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
(8377, 1006, 12488, NULL, '2021-03-23 00:00:00.000', 'In Process', 'Request currently in process by the network team, need to check back in next week after 30 business days have elapsed.  Ticket# NAF392508 - Already closed, as the network has already sent us the contract as it should only take 30 business days from 02/09/2021.  Rep: Mark', NULL, NULL, '2021-03-18 13:15:33', '2021-03-18 13:15:33'),
(8378, 1006, 12488, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Received the following update from Aetna on the physician group contract:  \"Good afternoon, can you please complete the roster for this group?\"', NULL, NULL, '2021-03-22 09:33:34', '2021-03-22 09:33:34'),
(8379, 1006, 12488, NULL, '2021-03-29 00:00:00.000', 'In Process', 'The roster has been filled out and sent to So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com. Attached for reference.  ', NULL, NULL, '2021-03-22 09:50:47', '2021-03-22 09:50:47'),
(8380, 1006, 12488, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Sent a follow-up email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:  Sub: FW: [EXTERNAL] Your signature is required on TX_PhysicianGroup_100%AMFS-AMMFSwithMids85%_Right Step Medical Center LLC  \"Hello,   I hope that you\'re doing well, I wanted to get an update on the status of enrollment for our group & providers.   Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-05 16:29:06', '2021-04-05 16:29:06'),
(8381, 1006, 12488, NULL, '2021-04-30 00:00:00.000', 'In Process', 'Called Aetna, was informed to reach out to the email that we sent a roster to for better updates.   Ref# 6015065079  Sent email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:   Sub: Provider Enrollment Query - RSM - Aetna  \"Hello,  I wanted to get an update regarding the enrollment status for our group and providers, their information is as follows:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  I was informed that the group is showing up with the provider\'s NPI instead, could you please verify how we can correct this?  Thank you. \"', NULL, NULL, '2021-04-23 14:24:03', '2021-04-23 14:24:03'),
(8382, 1006, 12488, NULL, '2021-05-10 00:00:00.000', 'In Process', 'Sent another f/u email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:  Sub: Provider Enrollment Query - RSM - Aetna  \"Good morning,  I want to follow-up on the status of my enrollment for the following group and providers:Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Please get back to me as soon as possible as this request has been ongoing for more than 2 months without any updates from Aetna.  Thank you. \"', NULL, NULL, '2021-05-03 07:46:10', '2021-05-03 07:46:10'),
(8383, 1006, 12488, NULL, '2021-06-02 00:00:00.000', 'In Process', 'As per my discussion with Aetna representative (Roy), we need to send W9 for Ramegowda @ ATTN: Provider Relations and fax# 859-455-8650. W9 was faxed over. ', NULL, NULL, '2021-05-26 09:29:29', '2021-05-26 09:29:29'),
(8384, 1006, 12488, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:  Sub: Provider Enrollment Query - RSM - Aetna  \'Hello,  I appreciate the update, could you please let me know what the effective dates are for the providers that are linked to the group TIN?  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Thank you. \"', NULL, NULL, '2021-06-11 09:28:47', '2021-06-11 09:28:47'),
(8385, 1006, 12488, NULL, '2021-07-07 00:00:00.000', 'In Process', 'I have words with Ms. Julie about the enrollment process. She said us to fill out the online application form again but when we fill-up the form again the site responded to us that we are already an existing member of it.', NULL, NULL, '2021-06-30 16:52:05', '2021-06-30 16:52:05'),
(8386, 1006, 12488, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent f/u email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:  Sub: Provider Enrollment Query - RSM - Aetna  \"Hello,   As per my discussion with the Aetna representative on the given number they still do not see the group or providers listed, please get back to me on the status of this request as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-27 16:49:53', '2021-07-27 16:49:53'),
(8387, 1006, 12488, NULL, '2021-08-17 00:00:00.000', 'In Process', 'Sent f/u email @ SoTXNetworkManagement25WS@aetna.com:  Sub: Provider Enrollment Query - RSM - Aetna  \"Hello,   We are still waiting on the status of this request as soon as possible, we still have not received any response on this for quite some time.  Thank you. \"', NULL, NULL, '2021-08-10 16:40:33', '2021-08-10 16:40:33'),
(8388, 1006, 12488, NULL, '2021-09-07 00:00:00.000', 'In Process', 'Requested Aetna rep to get our enrollment request forwarded to management.  Ref# NAF454645 Rep: Jelo ', NULL, NULL, '2021-08-31 14:06:05', '2021-08-31 14:06:05'),
(8389, 11056, 12488, NULL, '2021-09-15 00:00:00.000', 'In Process', 'I have words with rep. She provide the below mentioned details.  Call rep. : MARS R REF CODE. : Hang up the call deliberately  The participation is out of network but still working to bring in network.  Application ticket no. : NAF454645', NULL, NULL, '2021-09-08 10:21:49', '2021-09-08 10:21:49'),
(8390, 11056, 12488, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Rep. Name : Theresa  R. & Mae D  Status : Reviewed by network team & Uploading the participation status .  Ref code no. : 92424  Phone no. : 800-353-1232  Application ticket no. : NAF454645', NULL, NULL, '2021-09-17 09:13:51', '2021-09-17 09:13:51'),
(8391, 11056, 12488, NULL, '2021-09-30 00:00:00.000', 'In Process', 'Rep : Amby J  Ramegowda = under process for loading and linking Shybi = In network and linked to the TIN Glory = getting loaded under process Group = will be loaded after the providers contracting immediately.  Also in network.  Eff date will be : 05/15/2021  May be completed in the 1st week or 2nd week of october  Contract has been provided to credentialing for uploading the system.  Ref code : 6044414296  Contact no. : 800-353-1232', NULL, NULL, '2021-09-23 17:02:27', '2021-09-23 17:02:27'),
(8392, 11056, 12488, NULL, '2021-10-11 00:00:00.000', 'In Process', 'Rep. : Jesse R  Status :   Showing out of network. Request Stiil in process network statrted loading provider 09/09/2021  Case no. : 1679009  Ref code : 6046707646  Contact no. : 800-353-1232', NULL, NULL, '2021-10-04 12:34:21', '2021-10-04 12:34:21'),
(8393, 11056, 12488, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Rep :  Rick N  Status : Ramegowda & Glory request is in received to link and load. Still in processing   created on : 10/10/2021 30 business days.  Case no. : 17559543  Ref code : 6049980343  contact no : 800-353-1232', NULL, NULL, '2021-10-13 13:05:53', '2021-10-13 13:05:53'),
(8394, 11056, 12488, NULL, '2021-10-28 00:00:00.000', 'In Process', 'Rep : Jam P  Status :  Process is completed. Loaded on the system and linked with the tax ID Future effective date is 11/01/2021   Ref code. : 6051507347  contact no : 800-353-1232', NULL, NULL, '2021-10-21 10:59:13', '2021-10-21 10:59:13'),
(8395, 11056, 12488, NULL, '2021-11-08 00:00:00.000', 'In Process', 'Rep:  Mark L  Status:  The group is in-network. Going to provide welcome letters in 10 business days for the providers.  Ref code: 6054022733  contact no : 800-353-1232', NULL, NULL, '2021-11-01 10:26:42', '2021-11-01 10:26:42'),
(8396, 11056, 12488, NULL, '2021-11-18 00:00:00.000', 'In Process', 'Rep : Vinz  S   Status: In-network case properly started in 9/15/21 ticket# NAF454645 Welcome letters are expected in the next week. The future effective date is 11/01/2021  Refcode: 6057564480', NULL, NULL, '2021-11-11 15:18:46', '2021-11-11 15:18:46'),
(8397, 11056, 12488, NULL, '2021-11-25 00:00:00.000', 'In Process', 'Rep: Cris S  Status:  Ramegowda Belakere: The application is in process. Needs around 30-40 days more.  Glory Abraham: completed. In-network  Refcode:  6058727694', NULL, NULL, '2021-11-18 12:01:13', '2021-11-18 12:01:13'),
(8398, 11056, 12488, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Rep: Dori M  Status: Case has been escalated. Ramegowda is in credentialing process. Glory Abraham case is missing by their side. LOI had to be sent to add this provider.  Case no.: 13547054  Ref code: 6059846680', NULL, NULL, '2021-11-24 18:05:50', '2021-11-24 18:05:50'),
(8399, 11056, 12488, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Rep: Arianne E   Status: Applications are still in process. Welcome letters can be expected soon.   Refcode: 11302021Ariannee', NULL, NULL, '2021-11-30 17:32:38', '2021-11-30 17:32:38'),
(8400, 11056, 12488, NULL, '2021-12-15 00:00:00.000', 'In Process', 'Rep: Mark C  Status:  11/1/2021 linked and credentialed under the facility TIN.  Plans:  Aetna Medicare Aetna Medicaid  Refcode: 6062355331', NULL, NULL, '2021-12-08 12:39:05', '2021-12-08 12:39:05'),
(8401, 11056, 12488, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Rep: Gelo C   Status:Fully loaded in the system.Gonna receive soon a welcome letter  Ref code: 6065804152', NULL, NULL, '2021-12-22 13:48:46', '2021-12-22 13:48:46'),
(8402, 19067, 12488, NULL, '2022-01-04 00:00:00.000', 'In Process', 'Email sent to: Laura.Bevin@aetna.com  Subject: Enrollment Status || RSM || Group & Provider || Aetna ||  Hello,  Hope you are having a productive day.  I would like to know the enrollment status of the following Providers and Group with Aetna.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Provider Name	NPI	Location Ani Stephen	1588959118	11925 Southwest Freeway, Suite 12, Stafford, TX 77477 Glory Abraham	1194206490	11925 Southwest Freeway, Suite 12, Stafford, TX 77477 Ramegowda Belakere	1235166687	11925 Southwest Freeway, Suite 12, Stafford, TX 77477   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-28 15:06:54', '2021-12-28 15:06:54'),
(8403, 20067, 12488, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Subject:  Enrollment Status || RSM || Group & Provider || Aetna ||   Good Afternoon, Hope you had a great day. I would like to know the enrollment status of the below-mentioned Group and providers under Right Step Medical Center LLC.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Primary Location	11925 Southwest Freeway, Suite# 12, Stafford, TX 77477-2300 Provider Name	NPI Ancy Kurian	1316558935 Ramegowda Belakere	1235166687 Glory Abraham	1194206490  Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-06 17:22:28', '2022-01-06 17:22:28'),
(8404, 19067, 12488, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: RE: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||   Hammad,  I only received the request for Ancy Kurian under this tin, I did not receive the request for these 3 providers, can you please confirm the role of these providers, will they be practicing in a PCP role or Specialist role?', NULL, NULL, '2022-01-09 21:30:50', '2022-01-09 21:30:50'),
(8405, 20067, 12488, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Sub: Enrollment Status || RSM || Group & Provider || Aetna ||   Until the missing information is confirmed, this request will remain to be incomplete, please answer the missing information so I can complete this request for you.     can you please confirm the role of these providers, will they be practicing in a PCP role or Specialist role? ', NULL, NULL, '2022-01-11 09:53:11', '2022-01-11 09:53:11'),
(8406, 20067, 12488, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: Machado-PetryS@aetna.com  Sub: Re: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||  Good Morning, Hope this email finds you well.   Ancy Vinoy Kurian is a Family Nurse Practitioner (363LF0000X) CAQH: 15187581  Ramegowda Belakere is a Family Medicine (207Q00000X) CAQH: 11817469  Glory Abraham is a Family Nurse Practitioner (363LF0000X) CAQH: 14381983  Kindly complete my request and update me ASAP.  Thanks and Regards, Syed Ahad', NULL, NULL, '2022-01-11 09:55:07', '2022-01-11 09:55:07'),
(8407, 19067, 12488, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: RE: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||    Syed,  We do not have a group agreement to add these providers currently, we do not complete group agreements with only mid-level providers staffed.  I see however, in this request you have submitted includes a physician that was not submitted previously, I will need to send you a group agreement before any providers can be added, please make sure the group owner signs the agreement.     In the future, any request you submit to add providers will need to be submitted as our process is to submit online through the provider portal here.  ', NULL, NULL, '2022-01-12 11:17:04', '2022-01-12 11:17:04'),
