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
(31613, 9057, 23813, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:18', '2021-05-25 10:19:18'),
(31614, 9057, 23813, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:25', '2021-05-25 10:19:25'),
(31615, 1006, 23813, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I want to check in on the status of this request for enrollment, as we still haven\'t heard anything back as of yet?   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-04 14:21:09', '2021-06-04 14:21:09'),
(31616, 1006, 23813, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a VM to Vicki Gera @ (800) 419-3461 as we haven\'t been receiving any replies on emails. ', NULL, NULL, '2021-06-11 14:13:49', '2021-06-11 14:13:49'),
(31617, 3040, 23813, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: vicki.guerra@christushealth.org  Subject:  Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,  I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?  Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-30 15:20:57', '2021-06-30 15:20:57'),
(31618, 1006, 23813, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hi Adil,  Happy Wednesday!  Thank you for reaching out. We would like for Statcare Minor Emergency Clinic to come back on board. The last time we spoke it was to my understanding that Ms. Rabagos did not have a sponsoring physician with hospital privileges for a Christus facility. This is one of the requirements to bring this provider group back on board with a new contract.  Is there a sponsor/supervising physician who has hospital affiliations at a Christus Facility that Ms. Rabagos will be utilizing?  Vicki Ann Guerra  Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Sent following reply:  \"Hello Vicki,   I appreciate the update, would you be able to check again if David Gray (NPI# 1902814874) now has hospital privileges with a Christus facility?   Thank you. \" ', NULL, NULL, '2021-07-01 14:11:22', '2021-07-01 14:11:22'),
(31619, 1006, 23813, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent following email to Vicki @ Guerra, Vicki A. vicki.guerra@christushealth.org:  Sub: Hospital Privileges - Gray  \"Hello Vicki,   I apologize for the incorrect information, the correct supervising physician for Katherine is Luis Leyton Gonzalez (NPI# 1013911601), please look into this provider instead.   Thank you. \" ', NULL, NULL, '2021-07-12 13:42:36', '2021-07-12 13:42:36'),
(31620, 1006, 23813, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following reply from vicki.guerra@christushealth.org:  Sub: vicki.guerra@christushealth.org  \"Hi Brad,  Happy Tuesday!  Can I have the last 4 of Dr. Leyton Gonzalez SS? This is the only way for me to verify in the portal along with NPI.  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  I replied with the requested information to her.', NULL, NULL, '2021-08-02 17:07:24', '2021-08-02 17:07:24'),
(31621, 1006, 23813, NULL, '2021-08-12 00:00:00.000', 'Not Eligible', 'Received the following denial notification:  Sub: Denial Letter CSHN: STATCARE Contract  \"August 3, 2021  STATCARE Administrator/Owner Rabagos C/O – Office Manager  Dear Administrator and Owner Rabagos (OM), Thank you for your continuous efforts to participate in the Christus Spohn Health Network. Currently to contract with CSHN, Ms. Rabagos will need to have a sponsoring physician to participate in the network. The requirement for a sponsoring physician is to have and maintain  hospital affiliations/memberships with a Christus facility as per Article 5.5 in CSHNs contract agreement and Section I, Article III, Section(s) 3.2-1 and 3.6. CSHN would love to see STACARE back on the Spohn Network directory. Until this criterion for a sponsoring physician is met with hospital affiliations/memberships with a Christus facility CSHN cannot extend a contract.  Locations: STATCARE Kingsville 500 E Caesar Ave, Kingsville Texas 78363 STATCARE Calallen 4042 River Hill Drive Corpus Christi Texas 78410 STATCARE Corpus Christi Southside 6646 S Staples St #122 Corpus Christi Texas 78413 STATCARE Corpus Christi SPID 3817 S. Padre Island Dr. Corpus Christi Texas 78415 STATCARE Rockport 2102 FM 2165 Rockport Texas 78382  Have a blessed and wonderful day. Sincerely,  Vicki Ann Guerra Provider Relations Representative\"', NULL, NULL, '2021-08-05 09:48:05', '2021-08-05 09:48:05'),
(31622, 11056, 23813, NULL, '2021-10-07 00:00:00.000', 'Approved', 'There is no need to enrolled the provider in Ancillary contract.', NULL, NULL, '2021-09-30 13:43:59', '2021-09-30 13:43:59'),
(31623, 1006, 23814, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:45:56', '2021-03-25 11:45:56'),
(31624, 1006, 23814, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Sent following enrollment request email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?   Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.   Thank you. \" ', NULL, NULL, '2021-04-08 18:47:48', '2021-04-08 18:47:48'),
(31625, 9057, 23814, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:33', '2021-05-25 10:19:33'),
(31626, 1006, 23814, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I want to check in on the status of this request for enrollment, as we still haven\'t heard anything back as of yet?   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-04 14:21:12', '2021-06-04 14:21:12'),
(31627, 1006, 23814, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a VM to Vicki Gera @ (800) 419-3461 as we haven\'t been receiving any replies on emails. ', NULL, NULL, '2021-06-11 14:13:46', '2021-06-11 14:13:46'),
(31628, 3040, 23814, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: vicki.guerra@christushealth.org  Subject:  Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,  I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?  Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-30 15:20:57', '2021-06-30 15:20:57'),
(31629, 1006, 23814, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hi Adil,  Happy Wednesday!  Thank you for reaching out. We would like for Statcare Minor Emergency Clinic to come back on board. The last time we spoke it was to my understanding that Ms. Rabagos did not have a sponsoring physician with hospital privileges for a Christus facility. This is one of the requirements to bring this provider group back on board with a new contract.  Is there a sponsor/supervising physician who has hospital affiliations at a Christus Facility that Ms. Rabagos will be utilizing?  Vicki Ann Guerra  Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Sent following reply:  \"Hello Vicki,   I appreciate the update, would you be able to check again if David Gray (NPI# 1902814874) now has hospital privileges with a Christus facility?   Thank you. \" ', NULL, NULL, '2021-07-01 14:11:18', '2021-07-01 14:11:18'),
(31630, 1006, 23814, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent following email to Vicki @ Guerra, Vicki A. vicki.guerra@christushealth.org:  Sub: Hospital Privileges - Gray  \"Hello Vicki,   I apologize for the incorrect information, the correct supervising physician for Katherine is Luis Leyton Gonzalez (NPI# 1013911601), please look into this provider instead.   Thank you. \" ', NULL, NULL, '2021-07-12 13:42:39', '2021-07-12 13:42:39'),
(31631, 1006, 23814, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following reply from vicki.guerra@christushealth.org:  Sub: vicki.guerra@christushealth.org  \"Hi Brad,  Happy Tuesday!  Can I have the last 4 of Dr. Leyton Gonzalez SS? This is the only way for me to verify in the portal along with NPI.  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  I replied with the requested information to her.', NULL, NULL, '2021-08-02 17:07:20', '2021-08-02 17:07:20'),
(31632, 1006, 23814, NULL, '2021-08-12 00:00:00.000', 'Not Eligible', 'Received the following denial notification:  Sub: Denial Letter CSHN: STATCARE Contract  \"August 3, 2021  STATCARE Administrator/Owner Rabagos C/O – Office Manager  Dear Administrator and Owner Rabagos (OM), Thank you for your continuous efforts to participate in the Christus Spohn Health Network. Currently to contract with CSHN, Ms. Rabagos will need to have a sponsoring physician to participate in the network. The requirement for a sponsoring physician is to have and maintain  hospital affiliations/memberships with a Christus facility as per Article 5.5 in CSHNs contract agreement and Section I, Article III, Section(s) 3.2-1 and 3.6. CSHN would love to see STACARE back on the Spohn Network directory. Until this criterion for a sponsoring physician is met with hospital affiliations/memberships with a Christus facility CSHN cannot extend a contract.  Locations: STATCARE Kingsville 500 E Caesar Ave, Kingsville Texas 78363 STATCARE Calallen 4042 River Hill Drive Corpus Christi Texas 78410 STATCARE Corpus Christi Southside 6646 S Staples St #122 Corpus Christi Texas 78413 STATCARE Corpus Christi SPID 3817 S. Padre Island Dr. Corpus Christi Texas 78415 STATCARE Rockport 2102 FM 2165 Rockport Texas 78382  Have a blessed and wonderful day. Sincerely,  Vicki Ann Guerra Provider Relations Representative\"', NULL, NULL, '2021-08-05 09:47:56', '2021-08-05 09:47:56'),
(31633, 11056, 23814, NULL, '2021-10-07 00:00:00.000', 'Approved', 'There is no need to enrolled the provider in Ancillary contract.', NULL, NULL, '2021-09-30 13:44:05', '2021-09-30 13:44:05'),
(31634, 1006, 23815, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:45:56', '2021-03-25 11:45:56'),
(31635, 1006, 23815, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Sent following enrollment request email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?   Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.   Thank you. \" ', NULL, NULL, '2021-04-08 18:47:52', '2021-04-08 18:47:52'),
(31636, 9057, 23815, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:42', '2021-05-25 10:19:42'),
(31637, 1006, 23815, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I want to check in on the status of this request for enrollment, as we still haven\'t heard anything back as of yet?   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-04 14:21:15', '2021-06-04 14:21:15'),
(31638, 1006, 23815, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a VM to Vicki Gera @ (800) 419-3461 as we haven\'t been receiving any replies on emails. ', NULL, NULL, '2021-06-11 14:13:43', '2021-06-11 14:13:43'),
(31639, 3040, 23815, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: vicki.guerra@christushealth.org  Subject:  Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,  I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?  Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-30 15:20:56', '2021-06-30 15:20:56'),
(31640, 1006, 23815, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hi Adil,  Happy Wednesday!  Thank you for reaching out. We would like for Statcare Minor Emergency Clinic to come back on board. The last time we spoke it was to my understanding that Ms. Rabagos did not have a sponsoring physician with hospital privileges for a Christus facility. This is one of the requirements to bring this provider group back on board with a new contract.  Is there a sponsor/supervising physician who has hospital affiliations at a Christus Facility that Ms. Rabagos will be utilizing?  Vicki Ann Guerra  Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Sent following reply:  \"Hello Vicki,   I appreciate the update, would you be able to check again if David Gray (NPI# 1902814874) now has hospital privileges with a Christus facility?   Thank you. \" ', NULL, NULL, '2021-07-01 14:11:14', '2021-07-01 14:11:14'),
(31641, 1006, 23815, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent following email to Vicki @ Guerra, Vicki A. vicki.guerra@christushealth.org:  Sub: Hospital Privileges - Gray  \"Hello Vicki,   I apologize for the incorrect information, the correct supervising physician for Katherine is Luis Leyton Gonzalez (NPI# 1013911601), please look into this provider instead.   Thank you. \" ', NULL, NULL, '2021-07-12 13:42:43', '2021-07-12 13:42:43'),
(31642, 1006, 23815, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following reply from vicki.guerra@christushealth.org:  Sub: vicki.guerra@christushealth.org  \"Hi Brad,  Happy Tuesday!  Can I have the last 4 of Dr. Leyton Gonzalez SS? This is the only way for me to verify in the portal along with NPI.  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  I replied with the requested information to her.', NULL, NULL, '2021-08-02 17:07:17', '2021-08-02 17:07:17'),
(31643, 1006, 23815, NULL, '2021-08-12 00:00:00.000', 'Not Eligible', 'Received the following denial notification:  Sub: Denial Letter CSHN: STATCARE Contract  \"August 3, 2021  STATCARE Administrator/Owner Rabagos C/O – Office Manager  Dear Administrator and Owner Rabagos (OM), Thank you for your continuous efforts to participate in the Christus Spohn Health Network. Currently to contract with CSHN, Ms. Rabagos will need to have a sponsoring physician to participate in the network. The requirement for a sponsoring physician is to have and maintain  hospital affiliations/memberships with a Christus facility as per Article 5.5 in CSHNs contract agreement and Section I, Article III, Section(s) 3.2-1 and 3.6. CSHN would love to see STACARE back on the Spohn Network directory. Until this criterion for a sponsoring physician is met with hospital affiliations/memberships with a Christus facility CSHN cannot extend a contract.  Locations: STATCARE Kingsville 500 E Caesar Ave, Kingsville Texas 78363 STATCARE Calallen 4042 River Hill Drive Corpus Christi Texas 78410 STATCARE Corpus Christi Southside 6646 S Staples St #122 Corpus Christi Texas 78413 STATCARE Corpus Christi SPID 3817 S. Padre Island Dr. Corpus Christi Texas 78415 STATCARE Rockport 2102 FM 2165 Rockport Texas 78382  Have a blessed and wonderful day. Sincerely,  Vicki Ann Guerra Provider Relations Representative\"', NULL, NULL, '2021-08-05 09:47:53', '2021-08-05 09:47:53'),
(31644, 11056, 23815, NULL, '2021-10-07 00:00:00.000', 'Approved', 'There is no need to enrolled the provider in Ancillary contract.', NULL, NULL, '2021-09-30 13:45:24', '2021-09-30 13:45:24'),
(31645, 1006, 23816, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:45:57', '2021-03-25 11:45:57'),
(31646, 1006, 23816, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Sent following enrollment request email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?   Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.   Thank you. \" ', NULL, NULL, '2021-04-08 18:47:56', '2021-04-08 18:47:56'),
(31647, 9057, 23816, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:50', '2021-05-25 10:19:50'),
(31648, 1006, 23816, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I want to check in on the status of this request for enrollment, as we still haven\'t heard anything back as of yet?   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-04 14:21:19', '2021-06-04 14:21:19'),
(31649, 1006, 23816, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a VM to Vicki Gera @ (800) 419-3461 as we haven\'t been receiving any replies on emails. ', NULL, NULL, '2021-06-11 14:13:40', '2021-06-11 14:13:40'),
(31650, 3040, 23816, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: vicki.guerra@christushealth.org  Subject:  Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,  I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?  Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-30 15:20:56', '2021-06-30 15:20:56'),
(31651, 1006, 23816, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hi Adil,  Happy Wednesday!  Thank you for reaching out. We would like for Statcare Minor Emergency Clinic to come back on board. The last time we spoke it was to my understanding that Ms. Rabagos did not have a sponsoring physician with hospital privileges for a Christus facility. This is one of the requirements to bring this provider group back on board with a new contract.  Is there a sponsor/supervising physician who has hospital affiliations at a Christus Facility that Ms. Rabagos will be utilizing?  Vicki Ann Guerra  Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Sent following reply:  \"Hello Vicki,   I appreciate the update, would you be able to check again if David Gray (NPI# 1902814874) now has hospital privileges with a Christus facility?   Thank you. \" ', NULL, NULL, '2021-07-01 14:11:09', '2021-07-01 14:11:09'),
(31652, 1006, 23816, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent following email to Vicki @ Guerra, Vicki A. vicki.guerra@christushealth.org:  Sub: Hospital Privileges - Gray  \"Hello Vicki,   I apologize for the incorrect information, the correct supervising physician for Katherine is Luis Leyton Gonzalez (NPI# 1013911601), please look into this provider instead.   Thank you. \" ', NULL, NULL, '2021-07-12 13:42:46', '2021-07-12 13:42:46'),
(31653, 1006, 23816, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following reply from vicki.guerra@christushealth.org:  Sub: vicki.guerra@christushealth.org  \"Hi Brad,  Happy Tuesday!  Can I have the last 4 of Dr. Leyton Gonzalez SS? This is the only way for me to verify in the portal along with NPI.  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  I replied with the requested information to her.', NULL, NULL, '2021-08-02 17:07:13', '2021-08-02 17:07:13'),
(31654, 1006, 23816, NULL, '2021-08-12 00:00:00.000', 'Not Eligible', 'Received the following denial notification:  Sub: Denial Letter CSHN: STATCARE Contract  \"August 3, 2021  STATCARE Administrator/Owner Rabagos C/O – Office Manager  Dear Administrator and Owner Rabagos (OM), Thank you for your continuous efforts to participate in the Christus Spohn Health Network. Currently to contract with CSHN, Ms. Rabagos will need to have a sponsoring physician to participate in the network. The requirement for a sponsoring physician is to have and maintain  hospital affiliations/memberships with a Christus facility as per Article 5.5 in CSHNs contract agreement and Section I, Article III, Section(s) 3.2-1 and 3.6. CSHN would love to see STACARE back on the Spohn Network directory. Until this criterion for a sponsoring physician is met with hospital affiliations/memberships with a Christus facility CSHN cannot extend a contract.  Locations: STATCARE Kingsville 500 E Caesar Ave, Kingsville Texas 78363 STATCARE Calallen 4042 River Hill Drive Corpus Christi Texas 78410 STATCARE Corpus Christi Southside 6646 S Staples St #122 Corpus Christi Texas 78413 STATCARE Corpus Christi SPID 3817 S. Padre Island Dr. Corpus Christi Texas 78415 STATCARE Rockport 2102 FM 2165 Rockport Texas 78382  Have a blessed and wonderful day. Sincerely,  Vicki Ann Guerra Provider Relations Representative\"', NULL, NULL, '2021-08-05 09:47:48', '2021-08-05 09:47:48'),
(31655, 11056, 23816, NULL, '2021-10-07 00:00:00.000', 'Approved', 'There is no need to enrolled the provider in Ancillary contract.', NULL, NULL, '2021-09-30 13:44:51', '2021-09-30 13:44:51'),
(31656, 1006, 23817, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:45:58', '2021-03-25 11:45:58'),
(31657, 1006, 23817, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Sent following enrollment request email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?   Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.   Thank you. \" ', NULL, NULL, '2021-04-08 18:47:59', '2021-04-08 18:47:59'),
(31658, 9057, 23817, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Status - RHC - Christus Spohn  \"Hello, We want to know the current status of the request we sent to you last month about the enrollment for the following group and its providers:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904  TIN#  46-0575924  Please get back to us as soon as possible.  Thank you\"', NULL, NULL, '2021-05-25 10:19:58', '2021-05-25 10:19:58'),
(31659, 1006, 23817, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,   I want to check in on the status of this request for enrollment, as we still haven\'t heard anything back as of yet?   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-04 14:20:29', '2021-06-04 14:20:29'),
(31660, 1006, 23817, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a VM to Vicki Gera @ (800) 419-3461 as we haven\'t been receiving any replies on emails. ', NULL, NULL, '2021-06-11 14:13:37', '2021-06-11 14:13:37'),
(31661, 3040, 23817, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: vicki.guerra@christushealth.org  Subject:  Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hello,  I hope you\'re doing well, we wanted to enroll our group and the following providers with Christus Spohn, please let me know what is required to proceed with this request?  Provider Information is as follows:  Practice Details: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider 2: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider 3: Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider 4: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Provider 5: Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 8: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 9: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597  Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Please get back to me as soon as you\'re able to.  Thank you. \"', NULL, NULL, '2021-06-30 15:20:54', '2021-06-30 15:20:54'),
(31662, 1006, 23817, NULL, '2021-07-08 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Provider/Group Enrollment Request - RHC - Christus Spohn  \"Hi Adil,  Happy Wednesday!  Thank you for reaching out. We would like for Statcare Minor Emergency Clinic to come back on board. The last time we spoke it was to my understanding that Ms. Rabagos did not have a sponsoring physician with hospital privileges for a Christus facility. This is one of the requirements to bring this provider group back on board with a new contract.  Is there a sponsor/supervising physician who has hospital affiliations at a Christus Facility that Ms. Rabagos will be utilizing?  Vicki Ann Guerra  Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Sent following reply:  \"Hello Vicki,   I appreciate the update, would you be able to check again if David Gray (NPI# 1902814874) now has hospital privileges with a Christus facility?   Thank you. \" ', NULL, NULL, '2021-07-01 14:11:03', '2021-07-01 14:11:03'),
(31663, 1006, 23817, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent following email to Vicki @ Guerra, Vicki A. vicki.guerra@christushealth.org:  Sub: Hospital Privileges - Gray  \"Hello Vicki,   I apologize for the incorrect information, the correct supervising physician for Katherine is Luis Leyton Gonzalez (NPI# 1013911601), please look into this provider instead.   Thank you. \" ', NULL, NULL, '2021-07-12 13:42:50', '2021-07-12 13:42:50'),
(31664, 1006, 23817, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following reply from vicki.guerra@christushealth.org:  Sub: vicki.guerra@christushealth.org  \"Hi Brad,  Happy Tuesday!  Can I have the last 4 of Dr. Leyton Gonzalez SS? This is the only way for me to verify in the portal along with NPI.  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  I replied with the requested information to her.', NULL, NULL, '2021-08-02 17:07:10', '2021-08-02 17:07:10'),
(31665, 1006, 23817, NULL, '2021-08-12 00:00:00.000', 'Not Eligible', 'Received the following denial notification:  Sub: Denial Letter CSHN: STATCARE Contract  \"August 3, 2021  STATCARE Administrator/Owner Rabagos C/O – Office Manager  Dear Administrator and Owner Rabagos (OM), Thank you for your continuous efforts to participate in the Christus Spohn Health Network. Currently to contract with CSHN, Ms. Rabagos will need to have a sponsoring physician to participate in the network. The requirement for a sponsoring physician is to have and maintain  hospital affiliations/memberships with a Christus facility as per Article 5.5 in CSHNs contract agreement and Section I, Article III, Section(s) 3.2-1 and 3.6. CSHN would love to see STACARE back on the Spohn Network directory. Until this criterion for a sponsoring physician is met with hospital affiliations/memberships with a Christus facility CSHN cannot extend a contract.  Locations: STATCARE Kingsville 500 E Caesar Ave, Kingsville Texas 78363 STATCARE Calallen 4042 River Hill Drive Corpus Christi Texas 78410 STATCARE Corpus Christi Southside 6646 S Staples St #122 Corpus Christi Texas 78413 STATCARE Corpus Christi SPID 3817 S. Padre Island Dr. Corpus Christi Texas 78415 STATCARE Rockport 2102 FM 2165 Rockport Texas 78382  Have a blessed and wonderful day. Sincerely,  Vicki Ann Guerra Provider Relations Representative\"', NULL, NULL, '2021-08-05 09:47:40', '2021-08-05 09:47:40'),
(31666, 11056, 23817, NULL, '2021-10-07 00:00:00.000', 'Approved', 'There is no need to enrolled the provider in Ancillary contract.', NULL, NULL, '2021-09-30 13:44:57', '2021-09-30 13:44:57'),
(31667, 1006, 23818, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:25', '2021-03-25 11:46:25'),
(31668, 1006, 23818, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:08', '2021-03-26 14:45:08'),
(31669, 1006, 23819, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:26', '2021-03-25 11:46:26'),
(31670, 1006, 23819, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:44:35', '2021-03-26 14:44:35'),
