06 17:09:37'),
(39149, 10057, 29816, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good afternoon,  Hope this email finds you in good health. I\'m writing this email to check the latest update on the below mentioned providers and group enrollment status under the TIN.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus , TX 78934-2215  Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509  Please get back to me as soon as possible. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-12-13 12:21:39', '2021-12-13 12:21:39'),
(39150, 10057, 29816, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:55:05', '2021-12-20 09:55:05'),
(39151, 10057, 29816, NULL, '2021-12-28 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org & hunter.barrett@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Greetings for the day!  Any update on the below request. It is my SECOND REMINDER, please reach out to me ASAP...  Kind Regards,', NULL, NULL, '2021-12-20 09:57:57', '2021-12-20 09:57:57'),
(39152, 10057, 29816, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email Sent To : CHRISTUS.HP.Credentialing@christushealth.org  Sub : Enroll Group & Providers || Columbus Urgent Care PA || CHRISTUS HEALTH PLAN ||  Good Morning,  Hope this email finds you well. This is THIRD REMINDER on the below request.  your earliest response will be highly appreciated!  Regards,', NULL, NULL, '2021-12-28 11:47:22', '2021-12-28 11:47:22'),
(39153, 19067, 29816, NULL, '2022-01-11 00:00:00.000', 'In Process', 'Email sent to: CHRISTUS.HP.Credentialing@christushealth.org  Subject: Enrollment Query  || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||  Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Christus Health Plan.  Group Name	Columbus Urgent Care Tax ID	47-1914151 Group NPI	1215330501 Practice Address	926 Walnut St, Columbus, TX 78934-2215 Provider Name	NPI Fernandus, Limy	1972005189 PAUL, SIGI	1033623616 Jacob, Jaya	1194336149 Abraham, Jeena	1467901587 Thomas, Cini	1134777238 Kourouma , Odette Tiranke	1134525868 Rauf, Abdur	1497726202 Joseph, Molly	1396380077 John, Jeny	1073019493 Stephen, Ani	1588959118 Brown, Brittany	1275163537 Joseph, Vibitha	1952931560 George, Jeemol	1497219067 Jose, Julie	1447883061 Abraham, Glory	1194206490 Chennemkara, Mini Philip	1841755956 Piccione JR, James M	1356321509   Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-04 13:45:30', '2022-01-04 13:45:30'),
(39154, 20067, 29816, NULL, '2022-01-26 00:00:00.000', 'In Process', 'Email sent to: christus.hp.credentialing@christushealth.org, CHP.NetworkDevelopment@christushealth.org   Sub: Re: Enrollment Query || Columbus Urgent Care PA || Providers & Group || CHRISTUS HEALTH PLAN ||   Good Morning! Hope this email finds you well. We are continuously emailing you guys but haven\'t received any response from your side. Kindly respond to the previous request as soon as possible.  Thanks & Regards, Syed Ahad.', NULL, NULL, '2022-01-19 13:37:08', '2022-01-19 13:37:08'),
(39155, 20067, 29816, NULL, '2022-01-28 00:00:00.000', 'Approved', 'Received the following email from: Sonia.Gonzales@christushealth.org  Hello,  Perfect contract is effective as of 01/01/2022,  all claims should be billed on a CMS  with group information in box 31 instead of rendering provider.  Thanks and have a wonderful day!   Respectfully,  This is an Ancillary group contract.', NULL, NULL, '2022-01-21 14:22:01', '2022-01-21 14:22:01'),
(39156, 1019, 29817, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39157, 1019, 29817, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 07:59:05', '2021-05-12 07:59:05'),
(39158, 1019, 29817, NULL, '2021-06-29 00:00:00.000', 'Initiated', 'Initiated thru BCBSRI Website. Attached is the application form and Submission Confirmation for the request.  \"Thank you for your enrollment request. Within four business days of the submission of this form, you should receive an email that will serve to confirm receipt of your request. The email will also include an attachment that contains a packet of important forms such as a provider agreement, W9, EFT instructions, etc., as well as information that will help guide you through the initial credentialing process. Those forms should be completed and returned to Database.Credentialing@bcbsri.org as soon as possible. It is important to note that your application will not be considered complete until all of the required documents have been returned. Additionally, BCBSRI utilizes the CAQH application to credential providers. It is very important to ensure that you have made your CAQH accessible to BCBSRI and updated and attested to the information in CAQH within the last 120 days. If you do not receive an email response within two days after submitting this form please email Database.Credentialing@bcbsri.org to confirm the status of your submission and request that the packet be resent to you. We appreciate your interest in joining the BCBSRI network and will work to begin prompt processing of your request. However, please note the credentialing process may be discontinued if we are unable to access your CAQH application or if your CAQH application is not updated and attested to in the required timeframe, or if you do not return the provider agreement and required forms.\"', NULL, NULL, '2021-06-15 07:54:40', '2021-06-15 07:54:40'),
(39159, 1019, 29817, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:57:02', '2021-10-25 10:57:02'),
(39160, 1019, 29818, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39161, 1019, 29818, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 07:57:38', '2021-05-12 07:57:38'),
(39162, 1019, 29818, NULL, '2021-06-29 00:00:00.000', 'Initiated', 'Submitted Application Online thru Website. Attached is the copy of the Request for Ref.', NULL, NULL, '2021-06-14 16:12:11', '2021-06-14 16:12:11'),
(39163, 1019, 29818, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Sent the following email to Laura.Bevin@aetna.com  Hello, We need the enrollment application status for the following providers,   Group Information: Spectrum Neuro Behavioral Care NPI: 1356906572 TAX ID: 834482753 Primary Location: 61 Lincoln Street, Suite 203, Framingham, MA, 01702. Secondary Location: 100 New State Highway, Raynham, MA, 02767.  Individual Providers:  Barbara Hignite NPI: 1982617262 Primary Location: 61 Lincoln Street, Suite 203, Framingham, MA, 01702. Secondary Location: 100 New State Highway, Raynham, MA, 02767.  Rodesia Edmundson  NPI: 1124622667  Primary Location: 61 Lincoln Street, Suite 203, Framingham, MA, 01702. Secondary Location: 100 New State Highway, Raynham, MA, 02767.     Jessica Hartman  NPI: 1326665472  Primary Location: 61 Lincoln Street, Suite 203, Framingham, MA, 01702. Secondary Location: 100 New State Highway, Raynham, MA, 02767.      Lynnetta Loveland  NPI: 1598163602  Secondary Location: 100 New State Highway, Raynham, MA, 02767.    Cemetrice Muhammed NPI: 1548843410  Primary Location: 63 Eddie Dowling Highway, Suite 9, North Smithfield, RI, 02896.    Jonathan Schubert  NPI: 1235755505   Secondary Location: 100 New State Highway, Raynham, MA, 02767.     Kerry Smith  NPI: 1275083230  Primary Location: 61 Lincoln Street, Suite 203, Framingham, MA, 01702 Secondary Location: 100 New State Highway, Raynham, MA, 02767.    Jennifer Ullrich  NPI: 1710489760  Secondary Location: 100 New State Highway, Raynham, MA, 02767      Regards, Alex G.', NULL, NULL, '2021-08-24 11:10:16', '2021-08-24 11:10:16'),
(39164, 1019, 29818, NULL, '2021-10-14 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE.', NULL, NULL, '2021-10-06 23:49:24', '2021-10-06 23:49:24'),
(39165, 1019, 29819, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39166, 1019, 29819, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 07:59:19', '2021-05-12 07:59:19'),
(39167, 1019, 29819, NULL, '2021-06-29 00:00:00.000', 'Initiated', 'Received the following email from behavioralcontracting@cigna.com  SUB: You have successfully submitted your application  Your application has been received, your CBP ID is CBP-0000219521. A recruiter will process your application and provide onboarding instructions within 20 business days. The process to join the Cigna Network can take up to 90 days. To check the status of your application, please email behavioralcontracting@cigna.com.  Regards, Alex', NULL, NULL, '2021-06-14 16:54:09', '2021-06-14 16:54:09'),