(8408, 19067, 12488, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email received from: Machado-PetryS@aetna.com  Subject: Enrollment Status || RSM || Group & Provider || Aetna ||    Syed,  We do not have a group agreement to add these providers currently, we do not complete group agreements with only mid-level providers staffed.  I see however, in this request you have submitted includes a physician that was not submitted previously, I will need to send you a group agreement before any providers can be added, please make sure the group owner signs the agreement.     In the future, any request you submit to add providers will need to be submitted as our process is to submit online through the provider portal here.', NULL, NULL, '2022-01-25 13:15:05', '2022-01-25 13:15:05'),
(8409, 19067, 12488, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Re: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||    Hello!  Still waiting to get the group agreement from your side.   Kindly respond as per your convenience.  Regards, Hammad Ahmed.', NULL, NULL, '2022-02-08 11:53:24', '2022-02-08 11:53:24'),
(8410, 19067, 12488, NULL, '2022-02-25 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Re: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||    Hello!  I have updated the agreement, Kindly look into it.  Regards.', NULL, NULL, '2022-02-18 11:42:04', '2022-02-18 11:42:04'),
(8411, 19067, 12488, NULL, '2022-03-18 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Re: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||   Hi Sylvia,  Did you receive the signed agreement? Kindly respond timely.  Regards, Hammad.', NULL, NULL, '2022-03-11 09:53:15', '2022-03-11 09:53:15'),
(8412, 22077, 12488, NULL, '2022-04-11 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Fwd: [EXTERNAL] Enrollment Status || RSM || Group & Provider || Aetna ||   Hi,  Hope this email finds you well,  Did you receive the signed agreement? kindly respond timely.  Thanks,  Alex ', NULL, NULL, '2022-04-04 09:58:58', '2022-04-04 09:58:58'),
(8413, 19067, 12488, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: Machado-petrys@aetna.com  Subject: Sylvia Machado-Petry has shared the TX03_PhysicianGroup_100%AMFS-AMMFSwithMids85%_ Right Step Medical Center LLC with you    Hi Sylvia,  I am having a problem signing the contract I think the authorized signer for this contract is Syed Ahad his email is sah@claimsmedinc.com unfortunately, he no longer works here can you make me the authorized signer for the contract so that I can sign it and get it back to you as we are already late on this process.  Also, see the attached screenshot.   Thanks, Hammad Ahmed', NULL, NULL, '2022-04-13 14:32:18', '2022-04-13 14:32:18'),
(8414, 1006, 12489, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2020-12-31 12:59:06', '2020-12-31 12:59:06'),
(8415, 1006, 12489, NULL, '2021-01-07 00:00:00.000', 'Initiated', 'Initiated enrollment request online via Aetna website. Attached. ', NULL, NULL, '2020-12-31 13:00:14', '2020-12-31 13:00:14'),
(8416, 1006, 12489, NULL, '2021-01-18 00:00:00.000', 'In Process', 'They sent out a contract but it wasn\'t received on rsm@claimsmedinc.com, got them to resubmit it to a new email.  Tracking# PVB1229796', NULL, NULL, '2021-01-11 15:56:02', '2021-01-11 15:56:02'),
(8417, 1006, 12489, NULL, '2021-02-11 00:00:00.000', 'In Process', 'Contract received and signed, attached for reference. ', NULL, NULL, '2021-02-04 10:30:06', '2021-02-04 10:30:06'),
(8418, 1006, 12489, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Physician group contract received. It has been signed and sent back. Attached for reference. ', NULL, NULL, '2021-02-09 09:48:54', '2021-02-09 09:48:54'),
(8419, 1006, 12489, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Provider credentialing is still on-going and provider is currently going through verification and it can take up to 45 ~ 60 business days from 02/09/2021. Application# PVB1229796', NULL, NULL, '2021-03-18 13:15:53', '2021-03-18 13:15:53'),
(8420, 1006, 12489, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Received the following update from Aetna on the physician group contract:  \"Good afternoon, can you please complete the roster for this group?\"', NULL, NULL, '2021-03-22 09:33:40', '2021-03-22 09:33:40'),
(8421, 1006, 12489, NULL, '2021-03-29 00:00:00.000', 'In Process', 'The roster has been filled out and sent to So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com. Attached for reference.  ', NULL, NULL, '2021-03-22 09:50:52', '2021-03-22 09:50:52'),
(8422, 1006, 12489, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Sent a follow-up email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:  Sub: FW: [EXTERNAL] Your signature is required on TX_PhysicianGroup_100%AMFS-AMMFSwithMids85%_Right Step Medical Center LLC  \"Hello,   I hope that you\'re doing well, I wanted to get an update on the status of enrollment for our group & providers.   Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-04-05 16:29:10', '2021-04-05 16:29:10'),
(8423, 1006, 12489, NULL, '2021-04-30 00:00:00.000', 'In Process', 'Called Aetna, was informed to reach out to the email that we sent a roster to for better updates.   Ref# 6015065079  Sent email @ So TX Network Management 25WS SoTXNetworkManagement25WS@aetna.com:   Sub: Provider Enrollment Query - RSM - Aetna  \"Hello,  I wanted to get an update regarding the enrollment status for our group and providers, their information is as follows:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  I was informed that the group is showing up with the provider\'s NPI instead, could you please verify how we can correct this?  Thank you. \"', NULL, NULL, '2021-04-23 14:23:58', '2021-04-23 14:23:58'),
(8424, 1006, 12489, NULL, '2021-05-04 00:00:00.000', 'In Process', 'Received the following email from \'Machado-Petry, Sylvia D\':  Sub: Request for Network Participation  \"Please provide w9 for requested tin:  Sylvia Machado-Petry Network Ops Consultant Network Management – STX Markets  3 Sugar Creek Circle Sugarland, TX 77478  Aetna\"  Sent her W9 of group and asked about status.', NULL, NULL, '2021-04-27 12:05:37', '2021-04-27 12:05:37'),
(8425, 1006, 12489, NULL, '2021-05-05 00:00:00.000', 'Approved', 'Received the following welcome letter from reply-fec811777167077c-92_HTML-223860174-515007887-147@provider.aetna.com:  Sub: Welcome to our network. Let’s get started.   \"Hi Shybi Varghese,  Welcome to the provider network effective May 15 2021 12:00AM.  Your Provider Identification Number (PIN) is: 6151807.  Ready to get started? To help make your onboarding easy, just check out the attached welcome kit.    Register here to attend our new provider onboarding webinar - Doing business with Aetna® . Sessions are held on the second Tuesday and third Wednesday of each month from 1:00 p.m. – 2:15 p.m. ET. You\'ll discover additional online tools and resources to make your day-to-day Aetna tasks quick and simple.\"  Attached screenshot of the email as well for reference. ', NULL, NULL, '2021-04-28 09:36:56', '2021-04-28 09:36:56'),
(8426, 3040, 12490, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-04 13:58:11', '2021-01-04 13:58:11'),
(8427, 3040, 12490, NULL, '2021-01-11 00:00:00.000', 'Initiated', 'Provider Certification Application form send through fax.   Please see attachments ', NULL, NULL, '2021-01-04 13:59:45', '2021-01-04 13:59:45'),
(8428, 3040, 12490, NULL, '2021-01-18 00:00:00.000', 'In Process', 'I had a word with Tricare representative and they said allow up to 90 days for processing.   Ref: 11347755 ', NULL, NULL, '2021-01-11 10:01:29', '2021-01-11 10:01:29'),
(8429, 3040, 12490, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center || Tricare  Greetings,  Hope you are doing well. I want to know the enrollment status of this below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center  Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 1: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider:  Provider Name: Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-01-18 13:35:12', '2021-01-18 13:35:12'),
(8430, 3040, 12490, NULL, '2021-02-01 00:00:00.000', 'In Process', 'I had a word with Tricare representative and she advised the application is not certified yet and will take up to 90 Days ', NULL, NULL, '2021-01-25 11:39:06', '2021-01-25 11:39:06'),
(8431, 3040, 12490, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status of the below mentioned provider.  I had a word with Tricare representative and she said the below mentioned provider is certified and already In-network with Tricare and we can start sending the billings. When I checked the online portal it was not showing me any information about the providers. For your convenience I mentioned the certified dates of the providers which I got from the Tricare representative.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Please get back to me as soon as possible.   Thanks', NULL, NULL, '2021-02-01 15:52:45', '2021-02-01 15:52:45'),
(8432, 3040, 12490, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Follow up email sent to: ywyatt@humana.com, KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned providers.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Can you please get back to me as soon as possible. Waiting for your response. \'  Thanks', NULL, NULL, '2021-02-08 14:15:22', '2021-02-08 14:15:22'),
(8433, 3040, 12490, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  I submitted this provider for credentialing to review. Please allow 90 days.  Please use the provider portal to keep track of your providers and locations moving forward:  https://infocenter.humana-military.com/provider/service/Account/Login   ', NULL, NULL, '2021-02-09 13:22:48', '2021-02-09 13:22:48'),
(8434, 3040, 12490, NULL, '2021-02-23 00:00:00.000', 'In Process', 'Email sent to: kmoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Good Morning Katherine,  Hope you are doing well. Please find the attached screenshot that is showing the provider application completed and in-network. Can you please send me the welcome letter for that. Also I need to know the email that you sent me last time that belong to which facility because I mentioned the 03 facilities please clarify?  Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-16 11:01:06', '2021-02-16 11:01:06'),
(8435, 3040, 12490, NULL, '2021-03-02 00:00:00.000', 'In Process', 'Follow up email sent to:  ywyatt@humana.com, KMoten4@humana.com  Subject: Re: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I really appreciate your prompt response. Please advise me the process to add the provider under the Longpoint location.   Waiting for your response.   Thanks ', NULL, NULL, '2021-02-23 13:08:56', '2021-02-23 13:08:56'),
(8436, 3040, 12490, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Good Afternoon,  This provider is showing under the following locations:   ', NULL, NULL, '2021-02-25 17:11:04', '2021-02-25 17:11:04'),
(8437, 3040, 12490, NULL, '2021-03-12 00:00:00.000', 'Approved', 'Email confirmation rcvd from Kmoten4@humana.com  Please see attachment ', NULL, NULL, '2021-03-05 13:43:10', '2021-03-05 13:43:10'),
(8438, 3040, 12491, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-04 14:00:53', '2021-01-04 14:00:53'),
(8439, 3040, 12491, NULL, '2021-01-11 00:00:00.000', 'Initiated', 'Provider Certification Application form send through fax.   Please see attachments ', NULL, NULL, '2021-01-04 14:01:11', '2021-01-04 14:01:11'),
(8440, 3040, 12491, NULL, '2021-01-18 00:00:00.000', 'In Process', 'I had a word with Tricare representative and they said allow up to 90 days for processing.   Ref: 11347862', NULL, NULL, '2021-01-11 10:01:55', '2021-01-11 10:01:55'),
(8441, 3040, 12491, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center || Tricare  Greetings,  Hope you are doing well. I want to know the enrollment status of this below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center  Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 1: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider:  Provider Name: Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-01-18 13:35:43', '2021-01-18 13:35:43'),
(8442, 3040, 12491, NULL, '2021-02-01 00:00:00.000', 'In Process', 'I had a word with Tricare representative and she advised the application is not certified yet and will take up to 90 Days ', NULL, NULL, '2021-01-25 11:39:25', '2021-01-25 11:39:25'),
(8443, 3040, 12491, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status of the below mentioned provider.  I had a word with Tricare representative and she said the below mentioned provider is certified and already In-network with Tricare and we can start sending the billings. When I checked the online portal it was not showing me any information about the providers. For your convenience I mentioned the certified dates of the providers which I got from the Tricare representative.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Please get back to me as soon as possible.   Thanks', NULL, NULL, '2021-02-01 15:52:56', '2021-02-01 15:52:56'),
(8444, 3040, 12491, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Follow up email sent to: ywyatt@humana.com, KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned providers.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Can you please get back to me as soon as possible. Waiting for your response. \'  Thanks', NULL, NULL, '2021-02-08 14:15:35', '2021-02-08 14:15:35'),