(31671, 1006, 23820, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:26', '2021-03-25 11:46:26'),
(31672, 1006, 23820, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:44:42', '2021-03-26 14:44:42'),
(31673, 1006, 23821, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:27', '2021-03-25 11:46:27'),
(31674, 1006, 23821, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:44:48', '2021-03-26 14:44:48'),
(31675, 1006, 23822, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:28', '2021-03-25 11:46:28'),
(31676, 1006, 23822, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:44:54', '2021-03-26 14:44:54'),
(31677, 1006, 23823, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:28', '2021-03-25 11:46:28'),
(31678, 1006, 23823, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:01', '2021-03-26 14:45:01'),
(31679, 1006, 23824, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:29', '2021-03-25 11:46:29'),
(31680, 1006, 23824, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:15', '2021-03-26 14:45:15'),
(31681, 1006, 23825, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:29', '2021-03-25 11:46:29'),
(31682, 1006, 23825, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:21', '2021-03-26 14:45:21'),
(31683, 1006, 23826, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:30', '2021-03-25 11:46:30'),
(31684, 1006, 23826, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:27', '2021-03-26 14:45:27'),
(31685, 1006, 23827, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:30', '2021-03-25 11:46:30'),
(31686, 1006, 23827, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:33', '2021-03-26 14:45:33'),
(31687, 1006, 23828, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:46:31', '2021-03-25 11:46:31'),
(31688, 1006, 23828, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'CHC enrollment is not possible as our clinics do not fall under the CHC operating area, the map can be found @ https://www.communityhealthchoice.org/medicare/medicare-hmo-d-snp/service-area/  It is also attached for reference.  ', NULL, NULL, '2021-03-26 14:45:40', '2021-03-26 14:45:40'),
(31689, 1006, 23849, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:51:39', '2021-03-25 11:51:39'),
(31690, 1006, 23849, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-04-08 18:54:42', '2021-04-08 18:54:42'),
(31691, 9057, 23849, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:30', '2021-05-25 10:46:30'),
(31692, 9057, 23849, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:08:11', '2021-05-26 13:08:11');
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
(31693, 3040, 23849, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:11', '2021-06-15 16:30:11'),
(31694, 11056, 23849, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:52:09', '2021-07-01 14:52:09'),
(31695, 1006, 23849, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:20', '2021-07-07 08:52:20'),
(31696, 1006, 23849, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:37', '2021-08-17 17:28:37'),
(31697, 11056, 23849, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:25:32', '2021-09-21 16:25:32'),
(31698, 11056, 23849, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:17', '2021-10-01 14:39:17'),
(31699, 11056, 23849, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:48:22', '2021-10-13 16:48:22'),
(31700, 11056, 23849, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:32:06', '2021-10-20 14:32:06'),
(31701, 11056, 23849, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:37:52', '2021-11-10 17:37:52'),
(31702, 11056, 23849, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep:  Cris S  Eff date: 6/1/2021  Refcode: 6052218700', NULL, NULL, '2021-11-18 14:50:26', '2021-11-18 14:50:26'),
(31703, 11056, 23849, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep:  Cris S  Eff date: 6/1/2021  Refcode: 6052218700  Please see the attachment.', NULL, NULL, '2021-11-18 14:51:14', '2021-11-18 14:51:14'),
(31704, 1006, 23850, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:51:40', '2021-03-25 11:51:40'),
(31705, 1006, 23850, NULL, '2021-04-15 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-04-08 18:54:38', '2021-04-08 18:54:38'),
(31706, 9057, 23850, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:45', '2021-05-25 10:46:45'),
(31707, 9057, 23850, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:08:31', '2021-05-26 13:08:31'),
(31708, 3040, 23850, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:07', '2021-06-15 16:30:07'),
(31709, 11056, 23850, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:51:21', '2021-07-01 14:51:21'),
(31710, 1006, 23850, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:24', '2021-07-07 08:52:24'),
(31711, 1006, 23850, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:33', '2021-08-17 17:28:33'),
(31712, 11056, 23850, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:25:15', '2021-09-21 16:25:15'),
(31713, 11056, 23850, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani   ', NULL, NULL, '2021-10-01 14:38:19', '2021-10-01 14:38:19'),
(31714, 11056, 23850, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:48:07', '2021-10-13 16:48:07'),
(31715, 11056, 23850, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:31:33', '2021-10-20 14:31:33'),
(31716, 11056, 23850, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:37:35', '2021-11-10 17:37:35'),
(31717, 11056, 23850, NULL, '2021-11-29 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019  Refcode: 11222021  please see the attachment', NULL, NULL, '2021-11-22 17:22:46', '2021-11-22 17:22:46'),
(31718, 1006, 23851, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:52:06', '2021-03-25 11:52:06'),
(31719, 3040, 23851, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:07', '2021-03-29 17:13:07'),
(31720, 3040, 23851, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 09:43:44', '2021-03-30 09:43:44'),
(31721, 3040, 23851, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:43:59', '2021-03-30 09:43:59'),
(31722, 9057, 23851, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to Dmarley@ghn-mci.com Sub: Enrollment & Additional Location status request - RHC - Galaxy Health   Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:19:38', '2021-05-26 16:19:38'),
(31723, 1006, 23851, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:15', '2021-06-15 16:49:15'),
(31724, 1006, 23851, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:11:24', '2021-06-18 13:11:24'),
(31725, 1006, 23872, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:08', '2021-03-25 11:54:08'),
(31726, 3040, 23872, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Add Group Location || Statcare Minor Emergency Clinic || Group || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the group location in Healthwest for our group Statcare Minor Emergency Clinic under below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 10:49:25', '2021-03-30 10:49:25'),
(31727, 9057, 23872, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:12:37', '2021-05-25 12:12:37'),
(31728, 1006, 23872, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:33:04', '2021-06-11 14:33:04'),
(31729, 1006, 23872, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:26', '2021-06-25 11:05:26'),
(31730, 1006, 23873, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:09', '2021-03-25 11:54:09'),
(31731, 3040, 23873, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:42:26', '2021-03-30 12:42:26'),
(31732, 9057, 23873, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:12:53', '2021-05-25 12:12:53'),
(31733, 1006, 23873, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:33:01', '2021-06-11 14:33:01'),
(31734, 1006, 23873, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:30', '2021-06-25 11:05:30'),
(31735, 1006, 23874, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:10', '2021-03-25 11:54:10'),
(31736, 3040, 23874, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:41:55', '2021-03-30 12:41:55'),
(31737, 9057, 23874, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:04', '2021-05-25 12:13:04'),
(31738, 1006, 23874, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:58', '2021-06-11 14:32:58'),
(31739, 1006, 23874, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:38', '2021-06-25 11:05:38'),
(31740, 1006, 23875, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:11', '2021-03-25 11:54:11'),
(31741, 3040, 23875, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:41:28', '2021-03-30 12:41:28'),
(31742, 9057, 23875, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:24', '2021-05-25 12:13:24'),
(31743, 9057, 23875, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:24', '2021-05-25 12:13:24'),
(31744, 1006, 23875, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:55', '2021-06-11 14:32:55'),
(31745, 1006, 23875, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:41', '2021-06-25 11:05:41'),
(31746, 1006, 23876, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:12', '2021-03-25 11:54:12');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(31747, 3040, 23876, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:37:49', '2021-03-30 12:37:49'),
(31748, 9057, 23876, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:36', '2021-05-25 12:13:36'),
(31749, 1006, 23876, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:51', '2021-06-11 14:32:51'),
(31750, 1006, 23876, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:44', '2021-06-25 11:05:44'),
(31751, 1006, 23877, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:13', '2021-03-25 11:54:13'),
(31752, 3040, 23877, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:41:02', '2021-03-30 12:41:02'),
(31753, 9057, 23877, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:50', '2021-05-25 12:13:50'),
(31754, 1006, 23877, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:49', '2021-06-11 14:32:49'),
(31755, 1006, 23877, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:47', '2021-06-25 11:05:47'),
(31756, 1006, 23878, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:14', '2021-03-25 11:54:14'),
(31757, 3040, 23878, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:40:28', '2021-03-30 12:40:28'),
(31758, 9057, 23878, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:13:59', '2021-05-25 12:13:59'),
(31759, 1006, 23878, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:45', '2021-06-11 14:32:45'),
(31760, 1006, 23878, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:50', '2021-06-25 11:05:50'),
(31761, 1006, 23879, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:15', '2021-03-25 11:54:15'),
(31762, 3040, 23879, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:40:00', '2021-03-30 12:40:00'),
(31763, 9057, 23879, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:14:13', '2021-05-25 12:14:13'),
(31764, 1006, 23879, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:42', '2021-06-11 14:32:42'),
(31765, 1006, 23879, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:56', '2021-06-25 11:05:56'),
(31766, 1006, 23880, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:16', '2021-03-25 11:54:16'),
(31767, 3040, 23880, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:39:29', '2021-03-30 12:39:29'),
(31768, 9057, 23880, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:14:26', '2021-05-25 12:14:26'),
(31769, 1006, 23880, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:39', '2021-06-11 14:32:39'),
(31770, 1006, 23880, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:05:59', '2021-06-25 11:05:59'),
(31771, 1006, 23881, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:16', '2021-03-25 11:54:16'),
(31772, 3040, 23881, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:38:21', '2021-03-30 12:38:21'),
(31773, 9057, 23881, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:14:32', '2021-05-25 12:14:32'),
(31774, 1006, 23881, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:36', '2021-06-11 14:32:36'),
(31775, 1006, 23881, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:06:08', '2021-06-25 11:06:08'),
(31776, 1006, 23882, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:17', '2021-03-25 11:54:17'),
(31777, 3040, 23882, NULL, '2021-04-06 00:00:00.000', 'Initiated', 'Email sent to: Providers@healthwestonline.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Providers || Healthwest ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Healthwest for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 7: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Francis, William Robert. Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 10: Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413  Additional Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 12:38:40', '2021-03-30 12:38:40'),
(31778, 9057, 23882, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to providers@healthwestonline.com  Sub: Enrollment & Additional location status request - RHC - Healthwest  Hello, We submitted a request for the enrollment for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:14:42', '2021-05-25 12:14:42'),
(31779, 1006, 23882, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:29:35', '2021-06-11 14:29:35'),
(31780, 1006, 23882, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent a new f/u email @ kathy@healthwestonline.com & Providers@healthwestonline.com:   Sub: Enrollment Status/Location Addition - RHC - Healthwest  \"Hello,   I hope you\'re doing well, I wanted to check in on the enrollment status for the following group and providers as well as the mentioned locations, the group and provider information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to. Thank you!\"', NULL, NULL, '2021-06-11 14:32:32', '2021-06-11 14:32:32'),
(31781, 1006, 23882, NULL, '2021-07-02 00:00:00.000', 'Not Eligible', 'The insurance is not eligible for enrollment. ', NULL, NULL, '2021-06-25 11:06:12', '2021-06-25 11:06:12'),
(31782, 1006, 23883, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:54:51', '2021-03-25 11:54:51'),
(31783, 1006, 23883, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:04:03', '2021-03-29 17:04:03'),
(31784, 9057, 23883, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:29:47', '2021-05-25 12:29:47'),
(31785, 1006, 23883, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:18', '2021-06-11 14:47:18'),
(31786, 3040, 23883, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:49:20', '2021-06-30 16:49:20');
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
(31787, 1006, 23883, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:54:56', '2021-07-12 15:54:56'),
(31788, 1006, 23883, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:19', '2021-07-29 17:06:19'),
(31789, 1006, 23883, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:59', '2021-08-02 09:47:59'),
(31790, 1006, 23883, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:19', '2021-08-13 17:05:19'),
(31791, 1006, 23883, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-23 17:03:54', '2021-08-23 17:03:54'),
(31792, 11056, 23883, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:04:36', '2021-09-21 13:04:36'),
(31793, 11056, 23883, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:49:50', '2021-10-01 15:49:50'),
(31794, 11056, 23883, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:00:27', '2021-10-13 17:00:27'),
(31795, 11056, 23883, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:56:26', '2021-10-20 16:56:26'),
(31796, 11056, 23883, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:55:48', '2021-11-10 17:55:48'),
(31797, 11056, 23883, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:39', '2021-11-19 17:45:39'),
(31798, 11056, 23883, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:40', '2021-12-01 13:08:40'),
(31799, 11056, 23883, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:40', '2021-12-16 13:45:40'),
(31800, 11056, 23883, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:21:14', '2021-12-23 15:21:14'),
(31801, 19067, 23883, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:23:32', '2022-01-12 16:23:32'),
(31802, 19067, 23883, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:30:46', '2022-01-26 16:30:46'),
(31803, 19067, 23883, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:06', '2022-02-11 14:30:06'),
(31804, 19067, 23883, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:23:39', '2022-02-21 17:23:39'),
(31805, 19067, 23883, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:04:03', '2022-03-15 16:04:03'),
(31806, 1006, 23894, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:12', '2021-03-25 11:56:12'),
(31807, 3040, 23894, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:55:28', '2021-03-30 16:55:28'),
(31808, 1006, 23895, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:13', '2021-03-25 11:56:13'),
(31809, 3040, 23895, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:56:24', '2021-03-30 16:56:24'),
(31810, 1006, 23896, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:14', '2021-03-25 11:56:14'),
(31811, 3040, 23896, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:57:29', '2021-03-30 16:57:29'),
(31812, 1006, 23897, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:15', '2021-03-25 11:56:15'),
(31813, 3040, 23897, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:58:26', '2021-03-30 16:58:26'),
(31814, 1006, 23898, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:16', '2021-03-25 11:56:16'),
(31815, 3040, 23898, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:59:05', '2021-03-30 16:59:05'),
(31816, 1006, 23899, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:17', '2021-03-25 11:56:17'),
(31817, 3040, 23899, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 16:59:47', '2021-03-30 16:59:47'),
(31818, 1006, 23900, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:17', '2021-03-25 11:56:17'),
(31819, 3040, 23900, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 17:00:34', '2021-03-30 17:00:34'),
(31820, 1006, 23901, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:18', '2021-03-25 11:56:18'),
(31821, 3040, 23901, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 17:01:07', '2021-03-30 17:01:07'),
(31822, 1006, 23902, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:19', '2021-03-25 11:56:19'),
(31823, 3040, 23902, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 17:01:43', '2021-03-30 17:01:43'),
(31824, 1006, 23903, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:20', '2021-03-25 11:56:20'),
(31825, 3040, 23903, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 17:02:32', '2021-03-30 17:02:32'),
(31826, 1006, 23904, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:21', '2021-03-25 11:56:21'),
(31827, 3040, 23904, NULL, '2021-04-06 00:00:00.000', 'Rejected', '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, '2021-03-30 17:03:27', '2021-03-30 17:03:27'),
(31828, 1006, 23905, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:44', '2021-03-25 11:56:44'),
(31829, 1006, 23905, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'Renaissance Physicians does not cover Kingsville or Corpus Christi, we are unable to enroll with them.   Please take a look at the cities listed here @ https://myrpo.com/providers/how-to-join', NULL, NULL, '2021-03-31 15:25:02', '2021-03-31 15:25:02'),
(31830, 1006, 23906, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:56:59', '2021-03-25 11:56:59'),
(31831, 1006, 23906, NULL, '2021-04-14 00:00:00.000', 'Initiated', 'Received response stating that we should submit demographic update via https://swhp.org/forms/html/demographic-Update-Form.html  Request submitted:  \"Success! Thank you again for your interest in becoming a Scott and White Health Plan contracted provider.  Please allow 30-45 days before checking on status.  Your form submission identifier is: 125c3a8b-5205-47a4-80f6-82a3d12c4451\"  It has been attached for reference in group task as our contract is a facility one.  ', NULL, NULL, '2021-04-07 16:15:51', '2021-04-07 16:15:51'),
(31832, 9057, 23906, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Sent Following email to PRSupport@firstcare.com Sub: Additional location status request - RHC -Scott & White  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 14:06:18', '2021-05-25 14:06:18'),
(31833, 1006, 23906, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent another f/u email @ PR SUPPORT PRSUPPORT@bswhealth.org:  Sub: Enrollment Query/Location Addition - RHC - Scott & White  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the location status for the following group and providers, the information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able to.  Thank you.\"', NULL, NULL, '2021-06-11 16:22:53', '2021-06-11 16:22:53'),
(31834, 1006, 23906, NULL, '2021-06-30 00:00:00.000', 'Approved', 'The location has been added to the facility contract, confirmation for approval and location are attached for reference in the main group task as this is a facility contract.   Eff: 01/01/2021 ', NULL, NULL, '2021-06-23 14:30:22', '2021-06-23 14:30:22'),
(31835, 1006, 23907, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:34', '2021-03-25 11:57:34'),
(31836, 1006, 23907, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:41', '2021-03-26 13:33:41'),
(31837, 1006, 23908, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:35', '2021-03-25 11:57:35'),
(31838, 1006, 23908, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:34', '2021-03-26 13:33:34'),
(31839, 1006, 23909, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:36', '2021-03-25 11:57:36'),
(31840, 1006, 23909, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:28', '2021-03-26 13:33:28'),
(31841, 1006, 23910, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:37', '2021-03-25 11:57:37'),
(31842, 1006, 23910, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:20', '2021-03-26 13:33:20'),
(31843, 1006, 23911, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:37', '2021-03-25 11:57:37'),
(31844, 1006, 23911, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:13', '2021-03-26 13:33:13'),
(31845, 1006, 23912, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:38', '2021-03-25 11:57:38'),
(31846, 1006, 23912, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:02', '2021-03-26 13:33:02'),
(31847, 1006, 23913, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:39', '2021-03-25 11:57:39'),
(31848, 1006, 23913, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:32:56', '2021-03-26 13:32:56'),
(31849, 1006, 23914, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:40', '2021-03-25 11:57:40'),
(31850, 1006, 23914, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:32:51', '2021-03-26 13:32:51'),
(31851, 1006, 23915, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:41', '2021-03-25 11:57:41'),
(31852, 1006, 23915, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:32:44', '2021-03-26 13:32:44'),
(31853, 1006, 23916, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:41', '2021-03-25 11:57:41'),
(31854, 1006, 23916, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:32:37', '2021-03-26 13:32:37'),
(31855, 1006, 23917, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:57:42', '2021-03-25 11:57:42'),
(31856, 1006, 23917, NULL, '2021-04-02 00:00:00.000', 'Not Eligible', 'TCHP enrollment is not possible as our clinics do not fall under the TCHP operating area, the map can be found @ https://www.texaschildrenshealthplan.org/for-providers/becoming-a-participating-provider.   It is also attached for reference.  ', NULL, NULL, '2021-03-26 13:33:07', '2021-03-26 13:33:07'),
(31857, 1006, 23918, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:27', '2021-03-25 11:58:27'),
(31858, 1006, 23918, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:15', '2021-04-08 18:29:15'),
(31859, 1006, 23919, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:27', '2021-03-25 11:58:27'),
(31860, 1006, 23919, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:20', '2021-04-08 18:29:20'),
(31861, 1006, 23920, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:32', '2021-03-25 11:58:32'),
(31862, 1006, 23920, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:24', '2021-04-08 18:29:24'),
(31863, 1006, 23921, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:33', '2021-03-25 11:58:33'),
(31864, 1006, 23921, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:27', '2021-04-08 18:29:27'),
(31865, 1006, 23922, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:34', '2021-03-25 11:58:34'),
(31866, 1006, 23922, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:31', '2021-04-08 18:29:31'),
(31867, 1006, 23923, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:35', '2021-03-25 11:58:35'),
(31868, 1006, 23923, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:35', '2021-04-08 18:29:35'),
(31869, 1006, 23924, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:36', '2021-03-25 11:58:36'),
(31870, 1006, 23924, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:40', '2021-04-08 18:29:40'),
(31871, 1006, 23925, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:37', '2021-03-25 11:58:37'),
(31872, 1006, 23925, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:45', '2021-04-08 18:29:45'),
(31873, 1006, 23926, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:38', '2021-03-25 11:58:38'),