(39168, 1019, 29819, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Received the following email from Briana.Adams@cigna.com  Good afternoon,     Please verify the location you would like to link the provider.  Have a great day!        Briana Adams  Provider Relations Analyst | Cigna Behavioral Health National Contracting Unit     For assistance regarding claims, authorizations, eligibility, benefits, and demographic updates, please call 800.926.2273.     Learn more & apply at: CignaforHCP.com > Resources > Behavioral Resources > Doing Business with Cigna > Credentialing  Healthy people, healthy planet ~ Please consider the environment before printing this email.  Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © Copyright 2021 Cigna.   ', NULL, NULL, '2021-08-03 12:39:25', '2021-08-03 12:39:25'),
(39169, 1019, 29819, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Sent the following email to Briana.Adams@cigna.com  Hello, The location will be 63 Eddie Dowling Highway, Suite 9, North Smithfield, Rhode Island, 02896.   Regards, Alex', NULL, NULL, '2021-08-03 12:40:01', '2021-08-03 12:40:01'),
(39170, 1019, 29819, NULL, '2021-08-12 00:00:00.000', 'In Process', 'Received the following contract signed, which was signed sent back, please see attached for reference.', NULL, NULL, '2021-08-05 08:15:11', '2021-08-05 08:15:11'),
(39171, 1019, 29819, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:57:13', '2021-10-25 10:57:13'),
(39172, 1019, 29820, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39173, 1019, 29820, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 07:59:42', '2021-05-12 07:59:42'),
(39174, 1019, 29820, NULL, '2021-07-05 00:00:00.000', 'Initiated', 'Sent the provider roster to mtasby2@humana.com to add the following provider under our group.', NULL, NULL, '2021-06-18 09:23:54', '2021-06-18 09:23:54'),
(39175, 1019, 29820, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:57:46', '2021-10-25 10:57:46'),
(39176, 1019, 29821, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39177, 1019, 29821, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 08:00:41', '2021-05-12 08:00:41'),
(39178, 1019, 29821, NULL, '2021-06-29 00:00:00.000', 'On Hold', 'Waiting to get credentialed with Aetna First.', NULL, NULL, '2021-06-15 07:55:28', '2021-06-15 07:55:28'),
(39179, 1019, 29821, NULL, '2021-07-25 00:00:00.000', 'On Hold', 'Waiting to get credentialed with Aetna first.', NULL, NULL, '2021-06-18 09:25:53', '2021-06-18 09:25:53'),
(39180, 1019, 29821, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:57:35', '2021-10-25 10:57:35'),
(39181, 1019, 29822, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39182, 1019, 29822, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 08:01:19', '2021-05-12 08:01:19'),
(39183, 1019, 29822, NULL, '2021-08-25 00:00:00.000', 'Initiated', 'Sent the following application by mail to Gainwell, see attached for reference.', NULL, NULL, '2021-08-18 14:28:06', '2021-08-18 14:28:06'),
(39184, 1019, 29822, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:58:18', '2021-10-25 10:58:18'),
(39185, 1019, 29823, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39186, 1019, 29823, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 08:01:39', '2021-05-12 08:01:39'),
(39187, 1019, 29823, NULL, '2021-06-29 00:00:00.000', 'Initiated', 'Faxed the certification form to (608) 221-7535. Attached is the copy of the form for Ref.', NULL, NULL, '2021-06-15 09:33:31', '2021-06-15 09:33:31'),
(39188, 1019, 29823, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:58:40', '2021-10-25 10:58:40'),
(39189, 1019, 29824, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39190, 1019, 29824, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 08:01:56', '2021-05-12 08:01:56'),
(39191, 1019, 29824, NULL, '2021-06-25 00:00:00.000', 'On Hold', 'Waiting for State Medicare PTAN to load in there systems.', NULL, NULL, '2021-06-18 09:25:16', '2021-06-18 09:25:16'),
(39192, 1019, 29824, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer continue with SNBCARE. ', NULL, NULL, '2021-10-25 10:58:31', '2021-10-25 10:58:31'),
(39193, 1019, 29825, NULL, NULL, 'New/Not Initiated', '', NULL, NULL, '2021-05-12 07:55:58', '2021-05-12 07:55:58'),
(39194, 1019, 29825, NULL, '2021-06-01 00:00:00.000', 'On Hold', 'Waiting for Cemetrice State license.', NULL, NULL, '2021-05-12 08:02:33', '2021-05-12 08:02:33');