(8445, 3040, 12491, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  I submitted this provider for credentialing to review. Please allow 90 days.  Please use the provider portal to keep track of your providers and locations moving forward:  https://infocenter.humana-military.com/provider/service/Account/Login   ', NULL, NULL, '2021-02-09 13:23:01', '2021-02-09 13:23:01'),
(8446, 3040, 12491, NULL, '2021-02-23 00:00:00.000', 'In Process', 'Email sent to: kmoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Good Morning Katherine,  Hope you are doing well. Please find the attached screenshot that is showing the provider application completed and in-network. Can you please send me the welcome letter for that. Also I need to know the email that you sent me last time that belong to which facility because I mentioned the 03 facilities please clarify?  Waiting to hear from you soon.', NULL, NULL, '2021-02-16 11:01:35', '2021-02-16 11:01:35'),
(8447, 3040, 12491, NULL, '2021-03-02 00:00:00.000', 'New/Not Initiated', 'Follow up email sent to:  ywyatt@humana.com, KMoten4@humana.com  Subject: Re: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I really appreciate your prompt response. Please advise me the process to add the provider under the Longpoint location.   Waiting for your response.   Thanks ', NULL, NULL, '2021-02-23 13:08:51', '2021-02-23 13:08:51'),
(8448, 3040, 12491, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Good Afternoon,  This provider is showing under the following locations:   ', NULL, NULL, '2021-02-25 17:11:12', '2021-02-25 17:11:12'),
(8449, 3040, 12491, NULL, '2021-03-12 00:00:00.000', 'Approved', 'Email confirmation rcvd from Kmoten4@humana.com  Please see attachment ', NULL, NULL, '2021-03-05 13:43:08', '2021-03-05 13:43:08'),
(8450, 3040, 12492, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-04 14:02:07', '2021-01-04 14:02:07'),
(8451, 3040, 12492, NULL, '2021-01-11 00:00:00.000', 'Initiated', 'Provider Certification Application form send through fax.   Please see attachments ', NULL, NULL, '2021-01-04 14:02:17', '2021-01-04 14:02:17'),
(8452, 3040, 12492, NULL, '2021-01-18 00:00:00.000', 'In Process', 'I had a word with Tricare representative and they said allow up to 90 days for processing.   Ref: 11347952', NULL, NULL, '2021-01-11 10:02:28', '2021-01-11 10:02:28'),
(8453, 3040, 12492, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com   Subject: Enrollment Status || Fernandus, Limy || Longpoint Medical Center || Tricare  Greetings,  Hope you are doing well. I want to know the enrollment status of this below mentioned provider.  Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider:  Provider Name: Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-18 13:41:46', '2021-01-18 13:41:46'),
(8454, 3040, 12492, NULL, '2021-02-01 00:00:00.000', 'In Process', 'I had a word with Tricare representative and she advised the application is not certified yet and will take up to 90 Days ', NULL, NULL, '2021-01-25 11:39:39', '2021-01-25 11:39:39'),
(8455, 3040, 12492, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status of the below mentioned provider.  I had a word with Tricare representative and she said the below mentioned provider is certified and already In-network with Tricare and we can start sending the billings. When I checked the online portal it was not showing me any information about the providers. For your convenience I mentioned the certified dates of the providers which I got from the Tricare representative.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Please get back to me as soon as possible.   Thanks', NULL, NULL, '2021-02-01 15:53:13', '2021-02-01 15:53:13'),
(8456, 3040, 12492, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Follow up email sent to: ywyatt@humana.com, KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned providers.   Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/20/2021  Practice 3: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189 Certified: 01/28/2021 The provider is not in network  Can you please get back to me as soon as possible. Waiting for your response. \'  Thanks', NULL, NULL, '2021-02-08 14:15:47', '2021-02-08 14:15:47'),
(8457, 3040, 12492, NULL, '2021-02-22 00:00:00.000', 'In Process', 'Email sent to: kmoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. Please find the attached screenshot from Tricare portal and its showing that the provider is complete in 02 locations. Can you please send me the welcome letter for that.  In Long point location the provider is not showing so can you please advise me the process for the credentialing. The provider is already in-network with Tricare.   Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-15 10:44:54', '2021-02-15 10:44:54'),
(8458, 3040, 12492, NULL, '2021-03-01 00:00:00.000', 'In Process', 'Email sent to: kmoten4@humana.com  Subject:  Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. Please find the attached screenshot from Tricare portal in Long point location the provider is not showing so can you please advise me the process for the credentialing. The provider is already in-network with Tricare?   Waiting for your response.   Thanks', NULL, NULL, '2021-02-22 13:52:55', '2021-02-22 13:52:55'),
(8459, 3040, 12492, NULL, '2021-03-02 00:00:00.000', 'In Process', 'Follow up email sent to:  ywyatt@humana.com, KMoten4@humana.com  Subject: Re: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Greetings,  Hope you are doing well. I really appreciate your prompt response. Please advise me the process to add the provider under the Longpoint location.   Waiting for your response.   Thanks ', NULL, NULL, '2021-02-23 13:09:01', '2021-02-23 13:09:01'),
(8460, 3040, 12492, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Tricare ||  Good Afternoon,  This provider is showing under the following locations:   ', NULL, NULL, '2021-02-25 17:11:21', '2021-02-25 17:11:21'),
(8461, 3040, 12492, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Longpoint Medical Center || Tricare ||  Hello Katherine,   Thank you for the information. Please advise me that how much time will it take the provider to get In-network under the Long point medical center. The screenshot that you sent me its showing the provider is not in network.   Waiting for your reply.   Thanks', NULL, NULL, '2021-03-05 17:18:15', '2021-03-05 17:18:15'),
(8462, 3040, 12492, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Longpoint Medical Center || Tricare ||  Hello Katherine,  Hope you are doing well. Has there been any update?  Waiting to hear from you soon.  Thank you', NULL, NULL, '2021-03-12 18:03:34', '2021-03-12 18:03:34'),
(8463, 3040, 12492, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Email sent to:  KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Longpoint Medical Center || Tricare ||  Hello Katherine,  Hope you are doing well. Please find the attached screenshot from provider portal in which its not showing the provider name> Can you please check and advise.   Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-19 15:06:33', '2021-03-19 15:06:33'),
(8464, 3040, 12492, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Email rcvd from: KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Longpoint Medical Center || Tricare ||  Completed. Please allow 3 business days for system to reflect the update.  ', NULL, NULL, '2021-03-22 09:15:27', '2021-03-22 09:15:27'),
(8465, 3040, 12492, NULL, '2021-06-09 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enrollment Status || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Group & Providers || Tricare ||  Hello Katherine,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned group and providers in Tricare for our group under the below locations.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name:Longpoint Medical Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you   Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-02 16:10:47', '2021-06-02 16:10:47'),
(8466, 3040, 12492, NULL, '2021-06-29 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Group & Providers || Tricare ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned group and providers in Tricare for our group under the below locations.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name: Longpoint Medical Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 16:   Provider Name: Joseph, Molly Provider NPI# 1396380077  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-22 09:45:52', '2021-06-22 09:45:52'),
(8467, 3040, 12492, NULL, '2021-07-16 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Need Effective Date || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Group & Providers ||  Hello,   Hope you are doing well. As per your email the below mentioned providers are participating with Tricare in our group under the below locations. Can you please send the effective date.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name: Longpoint Medical Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider 1:   Provider Name: Abraham, Glory (Need Effective Date) Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy (Need Effective Date) Provider NPI# 1972005189  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-07-09 14:41:27', '2021-07-09 14:41:27'),
(8468, 3040, 12492, NULL, '2021-07-23 00:00:00.000', 'Approved', 'Email rcvd from: ywyatt@humana.com  Subject: RE: Enrollment Status || Normandy Urgent Care Center, Imperial Valley Urgent Care Center & Longpoint Medical Center || Group & Providers || Tricare ||  Good Morning Adil.  The status of each providers are listed below. Please check status by using the Provider Portal.  Here is the link to create a log in and if you do not want to create a log in here is the link to search via the website.  https://infocenter.humana-military.com/provider/service/Account/Login  HumanaMilitary - Search Results (goperspecta.com)  Thanks, Yvonne  Provider 8:    Provider Name: Fernandus, Limy- network all three locations,  status was previously given  Provider NPI# 1972005189', NULL, NULL, '2021-07-16 09:10:38', '2021-07-16 09:10:38');
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
(8469, 3040, 12493, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-04 14:03:11', '2021-01-04 14:03:11'),
(8470, 3040, 12493, NULL, '2021-01-11 00:00:00.000', 'Initiated', 'Provider Certification Application form send through fax.   Please see attachments ', NULL, NULL, '2021-01-04 14:03:20', '2021-01-04 14:03:20'),
(8471, 3040, 12493, NULL, '2021-01-18 00:00:00.000', 'In Process', 'I had a word with Tricare representative and they said allow up to 90 days for processing.   Ref: 11348008', NULL, NULL, '2021-01-11 10:02:54', '2021-01-11 10:02:54'),
(8472, 3040, 12493, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Email sent to: 	KMoten4@humana.com  Subject: Enrollment Status || Fernandus, Limy || Columbus Urgent Care PA || Tricare  Greetings,  Hope you are doing well. I want to know the enrollment status of this below mentioned provider.  Practice Name: Columbus Urgent Care PA Practice Tax-ID: 471914151 Practice NPI# 1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider:  Provider Name: Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-18 13:38:57', '2021-01-18 13:38:57'),
(8473, 3040, 12493, NULL, '2021-02-01 00:00:00.000', 'In Process', 'I had a word with Tricare representative and she advised the application is not certified yet and will take up to 90 Days  ', NULL, NULL, '2021-01-25 11:44:27', '2021-01-25 11:44:27'),
(8474, 3040, 12493, NULL, '2021-02-09 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Columbus Urgent Care PA || Tricare ||  Greetings,  Hope you are doing well. I want to know the enrollment status of this below mentioned provider.  Practice Name: Columbus Urgent Care PA Practice Tax-ID: 471914151 Practice NPI# 1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-02-02 14:23:33', '2021-02-02 14:23:33'),
(8475, 3040, 12493, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Email sent to: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Columbus Urgent Care PA || Tricare |  Greetings,  Hope you are doing well. I checked in the provider portal and its showed that action needed. I attached the screen shot for your reference.  Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-02-09 17:47:17', '2021-02-09 17:47:17'),
(8476, 3040, 12493, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Email rcvd from: ywyatt@humana.com  Subject: Enrollment Status || Fernandus, Limy || Columbus Urgent Care PA || Tricare ||   Good Morning Adil,  We show this provider as network. You can check status on a provider by creating a log in on the Provider Portal.  Here is the link highlighted below.  ', NULL, NULL, '2021-02-09 17:47:56', '2021-02-09 17:47:56'),