(31874, 1006, 23926, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:51', '2021-04-08 18:29:51'),
(31875, 1006, 23927, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 11:58:40', '2021-03-25 11:58:40'),
(31876, 1006, 23927, NULL, '2021-04-15 00:00:00.000', 'Approved', 'SPID location has been added to our CCN Contract. The group is effective as of 08/10/2020 holding an Ancillary contract, so no need to add individual providers.  Location addition approval, contract, and welcome letter are attached on group task for reference.  ', NULL, NULL, '2021-04-08 18:29:55', '2021-04-08 18:29:55'),
(31877, 1006, 23939, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:05', '2021-03-25 12:00:05'),
(31878, 3040, 23939, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:47:57', '2021-03-31 15:47:57'),
(31879, 1006, 23940, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:06', '2021-03-25 12:00:06'),
(31880, 3040, 23940, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:48:10', '2021-03-31 15:48:10'),
(31881, 1006, 23941, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:07', '2021-03-25 12:00:07'),
(31882, 3040, 23941, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:48:28', '2021-03-31 15:48:28'),
(31883, 1006, 23942, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:08', '2021-03-25 12:00:08'),
(31884, 3040, 23942, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:48:46', '2021-03-31 15:48:46'),
(31885, 1006, 23943, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:09', '2021-03-25 12:00:09'),
(31886, 3040, 23943, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:49:03', '2021-03-31 15:49:03'),
(31887, 1006, 23944, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:10', '2021-03-25 12:00:10'),
(31888, 3040, 23944, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:49:16', '2021-03-31 15:49:16'),
(31889, 1006, 23945, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:11', '2021-03-25 12:00:11'),
(31890, 3040, 23945, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:49:30', '2021-03-31 15:49:30'),
(31891, 1006, 23946, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:12', '2021-03-25 12:00:12'),
(31892, 3040, 23946, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:49:45', '2021-03-31 15:49:45'),
(31893, 1006, 23947, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:13', '2021-03-25 12:00:13'),
(31894, 3040, 23947, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:50:00', '2021-03-31 15:50:00'),
(31895, 1006, 23948, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-25 12:00:14', '2021-03-25 12:00:14'),
(31896, 3040, 23948, NULL, '2021-04-07 00:00:00.000', 'Not Eligible', 'They do not cover the county. ', NULL, NULL, '2021-03-31 15:50:14', '2021-03-31 15:50:14'),
(31897, 3040, 24021, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-26 14:00:03', '2021-03-26 14:00:03'),
(31898, 3040, 24021, NULL, '2021-06-08 00:00:00.000', 'Approved', 'Bankers Fidelity offers Medicare Supplement plans. Provider already enrolled in Medicare  no need to add the provider under Banker Fidelity.', NULL, NULL, '2021-06-01 17:07:22', '2021-06-01 17:07:22'),
(31899, 3040, 24046, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-26 14:07:36', '2021-03-26 14:07:36'),
(31900, 3040, 24046, NULL, '2021-06-08 00:00:00.000', 'Approved', 'Bankers Fidelity offers Medicare Supplement plans. Provider already enrolled in Medicare  no need to add the provider under Banker Fidelity.', NULL, NULL, '2021-06-01 17:07:20', '2021-06-01 17:07:20'),
(31901, 3040, 24047, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:29:23', '2021-04-01 08:29:23'),
(31902, 3040, 24047, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Mediciad approval. ', NULL, NULL, '2021-04-01 16:52:55', '2021-04-01 16:52:55'),
(31903, 3040, 24047, NULL, '2021-05-07 00:00:00.000', 'Rejected', 'Amerigroup does not service that region.  Please find below link from Amerigroup Website in which it shows they do not cover the counties for VMUC i.e. Hidalgo & Cameron:  https://www.myamerigroup.com/tx/apply/know-your-service-area.html ', NULL, NULL, '2021-04-30 12:47:03', '2021-04-30 12:47:03'),
(31904, 3040, 24048, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:29:24', '2021-04-01 08:29:24'),
(31905, 3040, 24048, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Mediciad approval. ', NULL, NULL, '2021-04-01 16:53:03', '2021-04-01 16:53:03'),
(31906, 3040, 24048, NULL, '2021-05-07 00:00:00.000', 'Rejected', 'Amerigroup does not service that region.  Please find below link from Amerigroup Website in which it shows they do not cover the counties for VMUC i.e. Hidalgo & Cameron: https://www.myamerigroup.com/tx/apply/know-your-service-area.html ', NULL, NULL, '2021-04-30 12:47:01', '2021-04-30 12:47:01'),
(31907, 3040, 24049, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:29:24', '2021-04-01 08:29:24'),
(31908, 3040, 24049, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Mediciad approval. ', NULL, NULL, '2021-04-01 16:53:08', '2021-04-01 16:53:08'),
(31909, 3040, 24049, NULL, '2021-05-07 00:00:00.000', 'Rejected', 'Amerigroup does not service that region.  Please find below link from Amerigroup Website in which it shows they do not cover the counties for VMUC i.e. Hidalgo & Cameron: https://www.myamerigroup.com/tx/apply/know-your-service-area.html ', NULL, NULL, '2021-04-30 12:47:00', '2021-04-30 12:47:00'),
(31910, 3040, 24050, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:30:44', '2021-04-01 08:30:44'),
(31911, 3040, 24050, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-04-01 15:49:22', '2021-04-01 15:49:22'),
(31912, 1006, 24050, NULL, '2021-06-02 00:00:00.000', 'On Hold', 'Pending Medicaid approval. ', NULL, NULL, '2021-05-26 08:55:00', '2021-05-26 08:55:00'),
(31913, 1006, 24050, NULL, '2021-06-21 00:00:00.000', 'Not Eligible', 'Driscoll does not cover Galveston county for enrollment.   Please see attached for reference: https://driscollhealthplan.com/providers/', NULL, NULL, '2021-06-14 16:31:50', '2021-06-14 16:31:50'),
(31914, 3040, 24051, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:30:45', '2021-04-01 08:30:45'),
(31915, 3040, 24051, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-04-01 15:49:26', '2021-04-01 15:49:26'),
(31916, 1006, 24051, NULL, '2021-06-02 00:00:00.000', 'On Hold', 'Pending Medicaid approval. ', NULL, NULL, '2021-05-26 08:54:24', '2021-05-26 08:54:24'),
(31917, 1006, 24051, NULL, '2021-06-21 00:00:00.000', 'Not Eligible', 'Driscoll does not cover Galveston county for enrollment.   Please see attached for reference: https://driscollhealthplan.com/providers/', NULL, NULL, '2021-06-14 16:31:46', '2021-06-14 16:31:46'),
(31918, 3040, 24052, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:30:46', '2021-04-01 08:30:46'),
(31919, 3040, 24052, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Waiting for the Medicaid approval. ', NULL, NULL, '2021-04-01 15:49:29', '2021-04-01 15:49:29'),
(31920, 1006, 24052, NULL, '2021-06-02 00:00:00.000', 'On Hold', 'Pending Medicaid approval. ', NULL, NULL, '2021-05-26 08:54:39', '2021-05-26 08:54:39'),
(31921, 1006, 24052, NULL, '2021-06-21 00:00:00.000', 'Not Eligible', 'Driscoll does not cover Galveston county for enrollment.   Please see attached for reference: https://driscollhealthplan.com/providers/', NULL, NULL, '2021-06-14 16:31:40', '2021-06-14 16:31:40'),
(31922, 3040, 24053, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:33:02', '2021-04-01 08:33:02'),
(31923, 3040, 24053, NULL, '2021-04-09 00:00:00.000', 'New/Not Initiated', 'Waiting for the enrollment in Scott and White. ', NULL, NULL, '2021-04-02 13:35:54', '2021-04-02 13:35:54'),
(31924, 1006, 24053, NULL, '2021-06-02 00:00:00.000', 'Not Eligible', 'This is a redundant task, Firstcare is covered under Scott & White. ', NULL, NULL, '2021-05-26 08:28:17', '2021-05-26 08:28:17'),
(31925, 3040, 24054, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:33:04', '2021-04-01 08:33:04'),
(31926, 3040, 24054, NULL, '2021-04-09 00:00:00.000', 'New/Not Initiated', 'Waiting for the enrollment in Scott and White. ', NULL, NULL, '2021-04-02 13:36:31', '2021-04-02 13:36:31'),
(31927, 1006, 24054, NULL, '2021-06-02 00:00:00.000', 'Not Eligible', 'This is a redundant task, Firstcare is covered under Scott & White. ', NULL, NULL, '2021-05-26 08:28:36', '2021-05-26 08:28:36'),
(31928, 3040, 24055, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:33:05', '2021-04-01 08:33:05'),
(31929, 3040, 24055, NULL, '2021-04-09 00:00:00.000', 'New/Not Initiated', 'Waiting for the enrollment in Scott and White. ', NULL, NULL, '2021-04-02 13:37:27', '2021-04-02 13:37:27'),
(31930, 1006, 24055, NULL, '2021-06-02 00:00:00.000', 'Not Eligible', 'This is a redundant task, Firstcare is covered under Scott & White. ', NULL, NULL, '2021-05-26 08:28:54', '2021-05-26 08:28:54'),
(31931, 3040, 24060, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:36:50', '2021-04-01 08:36:50'),
(31932, 3040, 24060, NULL, '2021-04-09 00:00:00.000', 'Initiated', 'Email sent to:  providerservices@memorialhermann.org, enterprise.credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Hope you are doing well. Please find the attached request for participation to enroll the below mentioned practice and providers in Memorial Hermann under the below location.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-02 13:34:05', '2021-04-02 13:34:05'),
(31933, 3040, 24060, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Please advise me the enrollment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-05-06 12:55:10', '2021-05-06 12:55:10'),
(31934, 3040, 24060, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Hello,   This is a follow up email regarding the annulment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Waiting for your response.   Thanks', NULL, NULL, '2021-05-25 16:02:04', '2021-05-25 16:02:04'),
(31935, 3040, 24060, NULL, '2021-06-07 00:00:00.000', 'Not Eligible', 'Email rcvd from: MHHPContracting@memorialhermann.org  Subject: Memorial Hermann Health Plan Request to Participate  May 29, 2021   Atinuke Olusayo Dada, AHP Ladot Healthcare LLC 2577 Madison Ave League City, TX 77573 Dear Atinuke Olusayo Dada, AHP: We would like to thank you for your interest in participating in the Memorial Hermann Health Plan network; however, we do not currently have a network need for the specialty and/or services which you provide. We will keep your Request for Participation on file and notify you if our needs change in the future. Should you have questions or need additional assistance, please contact our Provider Relations Department at 713.338.4801 or you can send an email to: Providerservices@memorialhermann.org. Thank you again for your interest in Memorial Hermann Health Plan Provider Network.  Kind regards,  Memorial Hermann Health Plan Provider Relations', NULL, NULL, '2021-05-31 08:24:12', '2021-05-31 08:24:12'),
(31936, 3040, 24062, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:38:01', '2021-04-01 08:38:01'),
(31937, 3040, 24062, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Multiplan is in process once the provider enrolled with insurance after that we can start enroll the providers in Multiplan Medicare Advantage Plan.', NULL, NULL, '2021-04-01 13:17:55', '2021-04-01 13:17:55'),
(31938, 1006, 24062, NULL, '2021-04-09 00:00:00.000', 'On Hold', 'The request is pending enrollment with Multiplan and Medicare. ', NULL, NULL, '2021-04-02 20:06:48', '2021-04-02 20:06:48'),
(31939, 1006, 24062, NULL, '2021-06-03 00:00:00.000', 'Not Eligible', 'This is a redundant task and not mentioned in Credentialing New Structure sheet by billing team. ', NULL, NULL, '2021-05-27 14:33:51', '2021-05-27 14:33:51'),
(31940, 3040, 24063, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-01 08:38:02', '2021-04-01 08:38:02'),
(31941, 3040, 24063, NULL, '2021-04-08 00:00:00.000', 'New/Not Initiated', 'Multiplan is in process once the provider enrolled with insurance after that we can start enroll the providers in Multiplan Medicare Advantage Plan.', NULL, NULL, '2021-04-01 13:17:59', '2021-04-01 13:17:59'),
(31942, 1006, 24063, NULL, '2021-04-09 00:00:00.000', 'On Hold', 'The request is pending enrollment with Multiplan and Medicare. ', NULL, NULL, '2021-04-02 20:06:52', '2021-04-02 20:06:52'),
(31943, 1006, 24063, NULL, '2021-06-03 00:00:00.000', 'Not Eligible', 'This is a redundant task and not mentioned in Credentialing New Structure sheet by billing team. ', NULL, NULL, '2021-05-27 14:33:35', '2021-05-27 14:33:35'),
(31944, 1019, 24071, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 10:20:21', '2021-04-02 10:20:21'),
(31945, 1019, 24071, NULL, '2021-04-09 00:00:00.000', 'Initiated', 'Sent email to MBHPNetworkOperations@beaconhealthoptions.com Sub: Enroll Provider || SNBCARE || Kerry Smith || MBHP   Hello, We wanted to enroll the below mentioned provider in MBHP, under our group. Can you let us know if you do enroll these types of provider.  Group Information: Spectrum Neuro Behavioral Care LLC Tax ID: 834482753 NPI: 1356906572 Individual Provider:  Kerry Smith NPI: 1275083230 Specialty: Licensed Clinical Social Worker', NULL, NULL, '2021-04-02 14:31:55', '2021-04-02 14:31:55'),
(31946, 3040, 24071, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: MBHPNetworkOperations@beaconhealthoptions.com  Subject: Enrollment Status || Spectrum Neuro Behavioral Care || Smith, Kerry R || MBHP ||  Greetings,   Can you please advise me the enrollment status for the below mentioned provider.   Practice Name: Spectrum Neuro Behavioral Care Practice Tax ID# 83-4482753 Practice NPI# 1356906572 Practice Address: 61 Lincoln St., Suite 203, Framingham , MA 01702  Provider Name: Smith, Kerry R Provider NPI# 1275083230  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-04-16 15:44:01', '2021-04-16 15:44:01'),
(31947, 3040, 24071, NULL, '2021-04-28 00:00:00.000', 'On Hold', 'Spoke to Furquan regarding this, providers will do their cultural competency and update me when that has been completed so we can move forward with this request.  ', NULL, NULL, '2021-04-21 08:19:14', '2021-04-21 08:19:14'),
(31948, 1006, 24077, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 11:12:38', '2021-04-02 11:12:38'),
(31949, 1006, 24077, NULL, '2021-04-09 00:00:00.000', 'On Hold', 'Cigna Healthspring is a Medicare Advantage Plan and is pending enrollment with Cigna and Medicare.   ', NULL, NULL, '2021-04-02 20:05:33', '2021-04-02 20:05:33'),
(31950, 1006, 24077, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Left VM @ 800-668-3813 for followup. ', NULL, NULL, '2021-05-26 17:15:03', '2021-05-26 17:15:03'),
(31951, 1006, 24077, NULL, '2021-06-04 00:00:00.000', 'Initiated', 'Sent following email @ TXMAContracting@cigna.com:  Sub: Enrollment Request - RSM - Cigna Healthspring  \"Hello,   Please find the attached enrollment requests for our group and providers, please let me know if you have any questions or if anything else is required.  Thank you.\"', NULL, NULL, '2021-05-28 11:50:54', '2021-05-28 11:50:54'),
(31952, 1006, 24077, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - RSM - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following group and providers, we submitted an enrollment application for them back in May:  Group Name: Right Step Medical Center LLC NPI# 1063008084TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me on the status of these as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-16 15:18:29', '2021-06-16 15:18:29'),
(31953, 1006, 24077, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:51', '2021-06-21 13:36:51'),
(31954, 1006, 24077, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:16', '2021-07-08 13:06:16'),
(31955, 1006, 24077, NULL, '2021-07-19 00:00:00.000', 'Not Eligible', 'We received a denial letter, stating that there\'s no need for additional providers for the geographic location. The denial letter is attached in the main group task for reference. ', NULL, NULL, '2021-07-12 09:08:11', '2021-07-12 09:08:11'),
(31956, 1006, 24078, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 11:12:39', '2021-04-02 11:12:39'),
(31957, 1006, 24078, NULL, '2021-04-09 00:00:00.000', 'On Hold', 'Cigna Healthspring is a Medicare Advantage Plan and is pending enrollment with Cigna and Medicare.   ', NULL, NULL, '2021-04-02 20:05:36', '2021-04-02 20:05:36'),
(31958, 1006, 24078, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Left VM @ 800-668-3813 for followup. ', NULL, NULL, '2021-05-26 17:15:07', '2021-05-26 17:15:07'),
(31959, 1006, 24078, NULL, '2021-06-04 00:00:00.000', 'Initiated', 'Sent following email @ TXMAContracting@cigna.com:  Sub: Enrollment Request - RSM - Cigna Healthspring  \"Hello,   Please find the attached enrollment requests for our group and providers, please let me know if you have any questions or if anything else is required.  Thank you.\"', NULL, NULL, '2021-05-28 11:50:58', '2021-05-28 11:50:58');
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
(31960, 1006, 24078, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - RSM - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following group and providers, we submitted an enrollment application for them back in May:  Group Name: Right Step Medical Center LLC NPI# 1063008084TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me on the status of these as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-16 15:18:25', '2021-06-16 15:18:25'),
(31961, 1006, 24078, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:47', '2021-06-21 13:36:47'),
(31962, 1006, 24078, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:12', '2021-07-08 13:06:12'),
(31963, 1006, 24078, NULL, '2021-07-19 00:00:00.000', 'Not Eligible', 'We received a denial letter, stating that there\'s no need for additional providers for the geographic location. The denial letter is attached in the main group task for reference. ', NULL, NULL, '2021-07-12 09:08:04', '2021-07-12 09:08:04'),
(31964, 1006, 24079, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 11:12:40', '2021-04-02 11:12:40'),
(31965, 1006, 24079, NULL, '2021-04-09 00:00:00.000', 'On Hold', 'Cigna Healthspring is a Medicare Advantage Plan and is pending enrollment with Cigna and Medicare.   ', NULL, NULL, '2021-04-02 20:05:40', '2021-04-02 20:05:40'),
(31966, 1006, 24079, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Left VM @ 800-668-3813 for followup. ', NULL, NULL, '2021-05-26 17:15:11', '2021-05-26 17:15:11'),
(31967, 1006, 24079, NULL, '2021-06-04 00:00:00.000', 'Initiated', 'Sent following email @ TXMAContracting@cigna.com:  Sub: Enrollment Request - RSM - Cigna Healthspring  \"Hello,   Please find the attached enrollment requests for our group and providers, please let me know if you have any questions or if anything else is required.  Thank you.\"', NULL, NULL, '2021-05-28 11:51:02', '2021-05-28 11:51:02'),
(31968, 1006, 24079, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ TXMAContracting@cigna.com & txgqproviderrelations@healthspring.com:  Sub: Enrollment Status - RSM - Cigna Healthspring  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following group and providers, we submitted an enrollment application for them back in May:  Group Name: Right Step Medical Center LLC NPI# 1063008084TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me on the status of these as soon as possible.  Thank you.\"', NULL, NULL, '2021-06-16 15:18:16', '2021-06-16 15:18:16'),
(31969, 1006, 24079, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following email from \"PEREZ, JENNIFER (JEN) 866\" JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"HI Brad,  I have not seen it come through. I noticed you sent another inquiry for Right Step Medical Center, if you send me both letter of interest forms I can place it on file\"  Sent following reply to her:   \"Hello Jennifer, Here are the facility interest forms for both groups. Please let me know if anything else is required. Thank you!\"', NULL, NULL, '2021-06-21 13:36:43', '2021-06-21 13:36:43'),
(31970, 1006, 24079, NULL, '2021-07-15 00:00:00.000', 'In Process', 'We received the following reply from PEREZ, JENNIFER (JEN) 866 JENNIFER.PEREZ@cigna.com:  Sub: Enrollment Status - BAQC - Cigna Healthspring  \"Thank you Brad! I will provide these to the Network committee, where they will review at our next meeting. Once reviewed, I will get back in touch with you to inform you of their decision.\"  Sent f/u email:  \"Hello Jennifer,   I hope you\'re doing well, I wanted to get an update regarding the enrollment request for both of our groups, could you please get back to me as soon as possible?  Thank you.\"', NULL, NULL, '2021-07-08 13:06:07', '2021-07-08 13:06:07'),
(31971, 1006, 24079, NULL, '2021-07-19 00:00:00.000', 'Not Eligible', 'We received a denial letter, stating that there\'s no need for additional providers for the geographic location. The denial letter is attached in the main group task for reference. ', NULL, NULL, '2021-07-12 09:07:51', '2021-07-12 09:07:51'),
(31972, 3040, 24094, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 12:40:34', '2021-04-02 12:40:34'),
(31973, 3040, 24094, NULL, '2021-04-09 00:00:00.000', 'Initiated', 'Email sent to:  providerservices@memorialhermann.org, enterprise.credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Hope you are doing well. Please find the attached request for participation to enroll the below mentioned practice and providers in Memorial Hermann under the below location.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-02 13:33:56', '2021-04-02 13:33:56'),
(31974, 3040, 24094, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Please advise me the enrollment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-05-06 12:55:14', '2021-05-06 12:55:14'),
(31975, 3040, 24094, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Hello,   This is a follow up email regarding the annulment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Waiting for your response.   Thanks', NULL, NULL, '2021-05-25 16:02:09', '2021-05-25 16:02:09'),
(31976, 3040, 24094, NULL, '2021-06-07 00:00:00.000', 'Not Eligible', 'Email rcvd from: MHHPContracting@memorialhermann.org  Subject:Memorial Hermann Health Plan Request to Participate.  May 29, 2021  Oladipo Ayowole Dada, MD Ladot Healthcare LLC 2577 Madison Ave League City, TX 77573 Dear Oladipo Ayowole Dada, MD: We would like to thank you for your interest in participating in the Memorial Hermann Health Plan network; however, we do not currently have a network need for the specialty and/or services which you provide. We will keep your Request for Participation on file and notify you if our needs change in the future. Should you have questions or need additional assistance, please contact our Provider Relations Department at 713.338.4801 or you can send an email to: Providerservices@memorialhermann.org. Thank you again for your interest in Memorial Hermann Health Plan Provider Network.  Kind regards,  Memorial Hermann Health Plan Provider Relations', NULL, NULL, '2021-05-31 08:25:56', '2021-05-31 08:25:56'),
(31977, 3040, 24095, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 12:40:37', '2021-04-02 12:40:37'),
(31978, 3040, 24095, NULL, '2021-04-09 00:00:00.000', 'Initiated', 'Email sent to:  providerservices@memorialhermann.org, enterprise.credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Hope you are doing well. Please find the attached request for participation to enroll the below mentioned practice and providers in Memorial Hermann under the below location.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-02 13:34:15', '2021-04-02 13:34:15'),
(31979, 3040, 24095, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Greetings,   Please advise me the enrollment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-05-06 12:55:18', '2021-05-06 12:55:18'),
(31980, 3040, 24095, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Email sent to: Enterprise.Credentialing@memorialhermann.org  Subject: Enroll Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || Memorial Hermann ||  Hello,   This is a follow up email regarding the annulment status for the below mentioned group and providers.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  Waiting for your response.   Thanks', NULL, NULL, '2021-05-25 16:02:15', '2021-05-25 16:02:15'),
(31981, 3040, 24095, NULL, '2021-06-07 00:00:00.000', 'Not Eligible', 'Email rcvd from: MHHPContracting@memorialhermann.org  Subject:Memorial Hermann Health Plan Request to Participate.  May 29, 2021  Oladipo Ayowole Dada, MD Ladot Healthcare LLC 2577 Madison Ave League City, TX 77573 Dear Oladipo Ayowole Dada, MD: We would like to thank you for your interest in participating in the Memorial Hermann Health Plan network; however, we do not currently have a network need for the specialty and/or services which you provide. We will keep your Request for Participation on file and notify you if our needs change in the future. Should you have questions or need additional assistance, please contact our Provider Relations Department at 713.338.4801 or you can send an email to: Providerservices@memorialhermann.org. Thank you again for your interest in Memorial Hermann Health Plan Provider Network.  Kind regards,  Memorial Hermann Health Plan Provider Relations', NULL, NULL, '2021-05-31 08:25:48', '2021-05-31 08:25:48'),