(8477, 3040, 12493, NULL, '2021-02-23 00:00:00.000', 'Approved', 'I had a word with (Erin) Tricare representative and she said the provider Get Credentialed: 02/10/2021.   See attachment.', NULL, NULL, '2021-02-16 14:50:02', '2021-02-16 14:50:02'),
(8478, 1006, 12494, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:01:46', '2021-01-05 12:01:46'),
(8479, 1006, 12494, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Submitted initial enrollment request via BCBSTX website. Attached for reference. ', NULL, NULL, '2021-01-05 12:02:27', '2021-01-05 12:02:27'),
(8480, 1006, 12494, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Sent a follow-up email @ AncillaryContracting_SE@bcbstx.com', NULL, NULL, '2021-01-15 15:36:11', '2021-01-15 15:36:11'),
(8481, 1006, 12494, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Received the following reply: \"Dear Provider,   Thank you for submitting the Provider Onboarding Form.  We have reviewed your application and discovered that request is for an ancillary group. Therefore, your request has been rejected. Please contact TXFPS@bcbstx.com for the correct application for those provider types.    Thank you,  Provider Data Management BlueCross BlueShield of Texas\"  Sent a follow-up email @ TXFPS@bcbstx.com requesting information on how to proceed. ', NULL, NULL, '2021-01-27 14:24:40', '2021-01-27 14:24:40'),
(8482, 1006, 12494, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Received following response, submitted another onboarding form to stop any delays: \"Hello Brad,     My apologies, I believe you may have been instructed incorrectly.  Facility/Ancillary records cannot have individuals set up under them, so this should be set up as a professional group through our online Onboarding Form.  I will forward your email to the management over the team that handles those requests so they can make sure their team does not make this mistake again, and I will see if they can resume your application.  I will advise you to go ahead and resubmit online as well, because that may end up being faster to get your record set up.     Thank you,     Facility Provider Services  BlueCross BlueShield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company  Fax: 972-766-7315 | Email: TXFPS@bcbstx.com\"', NULL, NULL, '2021-01-28 17:43:43', '2021-01-28 17:43:43'),
(8483, 1006, 12494, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Call received from BCBS regarding group contract process, it\'s currently processing and we should receive the completed PAR plan by tomorrow.  BCBS Provider Group ID# 00PA77', NULL, NULL, '2021-02-08 10:45:26', '2021-02-08 10:45:26'),
(8484, 1006, 12494, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Sent f/u email @ AncillaryContracting_SE@bcbstx.com & TXFPS@bcbstx.com for updated status. ', NULL, NULL, '2021-03-18 16:35:45', '2021-03-18 16:35:45'),
(8485, 1006, 12494, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Received the following reply from BCBS: \"Hello, Brad: In order to be setup as a medical group with providers under the medical group, you would go to our website at bcbstx.com/Providers/Network Participation/How to Join Our Networks and complete the onboarding process.\"  Replied with the following email:  \"Hello,  I appreciate the update, we\'ve already submitted the participation request back on 01/05/2021, with application# 273081. We also received a call with the following group ID# 00PA77. I\'d appreciate it if you could please let me know what the updated status is on our request.   Thank you very much. \"', NULL, NULL, '2021-03-22 08:54:06', '2021-03-22 08:54:06'),
(8486, 1006, 12494, NULL, '2021-03-30 00:00:00.000', 'Approved', 'The group roster has been received and is attached for reference, group was established as of 01/30/2021 but as per the rep, we should use the effective date of the provider that was last added i.e. Shybi Varghese whose eff: 03/09/2021', NULL, NULL, '2021-03-23 08:24:00', '2021-03-23 08:24:00'),
(8487, 1006, 12495, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:01:47', '2021-01-05 12:01:47'),
(8488, 1006, 12495, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Submitted initial enrollment request via BCBSTX website. Attached for reference. ', NULL, NULL, '2021-01-05 12:02:35', '2021-01-05 12:02:35'),
(8489, 1006, 12495, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Sent a follow-up email @ AncillaryContracting_SE@bcbstx.com', NULL, NULL, '2021-01-15 15:36:17', '2021-01-15 15:36:17'),
(8490, 1006, 12495, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Received the following reply: \"Dear Provider,   Thank you for submitting the Provider Onboarding Form.  We have reviewed your application and discovered that request is for an ancillary group. Therefore, your request has been rejected. Please contact TXFPS@bcbstx.com for the correct application for those provider types.    Thank you,  Provider Data Management BlueCross BlueShield of Texas\"  Sent a follow-up email @ TXFPS@bcbstx.com requesting information on how to proceed.  ', NULL, NULL, '2021-01-27 14:31:21', '2021-01-27 14:31:21'),
(8491, 1006, 12495, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Received following response, submitted another onboarding form to stop any delays: \"Hello Brad,     My apologies, I believe you may have been instructed incorrectly.  Facility/Ancillary records cannot have individuals set up under them, so this should be set up as a professional group through our online Onboarding Form.  I will forward your email to the management over the team that handles those requests so they can make sure their team does not make this mistake again, and I will see if they can resume your application.  I will advise you to go ahead and resubmit online as well, because that may end up being faster to get your record set up.     Thank you,     Facility Provider Services  BlueCross BlueShield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company  Fax: 972-766-7315 | Email: TXFPS@bcbstx.com\"', NULL, NULL, '2021-01-28 17:43:47', '2021-01-28 17:43:47'),
(8492, 1006, 12495, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Call received from BCBS regarding group contract process, it\'s currently processing and we should receive the completed PAR plan by tomorrow.  BCBS Provider Group ID# 00PA77', NULL, NULL, '2021-02-08 10:45:32', '2021-02-08 10:45:32'),
(8493, 1006, 12495, NULL, '2021-03-05 00:00:00.000', 'Approved', 'Network Name	                                   Network Effective Date BAV - Blue Advantage HMO	                   02/25/2021 HMO - Blue Essentials	                                   02/25/2021 BCA - BlueChoice PPO	                                   02/25/2021 SNP - Dual Eligible Special Needs Plan	   02/25/2021 HME - Health Select	                                   02/25/2021 MCH - Medicare Advantage HMO	           02/25/2021 PMC - Medicare Advantage PPO	           02/25/2021 WEL - WellMed MA HMO	                           02/25/2021', NULL, NULL, '2021-02-26 09:30:51', '2021-02-26 09:30:51'),
(8494, 1006, 12496, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:01:48', '2021-01-05 12:01:48'),
(8495, 1006, 12496, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Submitted initial enrollment request via BCBSTX website. Attached for reference. ', NULL, NULL, '2021-01-05 12:02:44', '2021-01-05 12:02:44'),
(8496, 1006, 12496, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Sent a follow-up email @ AncillaryContracting_SE@bcbstx.com', NULL, NULL, '2021-01-15 15:36:23', '2021-01-15 15:36:23'),
(8497, 1006, 12496, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Received the following reply: \"Dear Provider,   Thank you for submitting the Provider Onboarding Form.  We have reviewed your application and discovered that request is for an ancillary group. Therefore, your request has been rejected. Please contact TXFPS@bcbstx.com for the correct application for those provider types.    Thank you,  Provider Data Management BlueCross BlueShield of Texas\"  Sent a follow-up email @ TXFPS@bcbstx.com requesting information on how to proceed.  ', NULL, NULL, '2021-01-27 14:31:29', '2021-01-27 14:31:29'),
(8498, 1006, 12496, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Received following response, submitted another onboarding form to stop any delays: \"Hello Brad,     My apologies, I believe you may have been instructed incorrectly.  Facility/Ancillary records cannot have individuals set up under them, so this should be set up as a professional group through our online Onboarding Form.  I will forward your email to the management over the team that handles those requests so they can make sure their team does not make this mistake again, and I will see if they can resume your application.  I will advise you to go ahead and resubmit online as well, because that may end up being faster to get your record set up.     Thank you,     Facility Provider Services  BlueCross BlueShield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company  Fax: 972-766-7315 | Email: TXFPS@bcbstx.com\"', NULL, NULL, '2021-01-28 17:43:52', '2021-01-28 17:43:52'),
(8499, 1006, 12496, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Call received from BCBS regarding group contract process, it\'s currently processing and we should receive the completed PAR plan by tomorrow.  BCBS Provider Group ID# 00PA77', NULL, NULL, '2021-02-08 10:45:38', '2021-02-08 10:45:38'),
(8500, 1006, 12496, NULL, '2021-03-05 00:00:00.000', 'Approved', 'Network Name	                                   Network Effective Date BAV - Blue Advantage HMO	                   02/25/2021 HMO - Blue Essentials	                                   02/25/2021 BCA - BlueChoice PPO	                                   02/25/2021 SNP - Dual Eligible Special Needs Plan	   02/25/2021 HME - Health Select	                                   02/25/2021 MCH - Medicare Advantage HMO	           02/25/2021 PMC - Medicare Advantage PPO	           02/25/2021 WEL - WellMed MA HMO	                           02/25/2021', NULL, NULL, '2021-02-26 09:30:44', '2021-02-26 09:30:44'),
(8501, 1006, 12497, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:01:50', '2021-01-05 12:01:50'),
(8502, 1006, 12497, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Submitted initial enrollment request via BCBSTX website. Attached for reference. ', NULL, NULL, '2021-01-05 12:02:51', '2021-01-05 12:02:51'),
(8503, 1006, 12497, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Sent a follow-up email @ AncillaryContracting_SE@bcbstx.com', NULL, NULL, '2021-01-15 15:36:27', '2021-01-15 15:36:27'),
(8504, 1006, 12497, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Received the following reply: \"Dear Provider,   Thank you for submitting the Provider Onboarding Form.  We have reviewed your application and discovered that request is for an ancillary group. Therefore, your request has been rejected. Please contact TXFPS@bcbstx.com for the correct application for those provider types.    Thank you,  Provider Data Management BlueCross BlueShield of Texas\"  Sent a follow-up email @ TXFPS@bcbstx.com requesting information on how to proceed.  ', NULL, NULL, '2021-01-27 14:31:34', '2021-01-27 14:31:34'),
(8505, 1006, 12497, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Received following response, submitted another onboarding form to stop any delays: \"Hello Brad,     My apologies, I believe you may have been instructed incorrectly.  Facility/Ancillary records cannot have individuals set up under them, so this should be set up as a professional group through our online Onboarding Form.  I will forward your email to the management over the team that handles those requests so they can make sure their team does not make this mistake again, and I will see if they can resume your application.  I will advise you to go ahead and resubmit online as well, because that may end up being faster to get your record set up.     Thank you,     Facility Provider Services  BlueCross BlueShield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company  Fax: 972-766-7315 | Email: TXFPS@bcbstx.com\"', NULL, NULL, '2021-01-28 17:43:56', '2021-01-28 17:43:56'),
(8506, 1006, 12497, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Call received from BCBS regarding group contract process, it\'s currently processing and we should receive the completed PAR plan by tomorrow.  BCBS Provider Group ID# 00PA77', NULL, NULL, '2021-02-08 10:45:43', '2021-02-08 10:45:43'),
(8507, 1006, 12497, NULL, '2021-03-15 00:00:00.000', 'Approved', 'Group Name : RIGHT STEP MEDICAL CENTER LLC Group Record Id : H000PA7701  Provider Name : SHYBI P VARGHESE Provider Record Number : H08NW64101 Specialty : ANP/CERT/CLNP  Networks : Network Name	Network Effective Date BAV - Blue Advantage HMO	03/09/2021 HMO - Blue Essentials	03/09/2021 BCA - BlueChoice PPO	03/09/2021 SNP - Dual Eligible Special Needs Plan	03/09/2021 HME - Health Select	03/09/2021 MCH - Medicare Advantage HMO	03/09/2021 PMC - Medicare Advantage PPO	03/09/2021 WEL - WellMed MA HMO	03/09/2021 ', NULL, NULL, '2021-03-08 15:09:48', '2021-03-08 15:09:48'),
(8508, 3040, 12498, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:30:14', '2021-01-05 12:30:14'),
(8509, 3040, 12498, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Fernandus, Limy || UHC ||  Greetings,  Hope you are doing well. Please find below the information for practice and providers for enrollment in United Health care for our group Normandy Urgent Care Center and Imperial Valley Urgent Care Center.  Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060   Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.   Thanks.', NULL, NULL, '2021-01-05 12:31:01', '2021-01-05 12:31:01'),
(8510, 3040, 12498, NULL, '2021-01-12 00:00:00.000', 'In Process', 'Request For Participation Form Submitted online on 01/05/2021.  Please see attachment.  ', NULL, NULL, '2021-01-05 17:56:16', '2021-01-05 17:56:16'),
(8511, 3040, 12498, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject; LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC ||  Greetings,  Hope you are doing well. Please find the attached letter of intent for linking the provider with United Healthcare with an existing In-Network Tax ID.   Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Provider Name: Limy Fernandus  Provider NPI# 1972005189  If you need anything else please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-06 17:04:27', '2021-01-06 17:04:27'),
(8512, 3040, 12498, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Reference Number: PR-5672261  Received On: Jan 6, 2021 3:52:55 PM', NULL, NULL, '2021-01-06 18:13:53', '2021-01-06 18:13:53'),
(8513, 3040, 12498, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. I really appreciate your prompt response. Please find below the information that you requested in your previous email.   1. The NPI ending 171077 is linked with the Imperial valley urgent care as a secondary address.   2. No, Imperial Urgent Care Center doesn\'t have a separate NPI number; it\'s the same Normandy Urgent Care Center. Yes, it is listed as doing business as a name group and I checked the NPI registry over there the address is mentioned.   3. We don\'t want the Imperial Urgent Care Center as a separate group. Please find the attached the W9 form for Imperial Valley Urgent Care Center.   If you need any additional information please feel to call or email me. Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-01-13 10:56:58', '2021-01-13 10:56:58'),
(8514, 3040, 12498, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  We’ve reviewed the provider/group updates you requested on Jan 13, 2021 7:13:34 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care; Last 4-Digits of TIN: 6429 Request: Add the above group. 1: The NPI number provided in the clarification response ending in 171077 brings up Normandy Urgent Care Center in the NPI Registry. It does not list Imperial Urgent Care Center. 2: Can you verify if Imperial Urgent Care Center should be a separate group with a Type 2-NPI number that is different than Normandy Urgent Care Center or should it be listed with Normandy Urgent Care Center NPI number you provided as the Doing Business As name group. If you want it as the Doing Business As name group you will need to contact the NPI Registry and have it updated before we can add the group. 3: If you want Imperial Urgent Care Center as a separate group by itself, you will need to contact the NPI Registry and get a new Type-2 NPI number for that group that is different than the one you provided. We will also need a new W-9 with Imperial Valley Urgent Care on the top line in order to add the group.    If we don’t receive a response by Jan 21, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.    Questions? We’re here to help. For questions pertaining to this communication, contact us at submission_inquiry@uhc.com. Please include the reference number in the subject line of your email.    Thank you.', NULL, NULL, '2021-01-13 10:58:29', '2021-01-13 10:58:29'),
(8515, 3040, 12498, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings, \' Hope you are doing well. Please find below the information that you requested in your previous email.   Start date the group opened: 10/31/2013  NPI number of the group: 1407171077  Billing and place of service address: 16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Kindly add Limy Fernandus in both practices in Normandy Urgent Care as well as Imperial Valley Urgent Care Center.  If you need any additional information please feel free to email or contact me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-13 11:00:36', '2021-01-13 11:00:36'),
(8516, 3040, 12498, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  We’ve reviewed the provider/group updates you requested on Jan 12, 2021 5:34:19 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care Center; Last 4-Digits of TIN: 6429  Request: Add the above group.  1: We currently do not have this group linked to this Tax ID in our system, we only have Normandy Urgent Care Center in our system. Please provide the following information: if we need to add Imperial Valley Urgent Care Center can you verify the start date the group opened, the NPI number for the new group, and verify the billing and place of service addresses for the new group, or verify is we should add Limy Fernandus to Normandy Urgent Care Center.    If we don’t receive a response by Jan 20, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.    Questions? We’re here to help. For questions pertaining to this communication, contact us at submission_inquiry@uhc.com. Please include the reference number in the subject line of your email.     Thank you.', NULL, NULL, '2021-01-13 11:01:32', '2021-01-13 11:01:32'),
(8517, 3040, 12498, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,   Hope you are doing well. This has been updated. Please let me know if any additional information is needed.  Thanks', NULL, NULL, '2021-01-15 13:56:18', '2021-01-15 13:56:18'),
(8518, 3040, 12498, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  UnitedHealthcare Insurance Company   We’ve reviewed the provider/group updates you requested on Jan 14, 2021 5:58:37 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care Center; Last 4-Digits of TIN: 6429 Request: Add the above group. 1: In order for us to do what you are asking; you need to have NPPES updated to say Doing Business As Imperial Valley Urgent Care Center directly under the name Normandy Urgent Care Center. It is not enough to just have the address listed. Once this update is made please respond back and we can add the provider to this tin/group NPI with the DBA Imperial Valley Urgent Care Center.    If we don’t receive a response by Jan 22, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.  ', NULL, NULL, '2021-01-15 13:57:59', '2021-01-15 13:57:59'),
(8519, 3040, 12498, NULL, '2021-01-29 00:00:00.000', 'In Process', 'Follow up email sent to: unitedhealthcare_request_addlinfo@uhc.com,  networkhelp@uhc.com,  hpdemo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment of the below mentioned provider. Has there been any update?   Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060   Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-22 12:19:55', '2021-01-22 12:19:55'),
(8520, 3040, 12498, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com,  networkhelp@uhc.com,  hpdemo@uhc.com, submission_inquiry@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. Please note that it has been updated in the NPPES system the day we received the email. Kindly find the attached screenshot from NPPES website. PR-5699190  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-25 17:22:58', '2021-01-25 17:22:58'),
(8521, 3040, 12498, NULL, '2021-02-02 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject:  Secure Message from CAROL.LEE-BRYANT@uhc.com  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry. I attached your NPPES screenshot to PR-567226 currently in process. LIMY FERNANDUS currently out of network for tax id 27-0796429.', NULL, NULL, '2021-01-26 14:45:12', '2021-01-26 14:45:12'),
(8522, 3040, 12498, NULL, '2021-02-09 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. I just wanted to follow up regarding the enrollment status of the below mentioned provider. PR. 567226.  Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-02 13:10:36', '2021-02-02 13:10:36'),
(8523, 3040, 12498, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Can you please advise me on what is required to link the below mentioned provider to our group?  Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can. Waiting for your response.   Thanks ', NULL, NULL, '2021-02-03 17:54:05', '2021-02-03 17:54:05'),
(8524, 3040, 12498, NULL, '2021-02-11 00:00:00.000', 'In Process', 'Email rcvd from: amanda_vandiver@uhc.com  Subject: Secure Message from amanda_vandiver@uhc.com  Good morning.  Regarding the below, nothing further is need at this time. Your request for updates is currently in process (reference number PR-5672261) and you will receive a response when it is completed.  Please allow 30-90 days.  Thank you!  Please send all responses or questions pertaining to this email to networkhelp@uhc.com for further assistance.  If sent to amanda_vandiver@uhc.com, it will be considered responded to already and will be deleted.', NULL, NULL, '2021-02-04 09:18:34', '2021-02-04 09:18:34'),
(8525, 3040, 12498, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-11 09:58:58', '2021-02-11 09:58:58'),
(8526, 3040, 12498, NULL, '2021-02-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261=  Greetings,  This is a follow up email regarding the enrollment status for the below mentioned provider.   Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-18 14:12:42', '2021-02-18 14:12:42'),
(8527, 3040, 12498, NULL, '2021-02-26 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from tracy_brooks@uhc.com  Thank you for contacting the Network Management Resource Team. We will be happy to try to assist with your inquiry. PR 5672261 has been received and is in progress. Please allow 45 business days to complete. You will be sent an email letting you know when this request is completed.   Please send all responses or questions pertaining to this email to networkhelp@uhc.com for further assistance.  If sent to tracy_brooks@uhc.com, it will be considered responded to already and will be deleted.  Thank You,  Tracy Brooks United Healthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-02-19 14:55:20', '2021-02-19 14:55:20'),
(8528, 3040, 12498, NULL, '2021-03-05 00:00:00.000', 'Approved', 'Ancillary Contract. No need to add individual provider. ', NULL, NULL, '2021-02-26 10:54:54', '2021-02-26 10:54:54'),
(8529, 3040, 12499, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:31:33', '2021-01-05 12:31:33'),
(8530, 3040, 12499, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Fernandus, Limy || UHC ||  Greetings,  Hope you are doing well. Please find below the information for practice and providers for enrollment in United Health care for our group Normandy Urgent Care Center and Imperial Valley Urgent Care Center.  Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060   Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.   Thanks.', NULL, NULL, '2021-01-05 12:32:17', '2021-01-05 12:32:17'),
(8531, 3040, 12499, NULL, '2021-01-12 00:00:00.000', 'In Process', 'Request For Participation Form Submitted online on 01/05/2021.  Please see attachment.  ', NULL, NULL, '2021-01-05 17:56:13', '2021-01-05 17:56:13'),
(8532, 3040, 12499, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject; LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC ||  Greetings,  Hope you are doing well. Please find the attached letter of intent for linking the provider with United Healthcare with an existing In-Network Tax ID.   Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Provider Name: Limy Fernandus  Provider NPI# 1972005189  If you need anything else please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-06 17:03:54', '2021-01-06 17:03:54'),
(8533, 3040, 12499, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Reference Number: PR-5672261  Received On: Jan 6, 2021 3:52:55 PM', NULL, NULL, '2021-01-06 18:14:15', '2021-01-06 18:14:15'),
(8534, 3040, 12499, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. I really appreciate your prompt response. Please find below the information that you requested in your previous email.   1. The NPI ending 171077 is linked with the Imperial valley urgent care as a secondary address.   2. No, Imperial Urgent Care Center doesn\'t have a separate NPI number; it\'s the same Normandy Urgent Care Center. Yes, it is listed as doing business as a name group and I checked the NPI registry over there the address is mentioned.   3. We don\'t want the Imperial Urgent Care Center as a separate group. Please find the attached the W9 form for Imperial Valley Urgent Care Center.   If you need any additional information please feel to call or email me. Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-01-13 10:57:00', '2021-01-13 10:57:00'),