(31982, 3040, 24096, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 13:44:56', '2021-04-02 13:44:56'),
(31983, 3040, 24096, NULL, '2021-04-09 00:00:00.000', 'New/Not Initiated', 'Email sent to: providerrelations@trpnppo.com, trpndataentry@trpnppo.com  Subject: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned practice and providers in TRPN under the below location.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-02 14:06:17', '2021-04-02 14:06:17'),
(31984, 1006, 24096, NULL, '2021-04-09 00:00:00.000', 'Initiated', NULL, NULL, NULL, '2021-04-02 15:46:54', '2021-04-02 15:46:54'),
(31985, 3040, 24096, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: providerrelations@trpnppo.com,trpndataentry@trpnppo.com  Subject: Re: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Hello,  I wanted to enroll the group and providers in TRPN for our group Ladot Healthcare LLC. Can you advise me about the process?   Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-06 15:26:12', '2021-05-06 15:26:12'),
(31986, 3040, 24096, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Email sent to: mflores@trpnppo.com  Subject: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Hello Max,   Hope you are doing well. Please find the attached agreement as per your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-26 10:51:51', '2021-05-26 10:51:51'),
(31987, 1006, 24096, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Re: FW: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  \"Hello Max,   I hope you\'re doing well, I wanted to verify when can we expect the group and providers to be enrolled with TRPN or the copy of the countersigned agreement?  Thank you!\"', NULL, NULL, '2021-06-15 14:34:05', '2021-06-15 14:34:05'),
(31988, 1006, 24096, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from Max:  Sub:   \"Brad,  You should be receiving the countersigned copy before the end of this week. Once you receive the countersigned copy the providers will also be considered enrolled at that time.  Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Sent reply:  \"Hello Max,   We still haven\'t received any update on this, please get back to me as soon as you\'re able.   Thank you!\"', NULL, NULL, '2021-06-21 14:13:25', '2021-06-21 14:13:25'),
(31989, 1006, 24096, NULL, '2021-06-29 00:00:00.000', 'Approved', 'The group and providers are approved with TRPN.   EFF: 05/26/2021  Approval confirmation and signed contract are attached for reference in main group task. ', NULL, NULL, '2021-06-22 16:51:29', '2021-06-22 16:51:29'),
(31990, 3040, 24097, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-02 13:44:58', '2021-04-02 13:44:58'),
(31991, 3040, 24097, NULL, '2021-04-09 00:00:00.000', 'New/Not Initiated', 'Email sent to: providerrelations@trpnppo.com, trpndataentry@trpnppo.com  Subject: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned practice and providers in TRPN under the below location.   Practice Details: Practice Name: Ladot Healthcare LLC Practice Tax ID# 85-2432283 Practice NPI# 1912502626 Address: 2577 Madison Avenue League City , TX 77573  Provider 1: Provider Name: Dada, Atinuke Provider NPI# 1154782720  Provider 2:   Provider Name: Dada, Oladipo Provider NPI# 1760700223  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-02 14:06:18', '2021-04-02 14:06:18'),
(31992, 1006, 24097, NULL, '2021-04-09 00:00:00.000', 'Initiated', NULL, NULL, NULL, '2021-04-02 15:47:06', '2021-04-02 15:47:06'),
(31993, 3040, 24097, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: providerrelations@trpnppo.com,trpndataentry@trpnppo.com  Subject: Re: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Hello,  I wanted to enroll the group and providers in TRPN for our group Ladot Healthcare LLC. Can you advise me about the process?   Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-06 15:26:16', '2021-05-06 15:26:16'),
(31994, 3040, 24097, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Email sent to: mflores@trpnppo.com  Subject: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  Hello Max,   Hope you are doing well. Please find the attached agreement as per your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-26 10:51:55', '2021-05-26 10:51:55'),
(31995, 1006, 24097, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Re: FW: Enroll Group & Providers || Ladot Healthcare LLC || Dada, Oladipo & Dada, Atinuke || TRPN||  \"Hello Max,   I hope you\'re doing well, I wanted to verify when can we expect the group and providers to be enrolled with TRPN or the copy of the countersigned agreement?  Thank you!\"', NULL, NULL, '2021-06-15 14:33:31', '2021-06-15 14:33:31'),
(31996, 1006, 24097, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from Max:  Sub:   \"Brad,  You should be receiving the countersigned copy before the end of this week. Once you receive the countersigned copy the providers will also be considered enrolled at that time.  Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Sent reply:  \"Hello Max,   We still haven\'t received any update on this, please get back to me as soon as you\'re able.   Thank you!\"', NULL, NULL, '2021-06-21 14:13:16', '2021-06-21 14:13:16'),
(31997, 1006, 24097, NULL, '2021-06-29 00:00:00.000', 'Approved', 'The group and providers are approved with TRPN.   EFF: 05/26/2021  Approval confirmation and signed contract are attached for reference in main group task. ', NULL, NULL, '2021-06-22 16:51:24', '2021-06-22 16:51:24'),
(31998, 1006, 24104, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:48:43', '2021-04-09 13:48:43'),
(31999, 1006, 24104, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Confirmed the effective date for the group from Medicaid Provider line @ (401) 784-8100.   Group Effective: 10/01/2019 Ref# 486147', NULL, NULL, '2021-04-12 14:34:09', '2021-04-12 14:34:09'),
(32000, 1006, 24105, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:49:12', '2021-04-09 13:49:12'),
(32001, 1006, 24105, NULL, '2021-04-29 00:00:00.000', 'Approved', 'Group is enrolled with UBH, proof of enrollment and location addition is attached for reference.  Eff: 03/01/2020', NULL, NULL, '2021-04-22 15:31:18', '2021-04-22 15:31:18'),
(32002, 19067, 24105, NULL, '2022-04-12 00:00:00.000', 'Approved', 'Email sent to: andria_prado@optum.com  Subject: Enrollment Request || SNBCARE || TMS || UBH ||     Hello Andria,  Hope this email finds you well, has the CPT codes been added to our Fee Schedule yet?  Can a nurse practitioner associated with my existing contract prescribe transcranial magnetic stimulation? Can a nurse practitioner perform motor threshold mapping and oversee subsequent daily treatment sessions? What are the contracted amounts for each of the three CPT codes under a nurse practitioner (90867, 90868, 90869)?  Thanks, Hammad Ahmed', NULL, NULL, '2022-04-05 10:31:08', '2022-04-05 10:31:08'),
(32003, 1006, 24106, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:49:39', '2021-04-09 13:49:39'),
(32004, 1006, 24106, NULL, '2021-04-16 00:00:00.000', 'On Hold', 'The enrollment request is pending on the provider\'s RI PMHNP license to be issued. ', NULL, NULL, '2021-04-09 14:58:46', '2021-04-09 14:58:46'),
(32005, 1019, 24106, NULL, '2021-11-01 00:00:00.000', 'Not Eligible', 'Provider will no longer be working with SNBCare.', NULL, NULL, '2021-10-25 10:44:52', '2021-10-25 10:44:52'),
(32006, 1006, 24107, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:51:25', '2021-04-09 13:51:25'),
(32007, 3040, 24107, NULL, '2021-04-28 00:00:00.000', 'Approved', 'I had a word with (Ashley) MBHP representative and she said the provider is participating in-network with MBHP.   Effective Date: 01/01/2020  Call Ref# 04/21/2021 6671296 ', NULL, NULL, '2021-04-21 08:09:39', '2021-04-21 08:09:39'),
(32008, 1006, 24108, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:52:00', '2021-04-09 13:52:00'),
(32009, 1019, 24108, NULL, '2021-04-26 00:00:00.000', 'Approved', 'Effective date is 02/15/2020. Attached is the proof for In network ', NULL, NULL, '2021-04-19 13:21:11', '2021-04-19 13:21:11'),
(32010, 1006, 24109, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-09 13:52:21', '2021-04-09 13:52:21'),
(32011, 1019, 24109, NULL, '2021-04-26 00:00:00.000', 'Approved', 'Effective date is 02/15/2020. Attached is the proof for In network ', NULL, NULL, '2021-04-19 13:29:22', '2021-04-19 13:29:22'),
(32012, 3040, 24110, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:42:45', '2021-04-13 13:42:45'),
(32013, 3040, 24110, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:20', '2021-04-13 15:54:20'),
(32014, 1006, 24110, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:44', '2021-06-09 11:32:44'),
(32015, 1006, 24110, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:52:05', '2021-06-11 09:52:05'),
(32016, 3040, 24111, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:42:46', '2021-04-13 13:42:46'),
(32017, 3040, 24111, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:26', '2021-04-13 15:54:26'),
(32018, 1006, 24111, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:41', '2021-06-09 11:32:41'),
(32019, 1006, 24111, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:52:02', '2021-06-11 09:52:02'),
(32020, 3040, 24112, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:42:47', '2021-04-13 13:42:47'),
(32021, 3040, 24112, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:30', '2021-04-13 15:54:30'),
(32022, 1006, 24112, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:38', '2021-06-09 11:32:38'),
(32023, 1006, 24112, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:59', '2021-06-11 09:51:59'),
(32024, 3040, 24113, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:42:48', '2021-04-13 13:42:48'),
(32025, 3040, 24113, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:35', '2021-04-13 15:54:35'),
(32026, 1006, 24113, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:33', '2021-06-09 11:32:33'),
(32027, 1006, 24113, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:56', '2021-06-11 09:51:56'),
(32028, 3040, 24114, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:43:33', '2021-04-13 13:43:33'),
(32029, 3040, 24114, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:40', '2021-04-13 15:54:40'),
(32030, 1006, 24114, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:30', '2021-06-09 11:32:30'),
(32031, 1006, 24114, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:53', '2021-06-11 09:51:53'),
(32032, 3040, 24115, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:43:34', '2021-04-13 13:43:34'),
(32033, 3040, 24115, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:44', '2021-04-13 15:54:44'),
(32034, 1006, 24115, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:27', '2021-06-09 11:32:27'),
(32035, 1006, 24115, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:49', '2021-06-11 09:51:49'),
(32036, 3040, 24116, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:43:35', '2021-04-13 13:43:35'),
(32037, 3040, 24116, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:49', '2021-04-13 15:54:49'),
(32038, 1006, 24116, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:24', '2021-06-09 11:32:24'),
(32039, 1006, 24116, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:47', '2021-06-11 09:51:47'),
(32040, 3040, 24117, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 13:43:35', '2021-04-13 13:43:35'),
(32041, 3040, 24117, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:54:57', '2021-04-13 15:54:57'),
(32042, 1006, 24117, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:20', '2021-06-09 11:32:20');
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
(32043, 1006, 24117, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:43', '2021-06-11 09:51:43'),
(32044, 3040, 24118, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 15:55:15', '2021-04-13 15:55:15'),
(32045, 3040, 24118, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:55:20', '2021-04-13 15:55:20'),
(32046, 1006, 24118, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:15', '2021-06-09 11:32:15'),
(32047, 1006, 24118, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:33', '2021-06-11 09:51:33'),
(32048, 3040, 24119, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-13 15:55:36', '2021-04-13 15:55:36'),
(32049, 3040, 24119, NULL, '2021-04-20 00:00:00.000', 'Initiated', 'Email sent to: contract@hioscar.com  Subject: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  Greetings,   Hope you are doing well. I wanted to enroll the below mentioned group and providers in Oscar 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: Dehnisch, Frank R Provider NPI# 1952376345  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Paterson, Katherine D Provider NPI# 1164776548  Provider 4:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please let me know. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-13 15:55:41', '2021-04-13 15:55:41'),
(32050, 1006, 24119, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent f/u email @ contract@hioscar.com cc credentialing@hioscar.com:  Sub: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,   I hope you\'re doing well, I wanted to follow up with you regarding this query we sent out. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-09 11:32:00', '2021-06-09 11:32:00'),
(32051, 1006, 24119, NULL, '2021-06-18 00:00:00.000', 'Not Eligible', 'Received the following reply from credentialing@hioscar.com:  Sub: Re: Enroll Providers || Coastal Bend Urgent Care, LLC & George West Medical Clinic || Providers || Oscar ||  \"Hello,  Unfortunately, I was unable to find an active direct contract with Oscar associated with TIN 81-1890349. If this is in regards to the online application to join Oscar\'s network, the Contracting Team ( contracts@hioscar.com) will review your request and outreach only if there is a current opening for your market and specialty. Please note that completing the form is not a guarantee of contract and all requests are subject to contracting restriction and existing partnerships in any given market.  The Contracting Team does review these requests on an ongoing basis and will let you know if they are able to proceed with a contract. Please be advised, that if you do send an email directly to our Contracting Team inquiring on the status of this application, they do receive a high number of inquiries and their response times do vary.   Please let us know if you have any questions.   Best, Selene\"  As per the form we received the following information:   \"We are unable to contract with your practice at this time due to your location outside of Oscar\'s coverage area Thank you for your interest in joining the Oscar network. The state or market you\'ve indicated is currently outside of Oscar\'s coverage. As such, we are unable to pursue a direct contract with your practice at this time.   If you are still interested in joining the Oscar network, please check back as we approach Open Enrollment for 2022 to see if we\'re expanding into your area. \" ', NULL, NULL, '2021-06-11 09:51:22', '2021-06-11 09:51:22'),
(32052, 1006, 24120, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-16 10:37:43', '2021-04-16 10:37:43'),
(32053, 1006, 24120, NULL, '2021-06-14 00:00:00.000', 'Initiated', 'Sent following enrollment initiation request @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Request - BHUCC - Christus Spohn   \"Hello, We wish to enroll the following group and providers with Christus Spohn, their information is as follows:  Group Name: Best Health Urgent Care & Clinic NPI# 1013540962 TIN# 84-4737737  Provider Name: Stephane Cyriaque NPI# 1780192633  Provider Name: Shametria Tann NPI# 1124615612  Please let me know what is required to proceed with this process.  Thank you. \"', NULL, NULL, '2021-06-07 10:47:31', '2021-06-07 10:47:31'),
(32054, 1006, 24120, NULL, '2021-07-01 00:00:00.000', 'Not Eligible', 'Christus Spohn service area does not cover Missouri City/Fort Bend County: https://www.christushealth.org/spohn/patient-resources/spohn-health-network/service-area', NULL, NULL, '2021-06-24 13:43:41', '2021-06-24 13:43:41'),
(32055, 1006, 24126, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-16 16:01:59', '2021-04-16 16:01:59'),
(32056, 1006, 24126, NULL, '2021-04-29 00:00:00.000', 'Approved', 'Group is enrolled with UBH, proof of enrollment and location addition is attached for reference.  Eff: 03/01/2020', NULL, NULL, '2021-04-22 15:31:17', '2021-04-22 15:31:17'),
(32057, 1006, 24127, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:27:24', '2021-04-20 10:27:24'),
(32058, 1006, 24127, NULL, '2021-04-27 00:00:00.000', 'Initiated', 'Sent following email to PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,  I hope you\'re doing well, I wanted to verify the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If the above-mentioned providers are enrolled please send over their welcome letters and if they require enrollment please let me know what the process is.   Thank you.\"', NULL, NULL, '2021-04-20 13:05:41', '2021-04-20 13:05:41'),
(32059, 1006, 24127, NULL, '2021-05-05 00:00:00.000', 'In Process', 'Sent a f/u email @ PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,   I hope you\'re doing well, I wanted to follow-up on this request again, Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-28 12:44:20', '2021-04-28 12:44:20'),
(32060, 3040, 24127, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: DillikarA@aetna.com  Subject:  Status: [EXTERNAL] Enrollment Request/Status - Bay Area Quick Care - First Health Case# 12591444   Hi,  Provider (Cynthia Malowitz) is active under Tax ID: 271702009 With effective 11/01/2012 in First Health Networks.  And rest providers are not linked with First Health if they needs to be enrolled please send their complete provider details to pdsdallas@aetna.com from there your request will be taken care by a particular user.  Thanks, Akhilesh Dillikar', NULL, NULL, '2021-06-10 10:42:47', '2021-06-10 10:42:47'),
(32061, 1006, 24127, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent requested information @ Bharath, Bollu BharathB@aetna.com, TalasilaB@aetna.com, DillikarA@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   Please find the attached information:   Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  Please let me know what else is required to proceed with this request.  Thank you!\"', NULL, NULL, '2021-06-29 10:44:57', '2021-06-29 10:44:57'),
(32062, 1006, 24127, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ Bharath, Bollu BharathB@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following providers: Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-07-23 15:39:18', '2021-07-23 15:39:18'),
(32063, 1006, 24127, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ BharathB@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Thank you.\"', NULL, NULL, '2021-08-10 16:02:11', '2021-08-10 16:02:11'),
(32064, 11056, 24127, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : BharathB@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  If you have any questions  or concerns please let me know. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-20 13:24:44', '2021-08-20 13:24:44'),
(32065, 11056, 24127, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : PDSDallas@aetna.com & Machado-PetryS@aetna.com  &  	BharathB@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  If you have any questions or concerns please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 09:27:10', '2021-08-30 09:27:10'),
(32066, 11056, 24127, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com & DillikarA@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We are still waiting to get the latest updates regarding the enrollment status in First Health of the below mentioned providers and practice as soon as possible. Please respond to my query soon.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228   If you have any questions or concerns please let me know. Eagerly,waiting to get the response from you.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-24 09:30:34', '2021-09-24 09:30:34'),
(32067, 11056, 24127, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : sidleyj1@firsthealth.com>  Sub : Signature requested on \"TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210\"  Hello,  As a follow-up to my email, attached is the document for your review and signature.  After you sign TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210, the agreement will be sent to Jeanette Sidley. Then, all parties will receive a final PDF copy by email.  Thank you.  Jeanette Sidley JEANETTE SIDLEY sidleyj1@firsthealth.com  Signed by our side. Please see the attachment.   You finished signing “TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210”.  Next, Jeanette Sidley will sign.', NULL, NULL, '2021-10-01 10:07:59', '2021-10-01 10:07:59'),
(32068, 11056, 24127, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good afternoon Jeanette!  Hope you are doing great. Yes, the practice is interested in a group agreement. You may send the agreement to baqc@claimsmedinc.com and sta@claimsmedinc.com for review. Please find the roster in attachments.  I am grateful to you. Bundle of thanks for your prompt responses and assistance.  Take care! Have a wonderful & blessed week ahead!', NULL, NULL, '2021-10-11 10:12:46', '2021-10-11 10:12:46'),
(32069, 11056, 24127, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub  : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624   Hello Ahmed,  I hope that this email finds you well! I apologize that I have not been able to respond sooner, my son has been ill so I have been in and out of the office.   I will send the agreement over shortly for review. Thank you for providing the roster.  As always, please do not hesitate to reach out if you have any questions or concerns when reviewing.  Take care of yourself!  Jeanette', NULL, NULL, '2021-10-18 10:13:38', '2021-10-18 10:13:38'),
(32070, 11056, 24127, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email sent to :  SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning Jeanette!  Hope this email finds you well. There is no need for an apology. How is he now? Hope he finds strength with each new day.  Please don\'t hesitate if you have any queries or concerns. Send the agreement whenever it is convenient for you.  Take care of your son & yourself too!  Thank you! Have a blessed & great week ahead!', NULL, NULL, '2021-10-26 10:31:57', '2021-10-26 10:31:57'),
(32071, 11056, 24127, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning Ahmed,     I hope that this email finds you well! Thank you for the well wishes, we are hoping he starts to feel better soon.     I sent the agreement over for review yesterday. Please let me know if you did not receive it, I can resend the link.     Have a wonderful Friday!     Take care,', NULL, NULL, '2021-11-04 14:31:03', '2021-11-04 14:31:03'),
(32072, 11056, 24127, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email sent to: SidleyJ1@firsthealth.com  Sub: Fwd: FW: Bay Area Quick Care - First Health Case# 13578624   Good morning Jeanette!  Hope this email finds you well. He will feel better soon. He is in my prayers.  Yes, we have received that & after reviewing signed that too.  Thank you! Have a wonderful & blessed weekend ahead!', NULL, NULL, '2021-11-18 17:03:12', '2021-11-18 17:03:12'),
(32073, 11056, 24127, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email sent to:  SidleyJ1@firsthealth.com  Sub :  Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope this email finds you well. Are there any updates regarding the providers\' enrollment process? How is your son now?  Thank you! Have a blessed day!', NULL, NULL, '2021-12-01 12:20:09', '2021-12-01 12:20:09'),
(32074, 11056, 24127, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email received from:  SidleyJ1@firsthealth.com  Sub: Fwd: FW: Bay Area Quick Care - First Health Case# 13578624   Good morning Ahmed,   I hope that this email finds you well! My son is finally doing much better, thank you so much for asking!   The agreement for this practice is effective 11/1/21. It is still in the implementation stage with our Data Team. Once I have the new group ID number I will be sending over the welcome letter.   In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take care!', NULL, NULL, '2021-12-08 13:51:42', '2021-12-08 13:51:42'),
(32075, 11056, 24127, NULL, '2021-12-29 00:00:00.000', 'Approved', 'Email received from: SidleyJ1@firsthealth.com  Sub: Bay Area Quick Care PLLC - First Health Network   Hello,  It is with great pleasure to welcome you to the First Health Network. I would like to personally thank you for all of your time and efforts during the contracting process. You should have already received your fully executed copy of the First Health Agreement.  You may reference your CPD ID # 1074082 (which became effective 11/01/2021)   Please see the attachment.', NULL, NULL, '2021-12-22 15:15:41', '2021-12-22 15:15:41'),
(32076, 1006, 24128, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:27:26', '2021-04-20 10:27:26'),
(32077, 9057, 24128, NULL, '2021-06-07 00:00:00.000', 'Approved', 'This Group Has already been Approved  Effective Id :04/01/2010 Provider ID: TXB101017 Proof is attached', NULL, NULL, '2021-05-31 13:57:38', '2021-05-31 13:57:38'),