(8535, 3040, 12499, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  We’ve reviewed the provider/group updates you requested on Jan 13, 2021 7:13:34 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care; Last 4-Digits of TIN: 6429 Request: Add the above group. 1: The NPI number provided in the clarification response ending in 171077 brings up Normandy Urgent Care Center in the NPI Registry. It does not list Imperial Urgent Care Center. 2: Can you verify if Imperial Urgent Care Center should be a separate group with a Type 2-NPI number that is different than Normandy Urgent Care Center or should it be listed with Normandy Urgent Care Center NPI number you provided as the Doing Business As name group. If you want it as the Doing Business As name group you will need to contact the NPI Registry and have it updated before we can add the group. 3: If you want Imperial Urgent Care Center as a separate group by itself, you will need to contact the NPI Registry and get a new Type-2 NPI number for that group that is different than the one you provided. We will also need a new W-9 with Imperial Valley Urgent Care on the top line in order to add the group.    If we don’t receive a response by Jan 21, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.    Questions? We’re here to help. For questions pertaining to this communication, contact us at submission_inquiry@uhc.com. Please include the reference number in the subject line of your email.    Thank you.', NULL, NULL, '2021-01-13 10:58:41', '2021-01-13 10:58:41'),
(8536, 3040, 12499, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings, \' Hope you are doing well. Please find below the information that you requested in your previous email.   Start date the group opened: 10/31/2013  NPI number of the group: 1407171077  Billing and place of service address: 16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Kindly add Limy Fernandus in both practices in Normandy Urgent Care as well as Imperial Valley Urgent Care Center.  If you need any additional information please feel free to email or contact me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-13 11:00:35', '2021-01-13 11:00:35'),
(8537, 3040, 12499, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  We’ve reviewed the provider/group updates you requested on Jan 12, 2021 5:34:19 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care Center; Last 4-Digits of TIN: 6429  Request: Add the above group.  1: We currently do not have this group linked to this Tax ID in our system, we only have Normandy Urgent Care Center in our system. Please provide the following information: if we need to add Imperial Valley Urgent Care Center can you verify the start date the group opened, the NPI number for the new group, and verify the billing and place of service addresses for the new group, or verify is we should add Limy Fernandus to Normandy Urgent Care Center.    If we don’t receive a response by Jan 20, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.    Questions? We’re here to help. For questions pertaining to this communication, contact us at submission_inquiry@uhc.com. Please include the reference number in the subject line of your email.     Thank you.', NULL, NULL, '2021-01-13 11:01:39', '2021-01-13 11:01:39'),
(8538, 3040, 12499, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,   Hope you are doing well. This has been updated. Please let me know if any additional information is needed.  Thanks', NULL, NULL, '2021-01-15 13:56:20', '2021-01-15 13:56:20'),
(8539, 3040, 12499, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email rcvd from: unitedhealthcare_request_addlinfo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  UnitedHealthcare Insurance Company   We’ve reviewed the provider/group updates you requested on Jan 14, 2021 5:58:37 AM, Your request was assigned reference number PR-5672261 . The subject of your original submission was: LOI For Linkage || Fernandus, Limy || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || UHC || . Action Required Reply to this email to supply the following information:  Imperial Valley Urgent Care Center; Last 4-Digits of TIN: 6429 Request: Add the above group. 1: In order for us to do what you are asking; you need to have NPPES updated to say Doing Business As Imperial Valley Urgent Care Center directly under the name Normandy Urgent Care Center. It is not enough to just have the address listed. Once this update is made please respond back and we can add the provider to this tin/group NPI with the DBA Imperial Valley Urgent Care Center.    If we don’t receive a response by Jan 22, 2021 8:00:00 AM. we may not be able to make all of the updates you requested.  ', NULL, NULL, '2021-01-15 13:58:07', '2021-01-15 13:58:07'),
(8540, 3040, 12499, NULL, '2021-01-29 00:00:00.000', 'In Process', 'Follow up email sent to: unitedhealthcare_request_addlinfo@uhc.com,  networkhelp@uhc.com,  hpdemo@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment of the below mentioned provider. Has there been any update?   Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060   Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-22 12:20:01', '2021-01-22 12:20:01'),
(8541, 3040, 12499, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Email sent to: unitedhealthcare_request_addlinfo@uhc.com,  networkhelp@uhc.com,  hpdemo@uhc.com, submission_inquiry@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. Please note that it has been updated in the NPPES system the day we received the email. Kindly find the attached screenshot from NPPES website. PR-5699190  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-25 17:23:05', '2021-01-25 17:23:05'),
(8542, 3040, 12499, NULL, '2021-02-02 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject:  Secure Message from CAROL.LEE-BRYANT@uhc.com  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry. I attached your NPPES screenshot to PR-567226 currently in process. LIMY FERNANDUS currently out of network for tax id 27-0796429.', NULL, NULL, '2021-01-26 14:45:20', '2021-01-26 14:45:20'),
(8543, 3040, 12499, NULL, '2021-02-09 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Hope you are doing well. I just wanted to follow up regarding the enrollment status of the below mentioned provider. PR. 567226.  Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-02 13:10:42', '2021-02-02 13:10:42'),
(8544, 3040, 12499, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261  Greetings,  Can you please advise me on what is required to link the below mentioned provider to our group?  Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can. Waiting for your response.   Thanks ', NULL, NULL, '2021-02-03 17:54:10', '2021-02-03 17:54:10'),
(8545, 3040, 12499, NULL, '2021-02-11 00:00:00.000', 'In Process', 'Email rcvd from: amanda_vandiver@uhc.com  Subject: Secure Message from amanda_vandiver@uhc.com  Good morning.  Regarding the below, nothing further is need at this time. Your request for updates is currently in process (reference number PR-5672261) and you will receive a response when it is completed.  Please allow 30-90 days.  Thank you!  Please send all responses or questions pertaining to this email to networkhelp@uhc.com for further assistance.  If sent to amanda_vandiver@uhc.com, it will be considered responded to already and will be deleted.', NULL, NULL, '2021-02-04 09:18:41', '2021-02-04 09:18:41'),
(8546, 3040, 12499, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-11 09:59:06', '2021-02-11 09:59:06'),
(8547, 3040, 12499, NULL, '2021-02-25 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Clarification on Previous UnitedHealthcare Data Request - Reference: PR-5672261=  Greetings,  This is a follow up email regarding the enrollment status for the below mentioned provider.   Primary Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015  Secondary Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID# 27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-18 14:12:48', '2021-02-18 14:12:48'),
(8548, 3040, 12499, NULL, '2021-02-26 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from tracy_brooks@uhc.com  Thank you for contacting the Network Management Resource Team. We will be happy to try to assist with your inquiry. PR 5672261 has been received and is in progress. Please allow 45 business days to complete. You will be sent an email letting you know when this request is completed.   Please send all responses or questions pertaining to this email to networkhelp@uhc.com for further assistance.  If sent to tracy_brooks@uhc.com, it will be considered responded to already and will be deleted.  Thank You,  Tracy Brooks United Healthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-02-19 14:55:25', '2021-02-19 14:55:25'),
(8549, 3040, 12499, NULL, '2021-03-05 00:00:00.000', 'Approved', 'Ancillary Contract. No need to add individual provider. ', NULL, NULL, '2021-02-26 10:54:55', '2021-02-26 10:54:55'),
(8550, 3040, 12500, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:32:46', '2021-01-05 12:32:46'),
(8551, 3040, 12500, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || || Longpoint Medical Center || Fernandus, Limy || UHC ||  Greetings,  Hope you are doing well. Please find below the information for practice and providers for enrollment in United Health care for our group Longpoint Medical Center.  Practice 1: Practice Name: Longpoint Medical Center Practice NPI# 1770763815 Practice Tax ID# 76-0612416 Address: 9504 LONG POINT RD STE E Houston , TX 77055  Provider Information:  Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.   Thanks.', NULL, NULL, '2021-01-05 12:33:35', '2021-01-05 12:33:35'),
(8552, 3040, 12500, NULL, '2021-01-12 00:00:00.000', 'In Process', 'Request For Participation Form Submitted online on 01/05/2021.  Please see attachment.', NULL, NULL, '2021-01-05 16:51:00', '2021-01-05 16:51:00'),
(8553, 3040, 12500, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject; LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Greetings,  Hope you are doing well. Please find the attached letter of intent for linking the provider with United Healthcare with an existing In-Network Tax ID.   Practice Name: Long Point Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Provider Name: Limy Fernandus  Provider NPI# 1972005189  If you need anything else please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-06 17:02:39', '2021-01-06 17:02:39');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(8554, 3040, 12500, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Reference Number: PR-5672263  Received On: Jan 6, 2021 3:52:57 PM', NULL, NULL, '2021-01-06 18:14:58', '2021-01-06 18:14:58'),
(8555, 3040, 12500, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Greetings,  Hope you are doing well. I wanted to know the status of application regarding my previous email. Reference Number: PR-5672263.  Any update?    If you need anything else from my side please call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-13 12:07:12', '2021-01-13 12:07:12'),
(8556, 3040, 12500, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject:  Secure message from United_Healthcare_Provider_Operations@uhc.com  Thank you for submitting the attached request to update information within United Healthcare’s systems. We’ll begin working on the updates and will notify you when it’s completed or if additional information is needed. For your convenience, here are the request details:  Reference Number: PR-5690595  Received On: Jan 19, 2021 9:47:16 AM ', NULL, NULL, '2021-01-19 14:51:29', '2021-01-19 14:51:29'),
(8557, 3040, 12500, NULL, '2021-01-29 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from tanie_smith@uhc.com  Thank you for contacting the Network Management Resource Team.  Pr- 5690595 was closed because it was an inquire request and the demographic  department do not take inquires at the hpdemo email address.  Reviewing PR-5672263, it shows it was received on 01/08/21 is still processing.   The contract effective date is based on the language within your agreement. We recommend reviewing it again.  “If a new professional joins your professional staff, you will give us 60 days notice and provide the information included in Appendix 4. You will assure that the new professional will promptly submit a credentialing application to us (unless the new professional is already credentialed with us) and cooperate with our credentialing program.”', NULL, NULL, '2021-01-22 17:32:22', '2021-01-22 17:32:22'),
(8558, 3040, 12500, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-01 16:56:29', '2021-02-01 16:56:29'),
(8559, 3040, 12500, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Follow up email sent to: hpdemo@uhc.com, networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider. PR 5672263.  Practice Details: Practice Name: Long Point Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Detail: Provider Name: Limy Fernandus  Provider NPI# 1972005189  Please get back to me as soon as you get a chance. Waiting to your response.   Thanks', NULL, NULL, '2021-02-08 13:09:59', '2021-02-08 13:09:59'),
(8560, 3040, 12500, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from tracy_brooks@uhc.com  Thank you for contacting the Network Management Resource Team. We will be happy to try to assist with your inquiry. Our records indicate the provider has been demographically linked to your TIN. Contracting is still in process. Please allow 30-45 business days for contracting to complete. Please let us know if we can assist further.  If you have any questions or concerns about the content of this email, please do not reply to this email but rather email directly to: networkhelp@uhc.com for further assistance.  Thank you,', NULL, NULL, '2021-02-08 17:00:02', '2021-02-08 17:00:02'),
(8561, 3040, 12500, NULL, '2021-02-22 00:00:00.000', 'In Process', 'Follow up email sent to: hpdemo@uhc.com, networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Good Morning,  I hope you are doing well. Please advise me the status of the enrollment for the below mentioned provider.  Practice Details: Practice Name: Long Point Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Detail: Provider Name: Limy Fernandus  Provider NPI# 1972005189  Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-02-15 12:05:40', '2021-02-15 12:05:40'),
(8562, 3040, 12500, NULL, '2021-02-22 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from kathleen_m_mcnulty@uhc.com  Thank you for contacting UnitedHealthcare network.  The provider request to be linked to the group is still in process, PR-5671545.  This was submitted 1/7/21.  Please allow 45-60 days to link the provider.  Please let us know if there is anything else we can help with.', NULL, NULL, '2021-02-15 17:51:34', '2021-02-15 17:51:34'),
(8563, 3040, 12500, NULL, '2021-03-01 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject:  LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Greetings,  Hope you had a great weekend. I just wanted to follow up regarding the enrollment status for the below mentioned provider. PR-5671545.  Practice Details: Practice Name: Long Point Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Detail: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can get a chance, Waiting for your response.   Thanks', NULL, NULL, '2021-02-22 10:49:27', '2021-02-22 10:49:27'),
(8564, 3040, 12500, NULL, '2021-03-01 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from brian_k_autio@uhc.com  Good afternoon Adil,  Thank you for contacting the Network Management Resource Team. The provider has been linked to the group Tax ID, 760612416, but the contract has not been loaded yet. Request, PR-5671545, is still in process and should be completed very soon. Please feel free to email us at networkhelp@uhc.com to check the status of the request.  Please let us know if we can assist further via email. All responses must only be sent to networkhelp@uhc.com, so we don’t receive duplicate emails. Any emails sent to my personal email will be deleted.  If you have any questions or concerns about the content of this email, please do not reply to this email but rather email directly to: networkhelp@uhc.com for further assistance.  Brian K. Autio Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)   ', NULL, NULL, '2021-02-22 16:49:13', '2021-02-22 16:49:13'),
(8565, 3040, 12500, NULL, '2021-03-08 00:00:00.000', 'In Process', 'Email sent to: nelly_tully@uhc.com, networkhelp@uhc.com  Subject: Secure Message from nelly_tully@uhc.com  Greetings,  Hope you are doing well. I received an email from your side and they requested to send you the Medicare and Medicaid IDs. Below are the requested information:  Medicare ID: 1K5906 Medicaid ID: 409520003  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-03-01 15:10:03', '2021-03-01 15:10:03'),
(8566, 3040, 12500, NULL, '2021-03-08 00:00:00.000', 'In Process', 'Email rcvd from: nelly_tully@uhc.com  Subject: Secure Message from nelly_tully@uhc.com  Good morning,  Please provide the Medicare and Medicaid IDs for Limy Fernandus and Tax ID 76-0612416.  Thank you  Nelly Tully  Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group   ', NULL, NULL, '2021-03-01 15:10:52', '2021-03-01 15:10:52'),
(8567, 3040, 12500, NULL, '2021-03-09 00:00:00.000', 'In Process', 'Email rcvd from: nelly_tully@uhc.com  Subject: Secure Message from nelly_tully@uhc.com  Good morning,  Thank you for the quick response! I have forwarded the information you provided to the loading team already.  Regards,  Nelly Tully  Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group   ', NULL, NULL, '2021-03-02 09:18:07', '2021-03-02 09:18:07'),
(8568, 3040, 12500, NULL, '2021-03-09 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jean.lambert@optum.com  Good Morning,  Thank you for contacting the Network Management Resource Team. Our records show that the Medicare & Medicaid ID that you have provided have been noted on updated PR-5672263.   Please let us know if we can assist further via email.   This was sent by a general email box. \"Reply\" messages are automatically deleted and will not receive a response. Please direct all replies, questions, or concerns to Network Management to networkhelp@uhc.com for further assistance; thank you.  Je’an Lambert United Healthcare Network Management Resource Team (NMRT) ', NULL, NULL, '2021-03-02 10:30:42', '2021-03-02 10:30:42'),
(8569, 3040, 12500, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Jan 6, 2021 3:52:57 PM. Your request was assigned reference number PR-5672263 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations', NULL, NULL, '2021-03-05 12:11:51', '2021-03-05 12:11:51'),
(8570, 3040, 12500, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com, submission_inquiry@uhc.com, networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Hello,  Hope you are doing well. This is a follow up email regarding the enrollment status for the below mentioned provider.   Practice Details: Practice Name: Long Point Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Detail: Provider Name: Limy Fernandus Provider NPI# 1972005189 MPIN# 007241662 Reference# PR-5672263  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-03-18 10:18:18', '2021-03-18 10:18:18'),
(8571, 3040, 12500, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Email rcvd from: submission_inquiry@uhc.com  Subject: Secure Message from tremacie_a_stone@uhc.com  Good Afternoon Adil Abbas,  Your request for updates for provider Limy Fernandus TAX ID 2416* is currently in process and you will receive a response when it is completed.  Have a great day!  Tremacie UnitedHealthcare Operations *--SecureDelivery--*', NULL, NULL, '2021-03-19 14:41:08', '2021-03-19 14:41:08'),
(8572, 3040, 12500, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com, submission_inquiry@uhc.com, networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Longpoint Medical Center || UHC ||  Greetings,   Hope you are doing well. Please find the attached sheet that I received from your side and its mentioning the provider status completed. Can you please send me the effective date.   Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-04-14 10:01:08', '2021-04-14 10:01:08'),
(8573, 3040, 12500, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Mar 2, 2021 4:58:15 PM. Your request was assigned reference number PR-5770077 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations ', NULL, NULL, '2021-04-14 10:01:55', '2021-04-14 10:01:55'),
(8574, 3040, 12500, NULL, '2021-04-22 00:00:00.000', 'Approved', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from MAX.CONTRERAS@uhc.com  Hello and thank you for contacting the Network Management Resource Team.  The loading for LIMY FERNANDUS, NP , MPIN (Provider Number): 7241662 has been completed. Provider is showing as participating effective 03/06/2021 under group TIN # 76-0612416.  Please let us know if we can assist further via email.  *--SecureDelivery--* Sincerely, Max Contreras Jr. Network Management Resource Team (NMRT) United Healthcare', NULL, NULL, '2021-04-15 14:03:19', '2021-04-15 14:03:19'),
(8575, 3040, 12501, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 12:33:55', '2021-01-05 12:33:55'),
(8576, 3040, 12501, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Columbus Urgent Care PA || Fernandus, Limy || UHC ||  Greetings,  Hope you are doing well. Please find below the information for practice and providers for enrollment in United Health care for our group Columbus Urgent Care PA.  Practice 1: Practice Name: Columbus Urgent Care PA Practice NPI# 1215330501 Practice Tax ID# 47-1914151 Address: 926 Walnut St, Columbus , TX 78934  Provider Information:  Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.   Thanks.', NULL, NULL, '2021-01-05 12:34:34', '2021-01-05 12:34:34'),
(8577, 3040, 12501, NULL, '2021-01-12 00:00:00.000', 'In Process', 'Request For Participation Form Submitted online on 01/05/2021.  Please see attachment.  ', NULL, NULL, '2021-01-05 15:54:22', '2021-01-05 15:54:22'),
(8578, 3040, 12501, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Columbus Urgent Care PA || UHC ||  Greetings,  Hope you are doing well. Please find the attached letter of intent for linking the provider with United Healthcare with an existing In-Network Tax ID.   Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Provider Name: Limy Fernandus  Provider NPI# 1972005189  If you need anything else please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-06 16:55:14', '2021-01-06 16:55:14'),
(8579, 3040, 12501, NULL, '2021-01-13 00:00:00.000', 'In Process', 'Reference Number: PR-5672260  Received On: Jan 6, 2021 3:52:53 PM ', NULL, NULL, '2021-01-06 17:29:56', '2021-01-06 17:29:56'),
(8580, 3040, 12501, NULL, '2021-01-15 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  We’ve completed our review of the submission that you sent on Jan 6, 2021 3:52:53 PM and determined that no action is needed at this time. Specifically, no action is needed because: We have previously received a copy of this request and  it has been submitted for processing. The previous reference number is PR-5671060..  The subject of your original email submission was: LOI For Linkage || Fernandus, Limy || Columbus Urgent Care PA || UHC ||.   The request was assigned this reference number: PR-5672260.', NULL, NULL, '2021-01-08 09:31:26', '2021-01-08 09:31:26'),
(8581, 3040, 12501, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up Email sent to: hpdemo@uhc.com, Networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Columbus Urgent Care PA || UHC ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status of the below mentioned provider. Reference Number: PR-5672260.   Practice 1: Practice Name: Columbus Urgent Care PA Practice NPI# 1215330501 Practice Tax ID# 47-1914151 Address: 926 Walnut St, Columbus , TX 78934  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.  Thanks.  ', NULL, NULL, '2021-01-20 10:38:32', '2021-01-20 10:38:32'),
(8582, 3040, 12501, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  Thank you for submitting the attached request to update information within United Healthcare’s systems. We’ll begin working on the updates and will notify you when it’s completed or if additional information is needed. For your convenience, here are the request details:  Reference Number: PR-5692738  Received On: Jan 20, 2021 9:48:57 AM   If you have questions or need further assistance, please contact your Network Account Manager.  Thank you,  UnitedHealthcare Provider Operations ', NULL, NULL, '2021-01-20 14:01:53', '2021-01-20 14:01:53'),
(8583, 3040, 12501, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from gregory.s.carte@optum.com  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry. The service request number PR5672260 was considered a duplicate request and therefore closed. Please use service request number PR5671060 pending currently as of 1/6/2121 (linking the provider to the Tax ID record).  It can take approximately 45 business days for updates to process. Please use PR5671060 as your future follow up reference number.   ', NULL, NULL, '2021-01-21 12:15:48', '2021-01-21 12:15:48'),
(8584, 3040, 12501, NULL, '2021-01-29 00:00:00.000', 'In Process', 'Email sent to: Networkhelp@uhc.com  Subject: LOI For Linkage || Fernandus, Limy || Columbus Urgent Care PA || UHC ||  Greetings,  Hope you are doing well. I received an email from your side in which it\'s showing that you reviewed the provider/group updates and determined that our updates couldn\'t be completed. Please advise me what information you need from my side?  Reference Number: PR-5692738.   Practice 1: Practice Name: Columbus Urgent Care PA Practice NPI# 1215330501 Practice Tax ID# 47-1914151 Address: 926 Walnut St, Columbus , TX 78934  Provider Information: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need further information please feel free to call or email me. Waiting to hear from you soon.  Thanks.  ', NULL, NULL, '2021-01-22 17:39:23', '2021-01-22 17:39:23'),