(32078, 1006, 24129, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:27:27', '2021-04-20 10:27:27'),
(32079, 9057, 24129, NULL, '2021-06-05 00:00:00.000', 'Initiated', 'Form for the enrollment of group has been submitted  Waiting for the Response', NULL, NULL, '2021-05-28 14:46:59', '2021-05-28 14:46:59'),
(32080, 1006, 24129, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ SWHP REGION 4 SWHPRegion4@BSWhealth.org:  Sub: Enrollment Status - BAQC - Scott & White   \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers as we submitted an enrollment request back in May, their information is as follows:  Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: Francis William NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 13:39:40', '2021-06-16 13:39:40'),
(32081, 1006, 24129, NULL, '2021-06-29 00:00:00.000', 'Not Eligible', 'Received the following denial notification from SWHP PROVIDER NETWORK DEVELOPMENT SWHPPROVIDERNETWORKDEVELOPMENT@bswhealth.org:  Sub: New Contract Request  \"Tax ID#: 27-1702009  RE: Network Denial Letter  Dear Bay Area Quick Care PLLC  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 5/28/2021, SWHP and FirstCare regretfully declines to contract with Bay Area Quick Care PLLCat this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.  For commercial providers, we welcome you to review 28 TAC 3.3706 for more detail on denial review.  Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-22 16:37:49', '2021-06-22 16:37:49'),
(32082, 1006, 24130, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:27:29', '2021-04-20 10:27:29'),
(32083, 1006, 24130, NULL, '2021-05-20 00:00:00.000', 'Initiated', 'Sent an enrollment request @ trpndataentry@trpnppo.com & providerrelations@trpnppo.com:  Sub: Provider Enrollment Request - BAQC- TRPN  \"Hello,   We want to get the following providers and group enrolled with TRPN, their information is as follows:  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to initiate this request and what the enrollment timeframe is?  Thank you.\"', NULL, NULL, '2021-05-04 10:33:04', '2021-05-04 10:33:04'),
(32084, 9057, 24130, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to trpndataentry@trpnppo.com, providerrelations@trpnppo.com Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Hello, We submitted an enrollment form for the below mentioned providers under the following group.  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Kindly update me with the current status regarding the above mentioned request.  Thank you', NULL, NULL, '2021-05-27 11:07:06', '2021-05-27 11:07:06'),
(32085, 1006, 24130, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Called @ 800-966-8776 and spoke to Brixcia as per her we need to send an email as our group contract is under Cynthia Malowitz and we need to update it.   Email sent @ bcastillo@trpnppo.com & providerrelations@trpnppo.com:  \"Hello,  As per my discussion with Brixcia, we want to update our group contract to add the following individual providers under it, the group and providers information is as follows:   Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to update the contract.   Thank you!\"', NULL, NULL, '2021-06-16 13:58:59', '2021-06-16 13:58:59'),
(32086, 1006, 24130, NULL, '2021-06-29 00:00:00.000', 'In Process', 'We received the following reply from Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Good morning Brad,  I hope this message finds you well. Thank you for taking the time to speak to me today, per our conversation attached you will find the proposal if you have any questions please feel free to contact me directly for assistance. Thank you for your time today have a great Tuesday.  Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Sent following reply:  \"Hello, Max,   Thank you for the update, here\'s the group agreement filled out and signed. Do let me know if anything else is needed.  Thank you\"', NULL, NULL, '2021-06-22 16:16:01', '2021-06-22 16:16:01'),
(32087, 11056, 24130, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : mflores@trpnppo.com  Sub : Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Brad,   I will have the agreement processed and you can expect to receive the countersigned copy in 3 weeks, if you have any questions in the meantime please feel free to contact me directly for assistance.     Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive  Las Vegas, Nevada 89117  Phone: (619) 737-9546  Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com', NULL, NULL, '2021-07-06 15:03:49', '2021-07-06 15:03:49'),
(32088, 1006, 24130, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Hello Max,  I hope you\'re doing well, I wanted to get an update regarding this request. Please get back to me as soon as you\'re able.  Thank you!\"', NULL, NULL, '2021-07-23 16:37:01', '2021-07-23 16:37:01'),
(32089, 1006, 24130, NULL, '2021-08-03 00:00:00.000', 'Approved', 'The group and providers have been approved.   Eff: 06/22/2021  An executed contract is attached for reference. ', NULL, NULL, '2021-07-27 12:28:31', '2021-07-27 12:28:31'),
(32090, 1006, 24131, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:07', '2021-04-20 10:30:07'),
(32091, 9057, 24131, NULL, '2021-06-08 00:00:00.000', 'Not Eligible', 'We sent an email to: registrar@multiplan.com Sub: Request for Enrollment Status - BAQC - Multiplan  Hello, I want to get the current status of the below mentioned group & providers  Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda  NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Kindly respond to us as soon as possible.  Thank you ', NULL, NULL, '2021-05-31 17:02:55', '2021-05-31 17:02:55'),
(32092, 1006, 24132, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:09', '2021-04-20 10:30:09'),
(32093, 9057, 24132, NULL, '2021-06-07 00:00:00.000', 'In Process', 'We sent an email to Provider_Relations_Houston@bcbstx.com Sub: Request for Enrollment Status - BAQC - BCBS  Hello,  I want to get the current status of the below mentioned provider under the following group.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418 Provider Name: Malowitz, Cynthia NPI# 1336173244   Kindly update me regarding above mentioned request as soon as possible  Thank you', NULL, NULL, '2021-05-31 13:25:32', '2021-05-31 13:25:32'),
(32094, 1006, 24132, NULL, '2021-06-23 00:00:00.000', 'Approved', 'We received the group roster and the provider is showing as enrolled: Provider ID# H0819N1201 Effective Date: 06/11/2010  The roster is attached for reference.  ', NULL, NULL, '2021-06-16 11:04:05', '2021-06-16 11:04:05'),
(32095, 1006, 24133, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:11', '2021-04-20 10:30:11'),
(32096, 9057, 24133, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We Sent an email to: CSHNproviderrelations@christushealth.org Sub: Requisition of Enrollment - BAQC - Christus Spohn  Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 09:56:52', '2021-06-01 09:56:52'),
(32097, 1006, 24133, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hello,   I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009  Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-17 10:47:09', '2021-06-17 10:47:09'),
(32098, 11056, 24133, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to :   CSHNproviderrelations@christushealth.org  Sub : Enrollment Status - BAQC - Christus Spohn  Greetings,  Hope you are doing well. I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Practice: Practice Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Providers: Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible. Kindly Respond.  Thank you!', NULL, NULL, '2021-07-06 15:45:33', '2021-07-06 15:45:33'),
(32099, 1006, 24133, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"Guerra, Vicki A.\" vicki.guerra@christushealth.org ', NULL, NULL, '2021-07-27 16:33:37', '2021-07-27 16:33:37'),
(32100, 1006, 24133, NULL, '2021-08-12 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  Happy Thursday!  Does this provider group have hospital affiliations with a Christus facility? Or, is there a physician this group utilizes who does have hospital affiliations?  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Replied with:  \"Hello Vicki,   The group and provider do have a supervising physician David Gray (NPI# 1902814874) who has hospital affiliations. Please let me know if this works for you?  Thank you. \"', NULL, NULL, '2021-08-05 12:38:44', '2021-08-05 12:38:44'),
(32101, 1006, 24133, NULL, '2021-08-25 00:00:00.000', 'Not Eligible', 'We received the following denial notification from vicki.guerra@christushealth.org:  Sub: Gray MD Affiliations Expired: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  I reviewed Dr. Grays affiliations and they have expired with the hospital. Please see the attached. Dr. Gray will need to be credentialed again with the hospital in order for the group to be extended a contract. He may have missed his reappointment. Please see attached documentation.  Is this possible for Dr. Gray or yourself to reach out to medical staff administration and inquire?  Medical Staff Administration Tel: (361) 881-3151 Fax: (361) 881-3714  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"', NULL, NULL, '2021-08-18 10:57:14', '2021-08-18 10:57:14'),
(32102, 1006, 24136, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:16', '2021-04-20 10:30:16'),
(32103, 1006, 24136, NULL, '2021-04-27 00:00:00.000', 'Initiated', 'Sent following email to PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,  I hope you\'re doing well, I wanted to verify the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If the above-mentioned providers are enrolled please send over their welcome letters and if they require enrollment please let me know what the process is.   Thank you.\"', NULL, NULL, '2021-04-20 13:05:49', '2021-04-20 13:05:49'),
(32104, 1006, 24136, NULL, '2021-05-05 00:00:00.000', 'In Process', 'Sent a f/u email @ PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,   I hope you\'re doing well, I wanted to follow-up on this request again, Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-28 12:44:16', '2021-04-28 12:44:16'),
(32105, 3040, 24136, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: DillikarA@aetna.com  Subject:  Status: [EXTERNAL] Enrollment Request/Status - Bay Area Quick Care - First Health Case# 12591444   Hi,  Provider (Cynthia Malowitz) is active under Tax ID: 271702009 With effective 11/01/2012 in First Health Networks.  And rest providers are not linked with First Health if they needs to be enrolled please send their complete provider details to pdsdallas@aetna.com from there your request will be taken care by a particular user.  Thanks, Akhilesh Dillikar', NULL, NULL, '2021-06-10 10:42:42', '2021-06-10 10:42:42'),
(32106, 1006, 24136, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Hi,  Provider (Cynthia Malowitz) is active under Tax ID: 271702009 With effective 11/01/2012 in First Health Networks.  Approval confirmation is attached for reference. ', NULL, NULL, '2021-06-29 10:53:29', '2021-06-29 10:53:29'),
(32107, 1006, 24140, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:23', '2021-04-20 10:30:23'),
(32108, 9057, 24140, NULL, '2021-06-05 00:00:00.000', 'Initiated', 'Form for the enrollment of group has been submitted  Waiting for the Response', NULL, NULL, '2021-05-28 14:46:23', '2021-05-28 14:46:23'),
(32109, 1006, 24140, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ SWHP REGION 4 SWHPRegion4@BSWhealth.org:  Sub: Enrollment Status - BAQC - Scott & White   \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers as we submitted an enrollment request back in May, their information is as follows:  Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: Francis William NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 13:39:52', '2021-06-16 13:39:52'),
(32110, 1006, 24140, NULL, '2021-06-29 00:00:00.000', 'Not Eligible', 'Received the following denial notification from SWHP PROVIDER NETWORK DEVELOPMENT SWHPPROVIDERNETWORKDEVELOPMENT@bswhealth.org:  Sub: New Contract Request  \"Tax ID#: 27-1702009  RE: Network Denial Letter  Dear Bay Area Quick Care PLLC  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 5/28/2021, SWHP and FirstCare regretfully declines to contract with Bay Area Quick Care PLLCat this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.  For commercial providers, we welcome you to review 28 TAC 3.3706 for more detail on denial review.  Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-22 16:37:46', '2021-06-22 16:37:46'),
(32111, 1006, 24141, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:24', '2021-04-20 10:30:24'),
(32112, 1006, 24141, NULL, '2021-05-17 00:00:00.000', 'Initiated', 'We received the following email from Superior Healthplan @ SHP Network Development NPR Contracting SHPNetwork.DevelopmentNPRContracting@superiorhealthplan.com:  Sub: Important request from Superior HealthPlan  \"Hello Provider,  We received a request for TIN 27-1702009 to receive a new contract from Superior Health Plan.   In order to process your request:  Ø  Can you provide me the name of the group/ facility or if (provider) practices alone? Ø  Please respond with a copy of your W9. Ø  Does the provider want to participate with all of our products (Medicaid, Chip, Medicare, and Ambetter)? Ø  Please provide a good call back number.  Without a response, we are unable to move forward.   Jeannie Lopez Superior Health Plan | Network Operations\"  Replied to them with requested information. ', NULL, NULL, '2021-05-10 12:17:12', '2021-05-10 12:17:12'),
(32113, 1005, 24141, NULL, '2021-05-31 00:00:00.000', 'In Process', 'Awaiting response from the insurance.', NULL, NULL, '2021-05-24 09:47:18', '2021-05-24 09:47:18'),
(32114, 1006, 24141, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ SHP Network Development NPR Contracting SHPNetwork.DevelopmentNPRContracting@superiorhealthplan.com:  Sub: Enrollment Status - BAQC - Superior Health  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: Francis William NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible. Thank you.\"', NULL, NULL, '2021-06-11 11:48:27', '2021-06-11 11:48:27'),
(32115, 1006, 24141, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Left voicemail @ (877) 687-1196 asking for enrollment updates as we\'re not getting any updates through the email.  ', NULL, NULL, '2021-06-15 12:03:51', '2021-06-15 12:03:51'),
(32116, 1006, 24141, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from Credentialing Credentialing@superiorhealthplan.com:  Sub: 1437481421  \"Good Morning,  We received a voice message from you and I am happy to assist you. I understand that you would like to check the status for NPI: 1437481421.  I do not currently show information for this provider. The process to inquire about a new contract/adding provider or service to your existing contract begins by completing a Network Participation Inquiry through our website.   http://www.superiorhealthplan.com/for-providers/join-our-network/  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\"  Submitted ancillary enrollment request, attached in main group task for reference. ', NULL, NULL, '2021-06-16 16:38:54', '2021-06-16 16:38:54'),
(32117, 1006, 24141, NULL, '2021-07-09 00:00:00.000', 'In Process', 'We rcvd the following reply from SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"We received your signed contract. However, we have not received your Credentialing Application packet. Attached is the email that was sent. Please complete the forms & return along with a copy of your current W9 so that we can start the process.  Thank you, Leslie Gilchrist Intake Coordinator Contract Management\"  Replied with:  \"Hello Leslie,  Please find the requested documents attached, do let me know if anything else is required.  Thank you. \"  The ancillary contracting request is attached in the main group task for reference. ', NULL, NULL, '2021-07-02 10:59:48', '2021-07-02 10:59:48'),
(32118, 1006, 24141, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ SHP-Network Development SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello,   I wanted to get an update regarding the enrollment status for our provider. Please get back to me as soon as possible.  Thank you.\" ', NULL, NULL, '2021-07-23 16:33:23', '2021-07-23 16:33:23'),
(32119, 1006, 24141, NULL, '2021-08-17 00:00:00.000', 'In Process', 'We received the following update from SHP-NETWORKDEVELOPMENT@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello,  We received your completed application on July 2, 2021 Your projected effective date is August 1, 2021. Currently, it is in the process of being loaded in our system. Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Sincerely,  Lucy Escobar Lead Contracts Coordinatoor, Contract Management\"  Need to allow more time for it to process and complete. ', NULL, NULL, '2021-08-10 12:57:40', '2021-08-10 12:57:40'),
(32120, 11056, 24141, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Hello,   I appreciate the update, I just wanted to confirm what the status for the ancillary contract is as well?  Thank you. ', NULL, NULL, '2021-08-20 10:21:37', '2021-08-20 10:21:37'),
(32121, 11056, 24141, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Good morning!  Hope this email finds you well. Whenever the application is uploaded and the provider\'s enrollment is completed, please inform us. Please keep us updated with the process. Please let us know the latest status for the ancillary contract too.  If you need any document or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-30 10:20:35', '2021-08-30 10:20:35'),
(32122, 11056, 24141, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Good morning!  Hope you are doing well. We are still waiting to get the latest updates regarding the enrollment status of the below mentioned providers and practice as soon as possible. We haven\'t received the welcome packet yet.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    If you have any questions or concerns please let me know. Eagerly,waiting to get the response from you.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-24 09:12:35', '2021-09-24 09:12:35'),
(32123, 11056, 24141, NULL, '2021-10-05 00:00:00.000', 'In Process', 'Email received from : Jeannie.Lopez@superiorhealthplan.com  Sub : Superior HealthPlan Participating Provider Agreement - BAY AREA QUICK CARE (534990) has been Signed and Filed    Attached is the final agreement for your reference. You can also open it online to review its activity history.', NULL, NULL, '2021-09-28 13:32:41', '2021-09-28 13:32:41'),
(32124, 11056, 24141, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email received from : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Hello  We received your completed application for Melissa Ramsden on 7/2/21. Your effective date is 8/1/21  and will be receiving a welcome packet shortly. ', NULL, NULL, '2021-10-11 09:53:21', '2021-10-11 09:53:21'),
(32125, 11056, 24141, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Please assist me with the query at your earliest convenience. Does the Superior Health plan come under Medicare or Medicaid?', NULL, NULL, '2021-10-18 09:05:25', '2021-10-18 09:05:25'),
(32126, 11056, 24141, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email received from: SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Good morning!  Hope all is well. Please find the attached forms for the remaining providers mentioned below. If further information or documents are needed please let me know.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148 Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	1336173244   In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a great day!', NULL, NULL, '2021-10-26 09:59:11', '2021-10-26 09:59:11'),
(32127, 11056, 24141, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email received from :SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Hello     Thank you for your email. However, your Account Manager can best assist you with your questions.        Find my Account Manager:  https://www.superiorhealthplan.com/providers/resources/find-my-provider-rep.html', NULL, NULL, '2021-11-04 14:41:11', '2021-11-04 14:41:11');
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
(32128, 11056, 24141, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Good morning!  Hope all is well with you. Please respond to my query at your earliest convenience.  Also, provide us with the contact no. and the Account Manager\'s email for our further assistance.  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-18 16:53:09', '2021-11-18 16:53:09'),
(32129, 11056, 24141, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email received from:  AM.Houston@superiorhealthplan.com  Sub:  [secure]RE: MELISSA RAMSDEN  Hi, All of the requested information for Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 been received and they are still in the credentialing phase. Please reference ticket # 69145 if you have any questions.   Sincerely,  Barbara McDonald  Account Manager, Provider Relations Region 7 (Harris & Jefferson)   ', NULL, NULL, '2021-12-01 12:05:29', '2021-12-01 12:05:29'),
(32130, 11056, 24141, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email received from:  AM.Houston@superiorhealthplan.com  Sub:  [secure]Credentialing Updates   Hi, Both providers Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 are still being credentialed. It can take anywhere from 3 to 6 months to complete the process. The applications were received on 10/13/2021 and are still within the 3 month time frame. Please reference ticket #70273 if you have any questions.   Sincerely,       Barbara McDonald Account Manager, Provider Relations Region 7 (Harris & Jefferson)   711 N. Carancahua Street, Ste. 600 Corpus Christi, TX 78401 Direct Line: 1 (800)656-4817 Press 1 for English or 2 for Spanish, then option #3 for Provider Relations Fax: 1-866-683-5630 AM.houston@superiorhealthplan.com | SuperiorHealthPlan.com', NULL, NULL, '2021-12-08 14:23:30', '2021-12-08 14:23:30'),
(32131, 11056, 24141, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: AM.Houston@superiorhealthplan.com  Sub: Case 70277 RE: MELISSA RAMSDEN   & RE: MELISSA RAMSDEN  [secure]Credentialing Updates   Good morning!  Hope all is well with you. Kindly, update us regarding reference ticket # 69145, and with a credentialing phase of the providers, Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a great day!', NULL, NULL, '2021-12-16 17:56:16', '2021-12-16 17:56:16'),
(32132, 11056, 24141, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Sub: [secure] RE: [secure]Credentialing Updates   Hello Talha,     I hope this email finds you well. I reviewed both providers and am reflecting them to be in the credentialing process. Please take note credentialing review can take up to 90 days for completion.     Cynthia Malowitz- 1336173244 shows to be under review for 64 days  Kynda Orsak – 1528553724 shows to be under review for 64 days     Thank you,     Patricia Torres  Provider Account Manager II 711 N Carancahua Street, Ste. 600 Corpus Christi, Tx 78401  Toll-Free: 1-800-656-4817 Option 1, then Option 3 Fax: 1-866-683-5630 AM.CorpusChristi@superiorhealthplan.com| SuperiorHealthplan.com', NULL, NULL, '2021-12-22 17:13:14', '2021-12-22 17:13:14'),
(32133, 19067, 24141, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Kynda & Cynthia || Superior Health ||    Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers with Superior Health.  Group Name	Bay Area Quick Care Tax ID	27-1702009 Group NPI	1437481421 Provider Name	NPI	Location Kynda Orsak	1528553724	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148 Cynthia Malowitz	1336173244	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 14:28:23', '2021-12-30 14:28:23'),
(32134, 19067, 24141, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Group || Superior Health ||    Hi,  Providers Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 for Bay Area Quick Care PLLC, TIN 271702009 are in credentialing.  Please keep in mind process may take 180 days.      Thank you,     Yvette Hernandez Account Manager  Provider Relations Department', NULL, NULL, '2022-01-06 09:20:44', '2022-01-06 09:20:44'),
(32135, 19067, 24141, NULL, '2022-01-20 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Subject: Re: Enrollment Query || BAQC || Group || Superior Health ||    Greetings!  Any updates on this?  Don\'t hesitate to reach out if you need anything.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-13 11:29:07', '2022-01-13 11:29:07'),
(32136, 19067, 24141, NULL, '2022-01-28 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Group || Superior Health ||     Good Morning Hammad,  Both provider are still pending credentialing.     Providers Kynda Orsak NPI: 152855372  Cynthia Malowitz NPI: 1336173244  Bay Area Quick Care PLLC, TIN 271702009     Timothy Do  Provider Account Manager II  Region 7 (Harris & Jefferson)    ', NULL, NULL, '2022-01-20 18:56:25', '2022-01-20 18:56:25'),
(32137, 19067, 24141, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email received from: Dylan.BloomFernandez@superiorhealthplan.com  Subject: ${SECURE}FIRST Attempt - Credentialing Request; Cynthia Malowitz_1336173244    We received your credentialing application for Cynthia Malowitz; however, we did not receive all of the documentation necessary to complete the credentialing process.  Please submit the information marked below:                 Copy of your current malpractice insurance (showing amounts and dates of coverage)                 Professional work history does not fully cover the 5 year look back period.  Please provide a full work history and explain any gaps of 6 months or more.  Due to working remotely, email is the best form of communication currently. Any questions please email credentialing@superiorhealthplan.com.  You may email the requested information to the contact information listed below.     Regards,     Dylan Bloom-Fernandez     Provider Data Management Specialist    5900 E. Ben White Blvd. | Austin, TX 78741  Dylan.bloomfernandez@superiorhealthplan.com | SuperiorHealthPlan.com', NULL, NULL, '2022-02-08 09:21:56', '2022-02-08 09:21:56'),
(32138, 19067, 24141, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email sent to: dylan.bloomfernandez@superiorhealthplan.com  Subject: Re: ${SECURE}FIRST Attempt - Credentialing Request; Cynthia Malowitz_1336173244   Greetings!  Hope this email finds you well.  Kindly see the attachment for current COI as per your request and for a full work history and explanation of any gaps you can go through her CAQH. The number is 12083462.  Don\'t hesitate to reach me out if you need any document or information.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-08 10:21:49', '2022-02-08 10:21:49'),
(32139, 19067, 24141, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: RE: Enrollment Query || BAQC || Group || Superior Health || - REF # 79267    Good afternoon,     Please see credentialing status for each provider below under, Bay Area Quick Care PLLC, TIN 271702009  Kynda Orsak NPI: 152855372   - Credentialing Status, Application received on 10/18/2021.  Cynthia Malowitz NPI: 1336173244 - Credentialing Status, Application received on 10/18/2021.     Credentialing process can take between 60 -120 days. Please allow more time for application to process.     Thank you,     Yesenia Prado  Provider Account Manager  Nueces, Harris & Jefferson SDAs', NULL, NULL, '2022-02-08 14:28:30', '2022-02-08 14:28:30'),
(32140, 19067, 24141, NULL, '2022-02-22 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Re: Enrollment Query || BAQC || Group || Superior Health ||    - REF # 79267   Hi,  Hope this email finds you well.  Any updates on the request and don\'t hesitate to reach out if you need any document or information.   Regards, Hammad Ahmed', NULL, NULL, '2022-02-15 11:05:50', '2022-02-15 11:05:50'),
(32141, 19067, 24141, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email received from: Angela.Heard@superiorhealthplan.com  Subject: FINAL Credentialing Final Request; WILLIAM FRANCIS, NPI 1457994436    During the credentialing process, we found that the following information was missing, incomplete, or expired. Please provide the information noted by 03/09/2022.  Failure to provide the requested information will result in discontinuation from the credentialing process.   Missing Item(s):  **Copy of your current malpractice insurance (showing amounts and dates of coverage)     Due to working remotely, email is the best form of communication currently. Any questions please email credentialing@superiorhealthplan.com.  You may fax or email the requested information to the contact information listed below.     Sincerely,', NULL, NULL, '2022-03-07 10:47:37', '2022-03-07 10:47:37'),
(32142, 19067, 24141, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: angela.heard@superiorhealthplan.com  Subject: Re: FINAL Credentialing Final Request;  WILLIAM FRANCIS, NPI 1457994436   Hi,  Attached is the updated COI. Don\'t hesitate to contact me if you have any questions.  Thanks, Hammad Ahmed.', NULL, NULL, '2022-03-07 10:48:11', '2022-03-07 10:48:11'),
(32143, 19067, 24141, NULL, '2022-03-17 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Status || BAQC || Group & Providers || Ambetter ||    Good afternoon,     Your email was received. An Account Manager will be contacting you to address your request. When contacting Account Management for updates on this issue, you can Reference Case #84362.      If you are in need of immediate assistance, you can call to speak to an Account Manager by phone at 1-800-656-4817 (English 1, Spanish 2), and Option 3  Provider Relations Team.     Thank you,     Melinda Mendoza Account Manager  Provider Relations Department    711 N. Carancahua Street, Suite 600 Corpus Christi, TX  78401  Tolll-Free:  1-800-656-4817 Option 1 then Option 3  Fax:  1-866-683-5630  AM.CorpusChristi@superiorhealthplan.com |SuperiorHealthPlan.com', NULL, NULL, '2022-03-10 10:27:20', '2022-03-10 10:27:20'),
(32144, 19067, 24141, NULL, '2022-04-19 00:00:00.000', 'Approved', 'Email received from: ECMExecutionTeam@superiorhealthplan.com  Subject: CYNTHIA MALOWITZ WELCOME LETTER    CYNTHIA MALOWITZ  BAY AREA QUICK CARE  baqc@claimsmedinc.com     Welcome to the Superior HealthPlan network. We are excited to have you as a partner of our growing network of high quality health care professionals. You play a key role as we pursue our commitment to improve the health and well-being of the members we serve.Your records were reviewed and approved by our credentialing committee. You are now able to provide covered services to Superior members.     Your effective date is: 04/01/2022                                                    C/ 46071', NULL, NULL, '2022-04-12 14:02:29', '2022-04-12 14:02:29'),
(32145, 1006, 24142, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:26', '2021-04-20 10:30:26'),
(32146, 1006, 24142, NULL, '2021-05-20 00:00:00.000', 'Initiated', 'Sent an enrollment request @ trpndataentry@trpnppo.com & providerrelations@trpnppo.com:  Sub: Provider Enrollment Request - BAQC- TRPN  \"Hello,   We want to get the following providers and group enrolled with TRPN, their information is as follows:  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to initiate this request and what the enrollment timeframe is?  Thank you.\"', NULL, NULL, '2021-05-04 10:32:56', '2021-05-04 10:32:56'),
(32147, 9057, 24142, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to trpndataentry@trpnppo.com, providerrelations@trpnppo.com Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Hello, We submitted an enrollment form for the below mentioned providers under the following group.  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Kindly update me with the current status regarding the above mentioned request.  Thank you', NULL, NULL, '2021-05-27 11:06:28', '2021-05-27 11:06:28'),
(32148, 1006, 24142, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Called @ 800-966-8776 and spoke to Brixcia as per her we need to send an email as our group contract is under Cynthia Malowitz and we need to update it.   Email sent @ bcastillo@trpnppo.com & providerrelations@trpnppo.com:  \"Hello,  As per my discussion with Brixcia, we want to update our group contract to add the following individual providers under it, the group and providers information is as follows:   Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to update the contract.   Thank you!\"', NULL, NULL, '2021-06-16 13:59:09', '2021-06-16 13:59:09'),
(32149, 1006, 24142, NULL, '2021-06-29 00:00:00.000', 'In Process', 'We received the following reply from Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Good morning Brad,  I hope this message finds you well. Thank you for taking the time to speak to me today, per our conversation attached you will find the proposal if you have any questions please feel free to contact me directly for assistance. Thank you for your time today have a great Tuesday.  Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Sent following reply:  \"Hello, Max,   Thank you for the update, here\'s the group agreement filled out and signed. Do let me know if anything else is needed.  Thank you\"', NULL, NULL, '2021-06-22 16:16:18', '2021-06-22 16:16:18'),
(32150, 11056, 24142, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : mflores@trpnppo.com  Sub : Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Brad,   I will have the agreement processed and you can expect to receive the countersigned copy in 3 weeks, if you have any questions in the meantime please feel free to contact me directly for assistance.     Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive  Las Vegas, Nevada 89117  Phone: (619) 737-9546  Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com', NULL, NULL, '2021-07-06 15:03:55', '2021-07-06 15:03:55'),
(32151, 1006, 24142, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Hello Max,  I hope you\'re doing well, I wanted to get an update regarding this request. Please get back to me as soon as you\'re able.  Thank you!\"', NULL, NULL, '2021-07-23 16:36:57', '2021-07-23 16:36:57'),
(32152, 1006, 24142, NULL, '2021-08-03 00:00:00.000', 'Approved', 'The group and providers have been approved.   Eff: 06/22/2021  An executed contract is attached for reference. ', NULL, NULL, '2021-07-27 12:28:59', '2021-07-27 12:28:59'),
(32153, 1006, 24143, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:30:28', '2021-04-20 10:30:28'),
(32154, 1006, 24143, NULL, '2021-05-20 00:00:00.000', 'Initiated', 'Submitted enrollment form for Group and Cynthia as main provider via Wellcare portal:  \"Become A Provider  Your form was submitted successfully.  Thank you for contacting us. A representative will be in contact to discuss your interest in becoming a participating Provider.\"  Form attached in group task for reference. ', NULL, NULL, '2021-05-04 10:19:38', '2021-05-04 10:19:38'),
(32155, 1006, 24143, NULL, '2021-06-17 00:00:00.000', 'In Process', 'I had a word with (John) with Wellcare representative and he advises their network development department will contact us.   Ref: 1012719812', NULL, NULL, '2021-06-10 12:21:06', '2021-06-10 12:21:06'),
(32156, 1006, 24143, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: Enrollment Status - BAQC - Wellcare  \"Hello,   I wanted to get an update regarding the enrollment status for our group and providers, we submitted the enrollment application via the website last month. The group and provider information is as follows:  Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me on the updated status of the enrollment.  Thank you!\"', NULL, NULL, '2021-06-29 11:06:37', '2021-06-29 11:06:37'),
(32157, 1006, 24143, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: Enrollment Status - BAQC - Wellcare  \"Hello,   I hope you\'re doing well, please get back to me on the enrollment request for our group and providers.  Thank you!\"', NULL, NULL, '2021-07-23 16:47:53', '2021-07-23 16:47:53'),
(32158, 1006, 24143, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received response:  \"What is the TIN & NPI?  Thank you, Leslie Gilchrist Intake Coordinator Contract Management\"  Replied: \"Hello Melissa,   Sure thing, the information is as follows:  Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Melissa Ramsden NPI# 1194376228  Thank you. \"', NULL, NULL, '2021-07-29 13:00:12', '2021-07-29 13:00:12'),
(32159, 1006, 24143, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello Lucy,   I just wanted to check with you if there had been any new updates, please let me know.   Thank you. \"', NULL, NULL, '2021-08-10 16:22:39', '2021-08-10 16:22:39'),
(32160, 11056, 24143, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. I wanted to get an latest updates regarding the enrollment status of the following providers and practice:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details:  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:36:33', '2021-08-20 10:36:33'),
(32161, 11056, 24143, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com & cynthia.barnett@wellcare.com &  TERESA.Argueta@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. I wanted to get an latest updates regarding the enrollment status of the following providers and practice:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details:  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-30 10:27:49', '2021-08-30 10:27:49'),
(32162, 11056, 24143, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : Cynthia.Barnett@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning Cynthia!  Hope this email finds you well. Please provide me with someone who can respond to my query for Wellcare, because no one hasn\'t responded to me since August. Kindly provide with the representative\'s email or contact no. for this address :Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148.  I will be grateful to you.   Thank you! Have a wonderful Weekend!', NULL, NULL, '2021-09-24 09:20:32', '2021-09-24 09:20:32'),
(32163, 11056, 24143, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope you are doing great. I am still waiting for the representative details in the Corpus Christi area. Please assist me with that soon.  Eagerly, waiting to hear from you soon.  Thank you! Have a blessed day!  Contacted Miss Cynthia. She informed me that she gonna confirm if they provide services in Corpus christi area or  not.', NULL, NULL, '2021-10-11 10:36:51', '2021-10-11 10:36:51'),
(32164, 11056, 24143, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope you are doing great. I am still waiting for the representative details in the Corpus Christi area. Please assist me with that soon.  Eagerly, waiting to hear from you soon.  Thank you! Have a blessed day!  Contacted Miss Cynthia. She informed me that she gonna confirm if they provide services in Corpus christi area or  not.', NULL, NULL, '2021-10-11 10:37:14', '2021-10-11 10:37:14'),
(32165, 11056, 24143, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope you are doing great. I am still waiting for the representative details in the Corpus Christi area. Please assist me with that soon.  Eagerly, waiting to hear from you soon.  Thank you! Have a blessed day!  Contacted Miss Cynthia. She informed me that she gonna confirm if they provide services in Corpus christi area or  not.', NULL, NULL, '2021-10-11 10:37:15', '2021-10-11 10:37:15'),
(32166, 11056, 24143, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email received from : Schlonda.Ramee@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good afternoon,     Ahmed, please excuse my tardiness.  The assigned Account Manager is Jetori Campbell. Jetori can be reached at Jetori.campbell@wellcare.com I have also included her in this email.     Jetori, can you please assist Ahmed?     Thanks,     Schlonda Ramee Jackson, Notary Public  Manager, Provider Network, G&A-Provider Relations     4888 Loop Central Drive, Suite 300  Houston, Texas 77081  Direct Mobile 713-409-6354  schlonda.rameejackson@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-10-18 09:22:33', '2021-10-18 09:22:33'),
(32167, 11056, 24143, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email received from : Jetori.Campbell@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE   Good Morning Ahmed,  Thank you for following up on your request to Join Our Network.  You should have received correspondence from Superior Health Plan/ WellCare in response to your request. Once all information is signed and received from both parties; please anticipate up to 90 days for credentialing to be completed.   Please let me know if you have any questions.  Thank You  Ms. JeTori Campbell Provider Account Manager 4888 Loop Central Drive, Suite 300  Houston, Texas 77081 Direct Mobile 972-795-8691 jetori.campbell@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-10-26 10:18:34', '2021-10-26 10:18:34'),
(32168, 11056, 24143, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email sent to: Jetori.Campbell@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well.  We haven\'t received any correspondence yet from the WellCare side. Please do provide the providers & facility enrollment status with WellCare. Please see below the case and emails from our side.  Please assist with the above at your earliest opportunity.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-04 14:46:31', '2021-11-04 14:46:31'),
(32169, 11056, 24143, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email received from: Jetori.Campbell@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELCARE  Good Morning,  Ahmed, I am the account manager once the groups and providers have been loaded the contracting department is responsible for loads and updates on loads. They can be reached at ProspectiveProviderTX@wellcare.com.   Ms. JeTori Campbell Provider Account Manager 4888 Loop Central Drive, Suite 300  Houston, Texas 77081 Direct Mobile 972-795-8691 jetori.campbell@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-11-18 16:56:47', '2021-11-18 16:56:47'),
(32170, 11056, 24143, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com  Sub:   Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. Is Wellcare comes Under Medicare or Medicaid? And if both tell me with plans which come under Medicare only and enrolling process to enroll in them only.  Eagerly waiting for your response.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-01 12:11:32', '2021-12-01 12:11:32'),
(32171, 11056, 24143, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com   Sub:  Enrollment Status Updates - BAQC - WELCARE    Good Morning,  WellCare is a Medicare Advantage plan only at this time.     Thank you', NULL, NULL, '2021-12-08 13:41:21', '2021-12-08 13:41:21'),
(32172, 11056, 24143, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com   Sub:  Enrollment Status Updates - BAQC - WELLCARE   Good afternoon!  Hope this email finds you well.  What do you mean by only at this time? Is it going to be changed in the future? If Yes, what are we going to do then?  Please elaborate on this and provide a detailed explanation about it.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 18:00:51', '2021-12-16 18:00:51'),
(32173, 11056, 24143, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from: ProspectiveProviderTX@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELLCARE   Dear Provider,   Superior Healthplan received the credentialing documents on 10/13/2021 for all the providers listed below. At this time they are all currently in credentialing which can take up to 90 days.  Sincerely,     Network Management– Texas | www.wellcare.com | www.superiorhealthplan.com', NULL, NULL, '2021-12-22 17:16:04', '2021-12-22 17:16:04'),
(32174, 19067, 24143, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Wellcare.   Group Name	Bay Area Quick Care Tax ID	27-1702009 Group NPI	1437481421 Provider Name	NPI	Location Kynda Orsak	1528553724	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148 Cynthia Malowitz	1336173244	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 14:23:43', '2021-12-30 14:23:43'),
(32175, 19067, 24143, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare |   Good Morning,    Happy New Year.     Both providers are still processing and are currently with the cred dept. Please keep in mind that it can take up to 90 days from the date Superior received the completed cred docs. Once they are credentialed by Superior then WellCare will get the files to load.     William Francis- NPI# 1457994436  cred docs were received on 10/13/2021     Kynda Orsak- NPI# 1528553724  cred docs were received on 10/13/2021', NULL, NULL, '2022-01-09 20:20:03', '2022-01-09 20:20:03'),
(32176, 19067, 24143, NULL, '2022-01-21 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope this email finds you well.  Any updates on this?  Thanks, Hammad Ahmed.', NULL, NULL, '2022-01-14 10:41:40', '2022-01-14 10:41:40'),
(32177, 19067, 24143, NULL, '2022-01-28 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||    Greetings!  Any updates on the request mentioned below?   Kindly respond promptly.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-20 20:09:51', '2022-01-20 20:09:51'),
(32178, 1019, 24143, NULL, '2022-02-09 00:00:00.000', 'In Process', 'Received the following email from ProspectiveProviderTX@wellcare.com  Both providers are still processing and are currently with the cred dept. Please keep in mind that it can take up to 90 days from the date Superior received the completed cred docs.     William Francis- NPI# 1457994436  C58035- credentialing, cred docs were received on 10/13/2021     Kynda Orsak- NPI# 1528553724  C58036- credentialing, cred docs were received on 10/13/2021    Sincerely,     Network Management– Texas | www.wellcare.com | www.superiorhealthplan.com  1634667499561', NULL, NULL, '2022-02-02 12:16:13', '2022-02-02 12:16:13'),
(32179, 19067, 24143, NULL, '2022-02-22 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope you are doing well. Kindly provide the enrollment status of the following providers with Wellcare.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary & Billing Location	9929 South Padre Island Drive Suite 10, Corpus Christi, TX 78418 Provider	NPI Cynthia Malowitz	1336173244 Kynda Orsak	1528553724  Regards, Hammad Ahmed.', NULL, NULL, '2022-02-15 11:34:37', '2022-02-15 11:34:37'),
(32180, 19067, 24143, NULL, '2022-03-16 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Good Morning!  Any updates on the request below? Have the providers been credentialed?  Thanks, Hammad Ahmed.', NULL, NULL, '2022-03-09 11:22:33', '2022-03-09 11:22:33'),
(32181, 22077, 24143, NULL, '2022-04-29 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||  Hi,  Any updates on the previously mentioned request?  I am looking forward to your kind response.  Thanks & Regards.', NULL, NULL, '2022-04-22 08:05:18', '2022-04-22 08:05:18'),
(32182, 1006, 24144, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:32:46', '2021-04-20 10:32:46'),
(32183, 9057, 24144, NULL, '2021-06-08 00:00:00.000', 'Not Eligible', 'We sent an email to: registrar@multiplan.com Sub: Request for Enrollment Status - BAQC - Multiplan  Hello, I want to get the current status of the below mentioned group & providers  Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda  NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Kindly respond to us as soon as possible.  Thank you ', NULL, NULL, '2021-05-31 17:02:41', '2021-05-31 17:02:41'),
(32184, 1006, 24145, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:32:48', '2021-04-20 10:32:48'),
(32185, 9057, 24145, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We Sent an email to: CSHNproviderrelations@christushealth.org Sub: Requisition of Enrollment - BAQC - Christus Spohn Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 09:56:59', '2021-06-01 09:56:59'),
(32186, 1006, 24145, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hello,   I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009  Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-17 10:47:06', '2021-06-17 10:47:06'),
(32187, 11056, 24145, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to :   CSHNproviderrelations@christushealth.org  Sub : Enrollment Status - BAQC - Christus Spohn  Greetings,  Hope you are doing well. I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Practice: Practice Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Providers: Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible. Kindly Respond.  Thank you!', NULL, NULL, '2021-07-06 15:45:46', '2021-07-06 15:45:46'),
(32188, 1006, 24145, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"Guerra, Vicki A.\" vicki.guerra@christushealth.org ', NULL, NULL, '2021-07-27 16:33:34', '2021-07-27 16:33:34'),
(32189, 1006, 24145, NULL, '2021-08-12 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  Happy Thursday!  Does this provider group have hospital affiliations with a Christus facility? Or, is there a physician this group utilizes who does have hospital affiliations?  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Replied with:  \"Hello Vicki,   The group and provider do have a supervising physician David Gray (NPI# 1902814874) who has hospital affiliations. Please let me know if this works for you?  Thank you. \"', NULL, NULL, '2021-08-05 12:38:47', '2021-08-05 12:38:47'),
(32190, 1006, 24145, NULL, '2021-08-25 00:00:00.000', 'Not Eligible', 'We received the following denial notification from vicki.guerra@christushealth.org:  Sub: Gray MD Affiliations Expired: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  I reviewed Dr. Grays affiliations and they have expired with the hospital. Please see the attached. Dr. Gray will need to be credentialed again with the hospital in order for the group to be extended a contract. He may have missed his reappointment. Please see attached documentation.  Is this possible for Dr. Gray or yourself to reach out to medical staff administration and inquire?  Medical Staff Administration Tel: (361) 881-3151 Fax: (361) 881-3714  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"', NULL, NULL, '2021-08-18 10:57:10', '2021-08-18 10:57:10'),
(32191, 1006, 24148, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:32:52', '2021-04-20 10:32:52'),
(32192, 1006, 24148, NULL, '2021-04-27 00:00:00.000', 'Initiated', 'Sent following email to PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,  I hope you\'re doing well, I wanted to verify the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If the above-mentioned providers are enrolled please send over their welcome letters and if they require enrollment please let me know what the process is.   Thank you.\"', NULL, NULL, '2021-04-20 13:05:54', '2021-04-20 13:05:54'),
(32193, 1006, 24148, NULL, '2021-05-05 00:00:00.000', 'In Process', 'Sent a f/u email @ PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,   I hope you\'re doing well, I wanted to follow-up on this request again, Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-28 12:44:12', '2021-04-28 12:44:12'),
(32194, 3040, 24148, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: DillikarA@aetna.com  Subject:  Status: [EXTERNAL] Enrollment Request/Status - Bay Area Quick Care - First Health Case# 12591444   Hi,  Provider (Cynthia Malowitz) is active under Tax ID: 271702009 With effective 11/01/2012 in First Health Networks.  And rest providers are not linked with First Health if they needs to be enrolled please send their complete provider details to pdsdallas@aetna.com from there your request will be taken care by a particular user.  Thanks, Akhilesh Dillikar', NULL, NULL, '2021-06-10 10:42:37', '2021-06-10 10:42:37'),
(32195, 1006, 24148, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent requested information @ Bharath, Bollu BharathB@aetna.com, TalasilaB@aetna.com, DillikarA@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   Please find the attached information:   Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  Please let me know what else is required to proceed with this request.  Thank you!\"', NULL, NULL, '2021-06-29 10:44:54', '2021-06-29 10:44:54'),
(32196, 1006, 24148, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ Bharath, Bollu BharathB@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following providers: Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-07-23 15:39:29', '2021-07-23 15:39:29'),
(32197, 1006, 24148, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ BharathB@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Thank you.\"', NULL, NULL, '2021-08-10 16:02:06', '2021-08-10 16:02:06'),
(32198, 11056, 24148, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : BharathB@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  If you have any questions  or concerns please let me know. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-20 13:24:39', '2021-08-20 13:24:39'),
(32199, 11056, 24148, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : PDSDallas@aetna.com & Machado-PetryS@aetna.com  &  	BharathB@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We\'re still waiting on an update regarding the status of this enrollment, please get back to me as soon as possible as this request has been pending for a few months now.  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details: Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  If you have any questions or concerns please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-30 09:27:56', '2021-08-30 09:27:56'),
(32200, 11056, 24148, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com & DillikarA@aetna.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope you are doing well. We are still waiting to get the latest updates regarding the enrollment status in First Health of the below mentioned providers and practice as soon as possible. Please respond to my query soon.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228   If you have any questions or concerns please let me know. Eagerly,waiting to get the response from you.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-24 09:30:28', '2021-09-24 09:30:28'),
(32201, 11056, 24148, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : sidleyj1@firsthealth.com>  Sub : Signature requested on \"TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210\"  Hello,  As a follow-up to my email, attached is the document for your review and signature.  After you sign TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210, the agreement will be sent to Jeanette Sidley. Then, all parties will receive a final PDF copy by email.  Thank you.  Jeanette Sidley JEANETTE SIDLEY sidleyj1@firsthealth.com  Signed by our side. Please see the attachment.   You finished signing “TX_Grp_Agmt_Bay Area Quick Care PLLC_MRT210”.  Next, Jeanette Sidley will sign.', NULL, NULL, '2021-10-01 10:06:45', '2021-10-01 10:06:45'),
(32202, 11056, 24148, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good afternoon Jeanette!  Hope you are doing great. Yes, the practice is interested in a group agreement. You may send the agreement to baqc@claimsmedinc.com and sta@claimsmedinc.com for review. Please find the roster in attachments.  I am grateful to you. Bundle of thanks for your prompt responses and assistance.  Take care! Have a wonderful & blessed week ahead!', NULL, NULL, '2021-10-11 10:12:38', '2021-10-11 10:12:38'),
(32203, 11056, 24148, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email received from: SidleyJ1@firsthealth.com  Sub: Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Hello Ahmed,  I hope that this email finds you well! I apologize that I have not been able to respond sooner, my son has been ill so I have been in and out of the office.   I will send the agreement over shortly for review. Thank you for providing the roster.  As always, please do not hesitate to reach out if you have any questions or concerns when reviewing.  Take care of yourself!  Jeanette', NULL, NULL, '2021-10-18 10:14:11', '2021-10-18 10:14:11'),
(32204, 11056, 24148, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email sent to :  SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning Jeanette!  Hope this email finds you well. There is no need for an apology. How is he now? Hope he finds strength with each new day.  Please don\'t hesitate if you have any queries or concerns. Send the agreement whenever it is convenient for you.  Take care of your son & yourself too!  Thank you! Have a blessed & great week ahead!', NULL, NULL, '2021-10-26 10:31:51', '2021-10-26 10:31:51'),
(32205, 11056, 24148, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning Ahmed,     I hope that this email finds you well! Thank you for the well wishes, we are hoping he starts to feel better soon.     I sent the agreement over for review yesterday. Please let me know if you did not receive it, I can resend the link.     Have a wonderful Friday!     Take care,', NULL, NULL, '2021-11-04 14:30:58', '2021-11-04 14:30:58'),
(32206, 11056, 24148, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email sent to: SidleyJ1@firsthealth.com  Sub: Fwd: FW: Bay Area Quick Care - First Health Case# 13578624   Good morning Jeanette!  Hope this email finds you well. He will feel better soon. He is in my prayers.  Yes, we have received that & after reviewing signed that too.  Thank you! Have a wonderful & blessed weekend ahead!', NULL, NULL, '2021-11-18 17:03:07', '2021-11-18 17:03:07'),
(32207, 11056, 24148, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email sent to:  SidleyJ1@firsthealth.com  Sub :  Fwd: FW: Bay Area Quick Care - First Health Case# 13578624  Good morning!  Hope this email finds you well. Are there any updates regarding the providers\' enrollment process? How is your son now?  Thank you! Have a blessed day!', NULL, NULL, '2021-12-01 12:20:03', '2021-12-01 12:20:03'),
(32208, 11056, 24148, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email received from:  SidleyJ1@firsthealth.com  Sub: Fwd: FW: Bay Area Quick Care - First Health Case# 13578624   Good morning Ahmed,   I hope that this email finds you well! My son is finally doing much better, thank you so much for asking!   The agreement for this practice is effective 11/1/21. It is still in the implementation stage with our Data Team. Once I have the new group ID number I will be sending over the welcome letter.   In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take care!', NULL, NULL, '2021-12-08 13:51:37', '2021-12-08 13:51:37');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(32209, 11056, 24148, NULL, '2021-12-29 00:00:00.000', 'Approved', 'Email received from: SidleyJ1@firsthealth.com  Sub: Bay Area Quick Care PLLC - First Health Network   Hello,  It is with great pleasure to welcome you to the First Health Network. I would like to personally thank you for all of your time and efforts during the contracting process. You should have already received your fully executed copy of the First Health Agreement.  You may reference your CPD ID # 1074082 (which became effective 11/01/2021)   Please see the attachment.', NULL, NULL, '2021-12-22 15:15:18', '2021-12-22 15:15:18'),
(32210, 1006, 24152, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:32:58', '2021-04-20 10:32:58'),
(32211, 9057, 24152, NULL, '2021-06-05 00:00:00.000', 'Initiated', 'Form for the enrollment of group has been submitted  Waiting for the Response', NULL, NULL, '2021-05-28 14:45:46', '2021-05-28 14:45:46'),
(32212, 1006, 24152, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ SWHP REGION 4 SWHPRegion4@BSWhealth.org:  Sub: Enrollment Status - BAQC - Scott & White   \"Hello,   I wanted to get an update regarding the enrollment status for the following group and providers as we submitted an enrollment request back in May, their information is as follows:  Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: Francis William NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-16 13:39:55', '2021-06-16 13:39:55'),
(32213, 1006, 24152, NULL, '2021-06-29 00:00:00.000', 'Not Eligible', 'Received the following denial notification from SWHP PROVIDER NETWORK DEVELOPMENT SWHPPROVIDERNETWORKDEVELOPMENT@bswhealth.org:  Sub: New Contract Request  \"Tax ID#: 27-1702009  RE: Network Denial Letter  Dear Bay Area Quick Care PLLC  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 5/28/2021, SWHP and FirstCare regretfully declines to contract with Bay Area Quick Care PLLCat this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.  For commercial providers, we welcome you to review 28 TAC 3.3706 for more detail on denial review.  Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-22 16:37:42', '2021-06-22 16:37:42'),
(32214, 1006, 24153, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:33:00', '2021-04-20 10:33:00'),
(32215, 1006, 24153, NULL, '2021-05-17 00:00:00.000', 'Initiated', 'We received the following email from Superior Healthplan @ SHP Network Development NPR Contracting SHPNetwork.DevelopmentNPRContracting@superiorhealthplan.com:  Sub: Important request from Superior HealthPlan  \"Hello Provider,  We received a request for TIN 27-1702009 to receive a new contract from Superior Health Plan.   In order to process your request:  Ø  Can you provide me the name of the group/ facility or if (provider) practices alone? Ø  Please respond with a copy of your W9. Ø  Does the provider want to participate with all of our products (Medicaid, Chip, Medicare, and Ambetter)? Ø  Please provide a good call back number.  Without a response, we are unable to move forward.   Jeannie Lopez Superior Health Plan | Network Operations\"  Replied to them with requested information. ', NULL, NULL, '2021-05-10 12:17:16', '2021-05-10 12:17:16'),
(32216, 1006, 24153, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: SHPNetwork.DevelopmentNPRContracting@superiorhealthplan.com  Subject: Important request from Superior HealthPlan Hello,   Please find the requested information below:  Group Name: Bay Area Quick Care PLLC Yes, we wish to participate in all products. Call back# 713-893-6214 W9 is attached for your reference, please let me know if anything else is required and what the expected timeframe is for this to be completed?  Thank you. ', NULL, NULL, '2021-06-10 12:32:47', '2021-06-10 12:32:47'),
(32217, 1006, 24153, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ SHP Network Development NPR Contracting SHPNetwork.DevelopmentNPRContracting@superiorhealthplan.com:  Sub: Enrollment Status - BAQC - Superior Health  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: Francis William NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me as soon as possible. Thank you.\"', NULL, NULL, '2021-06-11 11:48:10', '2021-06-11 11:48:10'),
(32218, 1006, 24153, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Left voicemail @ (877) 687-1196 asking for enrollment updates as we\'re not getting any updates through the email.  ', NULL, NULL, '2021-06-15 12:03:46', '2021-06-15 12:03:46'),
(32219, 1006, 24153, NULL, '2021-06-23 00:00:00.000', 'In Process', 'We received the following reply from Credentialing Credentialing@superiorhealthplan.com:  Sub: 1437481421  \"Good Morning,  We received a voice message from you and I am happy to assist you. I understand that you would like to check the status for NPI: 1437481421.  I do not currently show information for this provider. The process to inquire about a new contract/adding provider or service to your existing contract begins by completing a Network Participation Inquiry through our website.   http://www.superiorhealthplan.com/for-providers/join-our-network/  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\"  Submitted ancillary enrollment request, attached in main group task for reference. ', NULL, NULL, '2021-06-16 16:38:59', '2021-06-16 16:38:59'),
(32220, 1006, 24153, NULL, '2021-07-09 00:00:00.000', 'In Process', 'We rcvd the following reply from SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"We received your signed contract. However, we have not received your Credentialing Application packet. Attached is the email that was sent. Please complete the forms & return along with a copy of your current W9 so that we can start the process.  Thank you, Leslie Gilchrist Intake Coordinator Contract Management\"  Replied with:  \"Hello Leslie,  Please find the requested documents attached, do let me know if anything else is required.  Thank you. \"  The ancillary contracting request is attached in the main group task for reference. ', NULL, NULL, '2021-07-02 10:59:41', '2021-07-02 10:59:41'),
(32221, 1006, 24153, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ SHP-Network Development SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello,   I wanted to get an update regarding the enrollment status for our provider. Please get back to me as soon as possible.  Thank you.\" ', NULL, NULL, '2021-07-23 16:33:20', '2021-07-23 16:33:20'),
(32222, 1006, 24153, NULL, '2021-08-17 00:00:00.000', 'In Process', 'We received the following update from SHP-NETWORKDEVELOPMENT@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello,  We received your completed application on July 2, 2021 Your projected effective date is August 1, 2021. Currently, it is in the process of being loaded in our system. Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Sincerely,  Lucy Escobar Lead Contracts Coordinatoor, Contract Management\"  Need to allow more time for it to process and complete. ', NULL, NULL, '2021-08-10 12:57:37', '2021-08-10 12:57:37'),
(32223, 11056, 24153, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Hello,   I appreciate the update, I just wanted to confirm what the status for the ancillary contract is as well?  Thank you. ', NULL, NULL, '2021-08-20 10:21:30', '2021-08-20 10:21:30'),
(32224, 11056, 24153, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Good morning!  Hope this email finds you well. Whenever the application is uploaded and the provider\'s enrollment is completed, please inform us. Please keep us updated with the process. Please let us know the latest status for the ancillary contract too.  If you need any document or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-30 10:20:28', '2021-08-30 10:20:28'),
(32225, 11056, 24153, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Good morning!  Hope you are doing well. We are still waiting to get the latest updates regarding the enrollment status of the below mentioned providers and practice as soon as possible. We haven\'t received the welcome packet yet.   Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148  Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	  1336173244 Melissa Ramsden	1194376228    If you have any questions or concerns please let me know. Eagerly,waiting to get the response from you.  Thank you! Have a great weekend!', NULL, NULL, '2021-09-24 09:12:30', '2021-09-24 09:12:30'),
(32226, 11056, 24153, NULL, '2021-10-05 00:00:00.000', 'In Process', 'Email received from : Jeannie.Lopez@superiorhealthplan.com  Sub : Superior HealthPlan Participating Provider Agreement - BAY AREA QUICK CARE (534990) has been Signed and Filed    Attached is the final agreement for your reference. You can also open it online to review its activity history.', NULL, NULL, '2021-09-28 13:31:59', '2021-09-28 13:31:59'),
(32227, 11056, 24153, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email received from : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Hello  We received your completed application for Melissa Ramsden on 7/2/21. Your effective date is 8/1/21  and will be receiving a welcome packet shortly. ', NULL, NULL, '2021-10-11 09:53:15', '2021-10-11 09:53:15'),
(32228, 11056, 24153, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Please assist me with the query at your earliest convenience. Does the Superior Health plan come under Medicare or Medicaid?', NULL, NULL, '2021-10-18 09:05:30', '2021-10-18 09:05:30'),
(32229, 11056, 24153, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email received from: SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Good morning!  Hope all is well. Please find the attached forms for the remaining providers mentioned below. If further information or documents are needed please let me know.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary Location	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148 Provider Name	NPI William Francis	1457994436 Kynda Orsak	1528553724 Cynthia Malowitz	1336173244   In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a great day!', NULL, NULL, '2021-10-26 09:59:05', '2021-10-26 09:59:05'),
(32230, 11056, 24153, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email received from :SHP-NETWORKDEVELOPMENT@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN  Hello     Thank you for your email. However, your Account Manager can best assist you with your questions.        Find my Account Manager:  https://www.superiorhealthplan.com/providers/resources/find-my-provider-rep.html', NULL, NULL, '2021-11-04 14:40:54', '2021-11-04 14:40:54'),
(32231, 11056, 24153, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Sub : RE: MELISSA RAMSDEN   Good morning!  Hope all is well with you. Please respond to my query at your earliest convenience.  Also, provide us with the contact no. and the Account Manager\'s email for our further assistance.  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-18 16:52:55', '2021-11-18 16:52:55'),
(32232, 11056, 24153, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email received from:  AM.Houston@superiorhealthplan.com  Sub:  [secure]RE: MELISSA RAMSDEN  Hi, All of the requested information for Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 been received and they are still in the credentialing phase. Please reference ticket # 69145 if you have any questions.   Sincerely,  Barbara McDonald  Account Manager, Provider Relations Region 7 (Harris & Jefferson)      ', NULL, NULL, '2021-12-01 12:05:03', '2021-12-01 12:05:03'),
(32233, 11056, 24153, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email received from:  AM.Houston@superiorhealthplan.com  Sub:  [secure]RE: MELISSA RAMSDEN  Hi, All of the requested information for Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 been received and they are still in the credentialing phase. Please reference ticket # 69145 if you have any questions.   Sincerely,  Barbara McDonald  Account Manager, Provider Relations Region 7 (Harris & Jefferson)      ', NULL, NULL, '2021-12-01 12:05:07', '2021-12-01 12:05:07'),
(32234, 11056, 24153, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email received from:  AM.Houston@superiorhealthplan.com  Sub:  [secure]Credentialing Updates   Hi, Both providers Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 are still being credentialed. It can take anywhere from 3 to 6 months to complete the process. The applications were received on 10/13/2021 and are still within the 3 month time frame. Please reference ticket #70273 if you have any questions.   Sincerely,       Barbara McDonald Account Manager, Provider Relations Region 7 (Harris & Jefferson)   711 N. Carancahua Street, Ste. 600 Corpus Christi, TX 78401 Direct Line: 1 (800)656-4817 Press 1 for English or 2 for Spanish, then option #3 for Provider Relations Fax: 1-866-683-5630 AM.houston@superiorhealthplan.com | SuperiorHealthPlan.com', NULL, NULL, '2021-12-08 14:23:15', '2021-12-08 14:23:15'),
(32235, 11056, 24153, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: AM.Houston@superiorhealthplan.com  Sub: Case 70277 RE: MELISSA RAMSDEN   & RE: MELISSA RAMSDEN  [secure]Credentialing Updates   Good morning!  Hope all is well with you. Kindly, update us regarding reference ticket # 69145, and with a credentialing phase of the providers, Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Thank you! Have a great day!', NULL, NULL, '2021-12-16 17:55:56', '2021-12-16 17:55:56'),
(32236, 11056, 24153, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Sub: [secure] RE: [secure]Credentialing Updates   Hello Talha,     I hope this email finds you well. I reviewed both providers and am reflecting them to be in the credentialing process. Please take note credentialing review can take up to 90 days for completion.     Cynthia Malowitz- 1336173244 shows to be under review for 64 days  Kynda Orsak – 1528553724 shows to be under review for 64 days     Thank you,     Patricia Torres  Provider Account Manager II 711 N Carancahua Street, Ste. 600 Corpus Christi, Tx 78401  Toll-Free: 1-800-656-4817 Option 1, then Option 3 Fax: 1-866-683-5630 AM.CorpusChristi@superiorhealthplan.com| SuperiorHealthplan.com   ', NULL, NULL, '2021-12-22 17:12:57', '2021-12-22 17:12:57'),
(32237, 19067, 24153, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Kynda & Cynthia || Superior Health ||    Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers with Superior Health.  Group Name	Bay Area Quick Care Tax ID	27-1702009 Group NPI	1437481421 Provider Name	NPI	Location Kynda Orsak	1528553724	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148 Cynthia Malowitz	1336173244	9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 14:28:18', '2021-12-30 14:28:18'),
(32238, 19067, 24153, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Group || Superior Health ||    Hi,  Providers Kynda Orsak NPI: 1528553724 & Cynthia Malowitz NPI: 1336173244 for Bay Area Quick Care PLLC, TIN 271702009 are in credentialing.  Please keep in mind process may take 180 days.      Thank you,     Yvette Hernandez Account Manager  Provider Relations Department', NULL, NULL, '2022-01-06 09:20:48', '2022-01-06 09:20:48'),
(32239, 19067, 24153, NULL, '2022-01-20 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Subject: Re: Enrollment Query || BAQC || Group || Superior Health ||    Greetings!  Any updates on this?  Don\'t hesitate to reach out if you need anything.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-13 11:29:15', '2022-01-13 11:29:15'),
(32240, 19067, 24153, NULL, '2022-01-28 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Enrollment Query || BAQC || Group || Superior Health ||     Good Morning Hammad,  Both provider are still pending credentialing.     Providers Kynda Orsak NPI: 152855372  Cynthia Malowitz NPI: 1336173244  Bay Area Quick Care PLLC, TIN 271702009     Timothy Do  Provider Account Manager II  Region 7 (Harris & Jefferson)    ', NULL, NULL, '2022-01-20 18:56:17', '2022-01-20 18:56:17'),
(32241, 19067, 24153, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email sent to: AM.CorpusChristi@superiorhealthplan.com  Subject: Re: Enrollment Query || BAQC || Group || Superior Health ||   Greetings!  Hope this email finds you well.  Any updates on the previously mentioned request?  Kindly respond as per your convenience.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-08 11:19:07', '2022-02-08 11:19:07'),
(32242, 19067, 24153, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: RE: Enrollment Query || BAQC || Group || Superior Health || - REF # 79267    Good afternoon,     Please see credentialing status for each provider below under, Bay Area Quick Care PLLC, TIN 271702009  Kynda Orsak NPI: 152855372   - Credentialing Status, Application received on 10/18/2021.  Cynthia Malowitz NPI: 1336173244 - Credentialing Status, Application received on 10/18/2021.     Credentialing process can take between 60 -120 days. Please allow more time for application to process.     Thank you,     Yesenia Prado  Provider Account Manager  Nueces, Harris & Jefferson SDAs', NULL, NULL, '2022-02-08 14:28:22', '2022-02-08 14:28:22'),
(32243, 19067, 24153, NULL, '2022-02-22 00:00:00.000', 'In Process', 'Email received from: AM.CorpusChristi@superiorhealthplan.com  Subject: Re: Enrollment Query || BAQC || Group || Superior Health ||    - REF # 79267   Hi,  Hope this email finds you well.  Any updates on the request and don\'t hesitate to reach out if you need any document or information.   Regards, Hammad Ahmed', NULL, NULL, '2022-02-15 11:05:44', '2022-02-15 11:05:44'),
(32244, 19067, 24153, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email received from: Angela.Heard@superiorhealthplan.com  Subject: FINAL Credentialing Final Request; WILLIAM FRANCIS, NPI 1457994436    During the credentialing process, we found that the following information was missing, incomplete, or expired. Please provide the information noted by 03/09/2022.  Failure to provide the requested information will result in discontinuation from the credentialing process.   Missing Item(s):  **Copy of your current malpractice insurance (showing amounts and dates of coverage)     Due to working remotely, email is the best form of communication currently. Any questions please email credentialing@superiorhealthplan.com.  You may fax or email the requested information to the contact information listed below.     Sincerely,', NULL, NULL, '2022-03-07 10:47:32', '2022-03-07 10:47:32'),
(32245, 19067, 24153, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: angela.heard@superiorhealthplan.com  Subject: Re: FINAL Credentialing Final Request;  WILLIAM FRANCIS, NPI 1457994436   Hi,  Attached is the updated COI. Don\'t hesitate to contact me if you have any questions.  Thanks, Hammad Ahmed.', NULL, NULL, '2022-03-07 10:48:07', '2022-03-07 10:48:07'),
(32246, 19067, 24153, NULL, '2022-04-19 00:00:00.000', 'Approved', 'Email received from: ECMExecutionTeam@superiorhealthplan.com  Subject: KYNDA ORSAK WELCOME LETTER    KYNDA ORSAK  BAY AREA QUICK CARE  baqc@claimsmedinc.com        Welcome to the Superior HealthPlan network. We are excited to have you as a partner of our growing network of high quality health care professionals. You play a key role as we pursue our commitment to improve the health and well-being of the members we serve.Your records were reviewed and approved by our credentialing committee. You are now able to provide covered services to Superior members.     Your effective date is:    03/01/2022                                                 C/ 58036   ', NULL, NULL, '2022-04-12 13:57:39', '2022-04-12 13:57:39'),
(32247, 1006, 24154, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:33:01', '2021-04-20 10:33:01'),
(32248, 1006, 24154, NULL, '2021-05-20 00:00:00.000', 'Initiated', 'Sent an enrollment request @ trpndataentry@trpnppo.com & providerrelations@trpnppo.com:  Sub: Provider Enrollment Request - BAQC- TRPN  \"Hello,   We want to get the following providers and group enrolled with TRPN, their information is as follows:  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to initiate this request and what the enrollment timeframe is?  Thank you.\"', NULL, NULL, '2021-05-04 10:32:52', '2021-05-04 10:32:52'),
(32249, 9057, 24154, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to trpndataentry@trpnppo.com, providerrelations@trpnppo.com Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Hello, We submitted an enrollment form for the below mentioned providers under the following group.  Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Kindly update me with the current status regarding the above mentioned request.  Thank you', NULL, NULL, '2021-05-27 11:05:49', '2021-05-27 11:05:49'),
(32250, 1006, 24154, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Called @ 800-966-8776 and spoke to Brixcia as per her we need to send an email as our group contract is under Cynthia Malowitz and we need to update it.   Email sent @ bcastillo@trpnppo.com & providerrelations@trpnppo.com:  \"Hello,  As per my discussion with Brixcia, we want to update our group contract to add the following individual providers under it, the group and providers information is as follows:   Group Name: Bay Area Quick Care PLLC TIN# 27-1702009 NPI# 1437481421 Group Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider 1 Provider Name: Cynthia Malowitz NPI# 1336173244  Provider 2 Provider Name: Kynda Orsak NPI# 1528553724  Provider 3 Provider Name: William Francis NPI# 1457994436  Provider 4 Provider Name: Melissa Ramsden NPI# 1194376228  Please let me know what is required to update the contract.   Thank you!\"', NULL, NULL, '2021-06-16 13:59:14', '2021-06-16 13:59:14'),
(32251, 1006, 24154, NULL, '2021-06-29 00:00:00.000', 'In Process', 'We received the following reply from Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Good morning Brad,  I hope this message finds you well. Thank you for taking the time to speak to me today, per our conversation attached you will find the proposal if you have any questions please feel free to contact me directly for assistance. Thank you for your time today have a great Tuesday.  Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive Las Vegas, Nevada 89117 Phone: (619) 737-9546 Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com\"  Sent following reply:  \"Hello, Max,   Thank you for the update, here\'s the group agreement filled out and signed. Do let me know if anything else is needed.  Thank you\"', NULL, NULL, '2021-06-22 16:16:24', '2021-06-22 16:16:24'),
(32252, 11056, 24154, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email received from : mflores@trpnppo.com  Sub : Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  Brad,   I will have the agreement processed and you can expect to receive the countersigned copy in 3 weeks, if you have any questions in the meantime please feel free to contact me directly for assistance.     Kind regards,  Max Flores Contracting Manager 6970 O’Bannon Drive  Las Vegas, Nevada 89117  Phone: (619) 737-9546  Fax: (619) 271-6316 mflores@trpnppo.com www.trpnppo.com', NULL, NULL, '2021-07-06 15:04:02', '2021-07-06 15:04:02'),
(32253, 1006, 24154, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ Max Flores mflores@trpnppo.com:  Sub: Request for enrollment status - BAQC - Three Rivers Provider Network - TRPN  \"Hello Max,  I hope you\'re doing well, I wanted to get an update regarding this request. Please get back to me as soon as you\'re able.  Thank you!\"', NULL, NULL, '2021-07-23 16:36:52', '2021-07-23 16:36:52'),
(32254, 1006, 24154, NULL, '2021-08-03 00:00:00.000', 'Approved', 'The group and providers have been approved.   Eff: 06/22/2021  An executed contract is attached for reference. ', NULL, NULL, '2021-07-27 12:28:54', '2021-07-27 12:28:54'),
(32255, 1006, 24155, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:33:03', '2021-04-20 10:33:03'),
(32256, 1006, 24155, NULL, '2021-05-20 00:00:00.000', 'Initiated', 'Submitted enrollment form for Group and Cynthia as main provider via Wellcare portal:  \"Become A Provider  Your form was submitted successfully.  Thank you for contacting us. A representative will be in contact to discuss your interest in becoming a participating Provider.\"  Form attached in group task for reference. ', NULL, NULL, '2021-05-04 10:19:42', '2021-05-04 10:19:42'),
(32257, 1006, 24155, NULL, '2021-06-17 00:00:00.000', 'In Process', 'I had a word with (John) with Wellcare representative and he advises their network development department will contact us.   Ref: 1012719812', NULL, NULL, '2021-06-10 12:21:00', '2021-06-10 12:21:00'),
(32258, 1006, 24155, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: Enrollment Status - BAQC - Wellcare  \"Hello,   I wanted to get an update regarding the enrollment status for our group and providers, we submitted the enrollment application via the website last month. The group and provider information is as follows:  Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009 Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  Please get back to me on the updated status of the enrollment.  Thank you!\"', NULL, NULL, '2021-06-29 11:06:34', '2021-06-29 11:06:34'),
(32259, 1006, 24155, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Sent f/u email @ \".ProspectiveProviderTX\" ProspectiveProviderTX@wellcare.com:  Sub: Enrollment Status - BAQC - Wellcare  \"Hello,   I hope you\'re doing well, please get back to me on the enrollment request for our group and providers.  Thank you!\"', NULL, NULL, '2021-07-23 16:47:50', '2021-07-23 16:47:50'),
(32260, 1006, 24155, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received response:  \"What is the TIN & NPI?  Thank you, Leslie Gilchrist Intake Coordinator Contract Management\"  Replied: \"Hello Melissa,   Sure thing, the information is as follows:  Group Name: Bay Area Quick Care PLLC NPI# 1437481421 TIN# 27-1702009  Provider Name: Melissa Ramsden NPI# 1194376228  Thank you. \"', NULL, NULL, '2021-07-29 13:00:08', '2021-07-29 13:00:08'),
(32261, 1006, 24155, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: MELISSA RAMSDEN  \"Hello Lucy,   I just wanted to check with you if there had been any new updates, please let me know.   Thank you. \"', NULL, NULL, '2021-08-10 16:22:43', '2021-08-10 16:22:43'),
(32262, 11056, 24155, NULL, '2021-08-27 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. I wanted to get an latest updates regarding the enrollment status of the following providers and practice:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details:  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-20 10:36:25', '2021-08-20 10:36:25'),
(32263, 11056, 24155, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com & cynthia.barnett@wellcare.com &  TERESA.Argueta@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. I wanted to get an latest updates regarding the enrollment status of the following providers and practice:  Practice Details: Practice Name: Bay Area Quick Care LLC Practice NPI# 1437481421 Practice TIN# 27-1702009 Practice Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Details:  Provider name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If you have any questions or need documents please let me know. Waiting for your response.  Thank you! Have a great weekend!', NULL, NULL, '2021-08-30 10:27:41', '2021-08-30 10:27:41'),
(32264, 11056, 24155, NULL, '2021-10-01 00:00:00.000', 'In Process', 'Email sent to : Cynthia.Barnett@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning Cynthia!  Hope this email finds you well. Please provide me with someone who can respond to my query for Wellcare, because no one hasn\'t responded to me since August. Kindly provide with the representative\'s email or contact no. for this address :Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148.  I will be grateful to you.   Thank you! Have a wonderful Weekend!', NULL, NULL, '2021-09-24 09:20:27', '2021-09-24 09:20:27'),
(32265, 11056, 24155, NULL, '2021-10-18 00:00:00.000', 'In Process', 'Email sent to : ProspectiveProviderTX@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope you are doing great. I am still waiting for the representative details in the Corpus Christi area. Please assist me with that soon.  Eagerly, waiting to hear from you soon.  Thank you! Have a blessed day!  Contacted Miss Cynthia. She informed me that she gonna confirm if they provide services in Corpus christi area or  not.', NULL, NULL, '2021-10-11 10:36:43', '2021-10-11 10:36:43'),
(32266, 11056, 24155, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email received from : Schlonda.Ramee@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE  Good afternoon,     Ahmed, please excuse my tardiness.  The assigned Account Manager is Jetori Campbell. Jetori can be reached at Jetori.campbell@wellcare.com I have also included her in this email.     Jetori, can you please assist Ahmed?     Thanks,     Schlonda Ramee Jackson, Notary Public  Manager, Provider Network, G&A-Provider Relations     4888 Loop Central Drive, Suite 300  Houston, Texas 77081  Direct Mobile 713-409-6354  schlonda.rameejackson@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-10-18 09:22:27', '2021-10-18 09:22:27'),
(32267, 11056, 24155, NULL, '2021-11-02 00:00:00.000', 'In Process', 'Email received from : Jetori.Campbell@wellcare.com  Sub : Enrollment Status Updates - BAQC - WELCARE   Good Morning Ahmed,  Thank you for following up on your request to Join Our Network.  You should have received correspondence from Superior Health Plan/ WellCare in response to your request. Once all information is signed and received from both parties; please anticipate up to 90 days for credentialing to be completed.   Please let me know if you have any questions.  Thank You  Ms. JeTori Campbell Provider Account Manager 4888 Loop Central Drive, Suite 300  Houston, Texas 77081 Direct Mobile 972-795-8691 jetori.campbell@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-10-26 10:18:28', '2021-10-26 10:18:28'),
(32268, 11056, 24155, NULL, '2021-11-11 00:00:00.000', 'In Process', 'Email sent to: Jetori.Campbell@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well.  We haven\'t received any correspondence yet from the WellCare side. Please do provide the providers & facility enrollment status with WellCare. Please see below the case and emails from our side.  Please assist with the above at your earliest opportunity.  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-04 14:46:00', '2021-11-04 14:46:00'),
(32269, 11056, 24155, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Email received from: Jetori.Campbell@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELCARE  Good Morning,  Ahmed, I am the account manager once the groups and providers have been loaded the contracting department is responsible for loads and updates on loads. They can be reached at ProspectiveProviderTX@wellcare.com.   Ms. JeTori Campbell Provider Account Manager 4888 Loop Central Drive, Suite 300  Houston, Texas 77081 Direct Mobile 972-795-8691 jetori.campbell@wellcare.com | https://www.wellcare.com', NULL, NULL, '2021-11-18 16:56:35', '2021-11-18 16:56:35'),
(32270, 11056, 24155, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com  Sub:   Enrollment Status Updates - BAQC - WELCARE  Good morning!  Hope this email finds you well. Is Wellcare comes Under Medicare or Medicaid? And if both tell me with plans which come under Medicare only and enrolling process to enroll in them only.  Eagerly waiting for your response.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-01 12:11:14', '2021-12-01 12:11:14'),
(32271, 11056, 24155, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com   Sub:  Enrollment Status Updates - BAQC - WELCARE    Good Morning,  WellCare is a Medicare Advantage plan only at this time.     Thank you', NULL, NULL, '2021-12-08 13:41:08', '2021-12-08 13:41:08'),
(32272, 11056, 24155, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to:  Jetori.Campbell@wellcare.com   Sub:  Enrollment Status Updates - BAQC - WELLCARE   Good afternoon!  Hope this email finds you well.  What do you mean by only at this time? Is it going to be changed in the future? If Yes, what are we going to do then?  Please elaborate on this and provide a detailed explanation about it.  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 18:00:28', '2021-12-16 18:00:28'),
(32273, 11056, 24155, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from: ProspectiveProviderTX@wellcare.com  Sub: Enrollment Status Updates - BAQC - WELLCARE   Dear Provider,   Superior Healthplan received the credentialing documents on 10/13/2021 for all the providers listed below. At this time they are all currently in credentialing which can take up to 90 days.  Sincerely,     Network Management– Texas | www.wellcare.com | www.superiorhealthplan.com', NULL, NULL, '2021-12-22 17:15:49', '2021-12-22 17:15:49'),
(32274, 19067, 24155, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers and Group with Wellcare.   Group Name	Bay Area Quick Care Tax ID	27-1702009 Group NPI	1437481421 Provider Name	NPI	Location Kynda Orsak	1528553724	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148 Cynthia Malowitz	1336173244	9929 South Padre Island Drive, Suite 109, Corpus Christi , TX 78418-5148   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 14:23:37', '2021-12-30 14:23:37'),
(32275, 19067, 24155, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare |   Good Morning,    Happy New Year.     Both providers are still processing and are currently with the cred dept. Please keep in mind that it can take up to 90 days from the date Superior received the completed cred docs. Once they are credentialed by Superior then WellCare will get the files to load.     William Francis- NPI# 1457994436  cred docs were received on 10/13/2021     Kynda Orsak- NPI# 1528553724  cred docs were received on 10/13/2021', NULL, NULL, '2022-01-09 20:19:58', '2022-01-09 20:19:58'),
(32276, 19067, 24155, NULL, '2022-01-21 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope this email finds you well.  Any updates on this?  Thanks, Hammad Ahmed.', NULL, NULL, '2022-01-14 10:41:35', '2022-01-14 10:41:35'),
(32277, 19067, 24155, NULL, '2022-01-28 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||    Greetings!  Any updates on the request mentioned below?   Kindly respond promptly.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-20 20:09:39', '2022-01-20 20:09:39'),
(32278, 1019, 24155, NULL, '2022-02-09 00:00:00.000', 'In Process', 'Received the following email from ProspectiveProviderTX@wellcare.com  Both providers are still processing and are currently with the cred dept. Please keep in mind that it can take up to 90 days from the date Superior received the completed cred docs.     William Francis- NPI# 1457994436  C58035- credentialing, cred docs were received on 10/13/2021     Kynda Orsak- NPI# 1528553724  C58036- credentialing, cred docs were received on 10/13/2021    Sincerely,     Network Management– Texas | www.wellcare.com | www.superiorhealthplan.com  1634667499561', NULL, NULL, '2022-02-02 12:16:08', '2022-02-02 12:16:08'),
(32279, 19067, 24155, NULL, '2022-02-22 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com, Jetori.Campbell@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Hello!  Hope you are doing well. Kindly provide the enrollment status of the following providers with Wellcare.  Group Name	Bay Area Quick Care PLLC Tax ID	27-1702009 Group NPI	1437481421 Primary & Billing Location	9929 South Padre Island Drive Suite 10, Corpus Christi, TX 78418 Provider	NPI Cynthia Malowitz	1336173244 Kynda Orsak	1528553724  Regards, Hammad Ahmed.', NULL, NULL, '2022-02-15 11:34:43', '2022-02-15 11:34:43'),
(32280, 19067, 24155, NULL, '2022-03-16 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Re: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||   Good Morning!  Any updates on the request below? Have the providers been credentialed?  Thanks, Hammad Ahmed.', NULL, NULL, '2022-03-09 11:22:26', '2022-03-09 11:22:26'),
(32281, 22077, 24155, NULL, '2022-04-29 00:00:00.000', 'In Process', 'Email sent to: ProspectiveProviderTX@wellcare.com  Subject: Enrollment Query || BAQC || Kynda, Cynthia & Group || Wellcare ||  Hi,  Any updates on the previously mentioned request?  I am looking forward to your kind response.  Thanks & Regards.', NULL, NULL, '2022-04-22 08:05:26', '2022-04-22 08:05:26'),
(32282, 1006, 24156, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:36:53', '2021-04-20 10:36:53'),
(32283, 9057, 24156, NULL, '2021-06-08 00:00:00.000', 'Not Eligible', '', NULL, NULL, '2021-05-31 17:01:45', '2021-05-31 17:01:45'),
(32284, 1006, 24157, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:36:58', '2021-04-20 10:36:58'),
(32285, 9057, 24157, NULL, '2021-06-08 00:00:00.000', 'Initiated', 'We Sent an email to: CSHNproviderrelations@christushealth.org Sub: Requisition of Enrollment - BAQC - Christus Spohn  Hello, Hope you are doing well, We wish to enroll our group and providers, find details given below.   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  If you need any more details, please let me know.  Thank you', NULL, NULL, '2021-06-01 09:58:06', '2021-06-01 09:58:06'),
(32286, 1006, 24157, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Sent f/u email @ CSHNproviderrelations@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hello,   I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Group Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009  Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-17 10:47:03', '2021-06-17 10:47:03'),
(32287, 11056, 24157, NULL, '2021-07-14 00:00:00.000', 'In Process', 'Email sent to :   CSHNproviderrelations@christushealth.org  Sub : Enrollment Status - BAQC - Christus Spohn  Greetings,  Hope you are doing well. I wanted to get an update regarding the enrollment query we submitted for the following group and providers, their information is as follows:   Practice: Practice Name: Bay Area Quick Care LLC NPI: 1437481421 TIN# 27-1702009 Main Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418  Providers: Provider name: Orsak, Kynda NPI# 1528553724  Provider Name: Malowitz, Cynthia NPI# 1336173244  Provider Name: Ramsden, Melissa NPI# 1194376228  Provider Name: Francis, William: NPI# 1457994436  Please get back to me as soon as possible. Kindly Respond.  Thank you!', NULL, NULL, '2021-07-06 15:46:01', '2021-07-06 15:46:01'),
(32288, 1006, 24157, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ \"Guerra, Vicki A.\" vicki.guerra@christushealth.org ', NULL, NULL, '2021-07-27 16:33:31', '2021-07-27 16:33:31'),
(32289, 1006, 24157, NULL, '2021-08-12 00:00:00.000', 'In Process', 'We received the following update from vicki.guerra@christushealth.org:  Sub: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  Happy Thursday!  Does this provider group have hospital affiliations with a Christus facility? Or, is there a physician this group utilizes who does have hospital affiliations?  Thanks,  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"  Replied with:  \"Hello Vicki,   The group and provider do have a supervising physician David Gray (NPI# 1902814874) who has hospital affiliations. Please let me know if this works for you?  Thank you. \"', NULL, NULL, '2021-08-05 12:38:51', '2021-08-05 12:38:51'),
(32290, 1006, 24157, NULL, '2021-08-25 00:00:00.000', 'Not Eligible', 'We received the following denial notification from vicki.guerra@christushealth.org:  Sub: Gray MD Affiliations Expired: Enrollment Status - BAQC - Christus Spohn  \"Hi Brad,  I reviewed Dr. Grays affiliations and they have expired with the hospital. Please see the attached. Dr. Gray will need to be credentialed again with the hospital in order for the group to be extended a contract. He may have missed his reappointment. Please see attached documentation.  Is this possible for Dr. Gray or yourself to reach out to medical staff administration and inquire?  Medical Staff Administration Tel: (361) 881-3151 Fax: (361) 881-3714  Vicki Ann Guerra Provider Relations Representative CHRISTUS Spohn Health Network 613 Elizabeth St Ste 604 Corpus Christi, TX 78404 O: 361-881-3167 F: 361-881-3745\"', NULL, NULL, '2021-08-18 10:57:05', '2021-08-18 10:57:05'),
(32291, 1006, 24160, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-04-20 10:37:03', '2021-04-20 10:37:03'),
(32292, 1006, 24160, NULL, '2021-04-27 00:00:00.000', 'Initiated', 'Sent following email to PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,  I hope you\'re doing well, I wanted to verify the enrollment status for the following group and providers:   Group Name: Bay Area Quick Care LLC NPI# 1437481421  Provider Name: Cynthia Malowitz NPI# 1336173244  Provider Name: Kynda Orsak NPI# 1528553724  Provider Name: William Francis NPI# 1457994436  Provider Name: Melissa Ramsden NPI# 1194376228  If the above-mentioned providers are enrolled please send over their welcome letters and if they require enrollment please let me know what the process is.   Thank you.\"', NULL, NULL, '2021-04-20 13:05:59', '2021-04-20 13:05:59'),
(32293, 1006, 24160, NULL, '2021-05-05 00:00:00.000', 'In Process', 'Sent a f/u email @ PDSDallas@aetna.com:  Sub: Enrollment Request/Status - Bay Area Quick Care - First Health  \"Hello,   I hope you\'re doing well, I wanted to follow-up on this request again, Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-28 12:44:03', '2021-04-28 12:44:03'),
(32294, 3040, 24160, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: DillikarA@aetna.com  Subject:  Status: [EXTERNAL] Enrollment Request/Status - Bay Area Quick Care - First Health Case# 12591444   Hi,  Provider (Cynthia Malowitz) is active under Tax ID: 271702009 With effective 11/01/2012 in First Health Networks.  And rest providers are not linked with First Health if they needs to be enrolled please send their complete provider details to pdsdallas@aetna.com from there your request will be taken care by a particular user.  Thanks, Akhilesh Dillikar', NULL, NULL, '2021-06-10 10:42:33', '2021-06-10 10:42:33'),
(32295, 1006, 24160, NULL, '2021-07-06 00:00:00.000', 'In Process', 'Sent requested information @ Bharath, Bollu BharathB@aetna.com, TalasilaB@aetna.com, DillikarA@aetna.com:  Sub: FW: Bay Area Quick Care - First Health Case# 13578624  \"Hello,   Please find the attached information:   Group Name: Bay Area Quick Care LLC NPI# 1437481421 TIN# 27-1702009  Address: 9929 South Padre Island Drive, Suite 109, Corpus Christi, TX 78418-5148  Provider Name: Kynda Orsak NPI# 1528553724 License# AP137831  Provider Name: William Francis NPI# 1457994436 License# AP143937  Provider Name: Melissa Ramsden NPI# 1194376228 License# AP142173  Please let me know what else is required to proceed with this request.  Thank you!\"', NULL, NULL, '2021-06-29 10:44:50', '2021-06-29 10:44:50');