(8585, 3040, 12501, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from j_mize@uhc.com  Good Morning-  The request to load contracts for your provider was closed at the Network Manager’s Request.  Please contact your Network Account Manager-                  Corey Ford                 (713) 232 3297                 Corey_j_ford@uhc.com  Thank you', NULL, NULL, '2021-01-25 14:33:14', '2021-01-25 14:33:14'),
(8586, 1006, 12501, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Request currently pending at Latresha\'s end sent the following email to her @ \"Coles, Latresha M\" latresha_m_coles@uhc.com: \"Hello,   I definitely appreciate the help, Corey.   @Latresha - I\'d appreciate it if you could please get back to us regarding what our options are for the group contract and how fast we would be able to set it up since we would also need to enroll our providers under it and that could take quite a while, so if there\'s any way to expedite both procedures I\'d definitely be thankful.   Thank you!\"', NULL, NULL, '2021-02-02 17:54:59', '2021-02-02 17:54:59'),
(8587, 1006, 12501, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Received the following reply from Coles, Latresha M latresha_m_coles@uhc.com: \"Greetings Brad,  As previously discussed, it is not our policy to contract urgent care centers, physicians, and medical groups, under the same TIN, under separate agreements.  This is something that cannot be administered  and you will need to make a business decision regarding how you would like to be contracted.  In our previous discussion you indicated that you would make a decision and get back to me.  Based on your request to reinstate the urgent care agreement, it appears that the decision was to be contracted as an urgent care center.   This prevents the contracting of a medical group agreement under this TIN.  As previously discussed, this will impact the current agreement for Dr. Rauf under this same TIN.  We will have to terminate his agreement, as we cannot not administer different types of agreements under the same TIN as there will be a negative impact on claims.  Please let me know if you have any additional questions.  Regards, Latresha Coles  Sr. Network Account Manager |UnitedHealthcare South Texas - Physician 2000 West Loop South, Suite 900, Houston, TX 77027 | (763)283-3194| 888-845-9481 (fax) | latresha_m_coles@uhc.com\"  Sent following reply:  \"Good morning Latresha,   I appreciate you finally getting back to me. We already made that business decision a few months ago when we asked Corey to remove the urgent care contract and initiated a request for the group contract. It wasn\'t our decision to reinstate the urgent care contract, Corey did that on his end as he did not see any other contracts and wanted our claims to be paid. As per my discussion with Corey, there was a group contract that was loaded under our group but wasn\'t set-up correctly and didn\'t have any physician lines on it, and my suggestion was to correct that group contract instead of reinstating the urgent care contract.   Do let me know how we can set up our group contract as it\'s been quite a few months already and we are still no further along than we were back then, so we need the request to be expedited as well.   Looking forward to hearing from you!  Thanks.\"', NULL, NULL, '2021-02-11 10:24:36', '2021-02-11 10:24:36'),
(8588, 3040, 12501, NULL, '2021-05-27 00:00:00.000', 'On Hold', 'Pending group enrollment. ', NULL, NULL, '2021-05-20 14:44:27', '2021-05-20 14:44:27'),
(8589, 1006, 12502, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 13:56:19', '2021-01-05 13:56:19'),
(8590, 1006, 12502, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Sent \"LOI\" @ psscentral@cigna.com: \"Hello,   We want to enroll the following ancillary group, the information is as follows:  Group Name: Right Step Medical Center LLC Address: 11925 Southwest Freeway, Suite 12, Stafford, TX 77477 TIN# 85-3252700 Services Provided: Urgent Care Services Contact Name: Brad Peterson Contact Number: 713-893-6214 Contact Email: rsm@claimsmedinc.com  Please let me know what is required to initiate this request as well as what is the expected time-frame for completion?  Thanks. \" ', NULL, NULL, '2021-01-05 13:56:57', '2021-01-05 13:56:57'),
(8591, 1006, 12502, NULL, '2021-01-21 00:00:00.000', 'In Process', 'The request was received and is in-process and has been moved to the credentialing department.   Rep: Natalie 01/12/2020', NULL, NULL, '2021-01-12 09:46:02', '2021-01-12 09:46:02'),
(8592, 1006, 12502, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ psscentral@cigna.com & PDM COGZ PDMCOGZ@cigna.com: \"Hello,  I wanted to get an update regarding the enrollment status for our group and providers:  Group Name: Right Step Medical Center LLC TIN# 85-3252700  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-03-08 15:43:28', '2021-03-08 15:43:28'),
(8593, 1006, 12502, NULL, '2021-03-25 00:00:00.000', 'In Process', 'As per the rep, the request will still be in-process as the time-frame is 90~120 days they cannot get any other updates until the time has elapsed.  Rep: Phil 03/18/2021', NULL, NULL, '2021-03-18 15:10:16', '2021-03-18 15:10:16'),
(8594, 1006, 12502, NULL, '2021-03-31 00:00:00.000', 'In Process', 'Requested a group contract as UC contract is taking too long and we haven\'t received any follow-ups from psscentral@cigna.com. Request can take up to 30~45 business days.   Contract received, signed and sent back. ', NULL, NULL, '2021-03-24 13:06:47', '2021-03-24 13:06:47'),
(8595, 1006, 12502, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Sent a follow-up email @ OnboardingStatus@Cigna.com & psscentral@cigna.com:  Sub: Enrollment Status - RSM - Cigna  \"Hello,   I wanted to get an update regarding the enrollment status of our group and providers, their information is as follows: Group Name: Right Step Medical Center TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687 Provider Name: Glory Abraham NPI# 1194206490 Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as you\'re able.   Thank you.\"', NULL, NULL, '2021-04-05 16:49:21', '2021-04-05 16:49:21'),
(8596, 1006, 12502, NULL, '2021-05-10 00:00:00.000', 'In Process', 'Re:	Reference number 12540899 Application to participate in the Cigna medical network Dear BELAKERE RAMEGOWDA,  Thank you for submitting an application to join a Cigna network. We have received your application and are in the process of reviewing it.  What happens next?  Once the application review is complete, we will begin the credentialing process. This usually takes 90 business days from the date we receive your completed application. In some states, individual mandates may affect turnaround time. We will contact you if there is any missing information.  Once the credentialing process is complete, we’ll let you know if you’ve been approved as a participating provider in the network(s) for which you\'ve applied.  Sincerely,  Cigna', NULL, NULL, '2021-05-03 07:49:31', '2021-05-03 07:49:31'),
(8597, 1006, 12502, NULL, '2021-05-14 00:00:00.000', 'In Process', 'Executed group contract received and attached for reference. ', NULL, NULL, '2021-05-07 14:21:57', '2021-05-07 14:21:57'),
(8598, 1006, 12502, NULL, '2021-06-02 00:00:00.000', 'Approved', 'Group is enrolled with Cigna, executed contract is attached for reference. ', NULL, NULL, '2021-05-26 11:27:57', '2021-05-26 11:27:57'),
(8599, 1006, 12503, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 15:28:55', '2021-01-05 15:28:55'),
(8600, 1006, 12503, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'As per my discussion with Humana on call submitted \"LOI\" @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I wish to get the following group enrolled with Humana, the group info is as follows:  Group Name: Right Step Medical Center LLC TIN# 85-3252700 Specialty: Urgentcare  Address: 11925 Southwest Freeway, Suite 12, Stafford, TX 77477  We also have the following providers that should be listed under the group: Provider Name: Shybi Varghese NPI# 1285270991 Provider Name: Abraham Glory NPI# 1194206490 Provider Name: Ramegowda Belakere NPI# 1235166687  Please get back to me as soon as you\'re able to.   Thanks.\" ', NULL, NULL, '2021-01-05 15:31:46', '2021-01-05 15:31:46'),
(8601, 1006, 12503, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Request has been received and is still pending processing.   Ref# 1000186164739', NULL, NULL, '2021-01-12 10:16:41', '2021-01-12 10:16:41'),
(8602, 1006, 12503, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,  I wanted to get an update regarding the enrollment status for our group and providers: Group Name: Right Step Medical Center LLC TIN# 85-3252700  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-03-08 15:45:11', '2021-03-08 15:45:11'),
(8603, 1006, 12503, NULL, '2021-03-22 00:00:00.000', 'In Process', 'Sent another f/u email @ humanahoustonpd@humana.com regarding status of enrollment, need to call in to check as well as request has been pending for a long while.  ', NULL, NULL, '2021-03-18 14:52:56', '2021-03-18 14:52:56'),
(8604, 1006, 12503, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Received the following denial letter from Humana:  \"Dear Provider, This letter serves as notice of denial of participation with Humana Health Plans of Texas, Humana Insurance Company, Inc and ChoiceCare. An analysis to determine if your services and specialty would complement our existing network was performed. The analysis process involves a review of network requirements, specialty needs, and geographical considerations. As a result of the analysis, we regret that we are unable to extend a participation agreement for Right Step Medical Center LLC. Please note that all requests are considered active for one year. Our office will contact you should our network requirements change during this period.  Please contact Michelle Horton at 713-513-4943 with any questions regarding this process.\"', NULL, NULL, '2021-03-22 08:41:26', '2021-03-22 08:41:26'),
(8605, 1006, 12503, NULL, '2021-04-09 00:00:00.000', 'In Process', 'Submitted a new LOI with different group specialty mentioned for enrollment purposes @ HumanaHoustonPD humanahoustonpd@humana.com:  Sub: Letter of Interest - RSM - Humana  \"Hello,   Please find the attached LOI for enrollment of our group & providers, please let me know if anything else is required.  Thank you. \"  Attached for reference. ', NULL, NULL, '2021-04-02 11:49:55', '2021-04-02 11:49:55'),
(8606, 1006, 12503, NULL, '2021-05-19 00:00:00.000', 'In Process', 'Sent a f/u email @ HumanaHoustonPD humanahoustonpd@humana.com:  Sub: Letter of Interest - RSM - Humana  \"Good morning,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for the following providers and group:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687 Provider Name: Glory Abraham NPI# 1194206490 Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible on the status of these.  Thank you. \"', NULL, NULL, '2021-05-03 08:14:36', '2021-05-03 08:14:36'),
(8607, 1006, 12503, NULL, '2021-05-14 00:00:00.000', 'Not Eligible', 'Humana replied with the following rejection again:  \"Dear Provider,  This letter serves as notice of denial of participation with Humana Health Plans of Texas, Humana Insurance Company, Inc and ChoiceCare.  An analysis to determine if your services and specialty would complement our existing network was performed. The analysis process involves a review of network requirements, specialty needs, and geographical considerations. As a result of the analysis, we regret that we are unable to extend a participation agreement for Right Step Medical Center LLC. Please note that all requests are considered active for one year.  Our office will contact you should our network requirements change during this period.  Please contact Michelle Horton at 713-513-4943 with any questions regarding this process.  Sincerely,  Matthew White,  Contracting Director, Provider Development, Houston\"', NULL, NULL, '2021-05-07 14:14:23', '2021-05-07 14:14:23'),
(8608, 19067, 12503, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email sent to: HumanaHoustonPD@humana.com  Subject: Enrollment Query || Group & Provider || RSM || Humana   Hello, Hope you had a nice weekend. I would like to enroll this group as In-Network with Humana. Group NameRight Step Medical Center LLCTax ID85-3252700 Group NPI1063008084Practice Location11925 Southwest Freeway, Suite 12 Stafford, TX 77477Provider NameNPIAni Stephen1588959118Ramegowda Belakere1235166687Glory Abraham1194206490Shybi Varghese1285270991Ancy Kurian1316558935  W9 is attached as well. Thanks & Regards,Ahmed, Hammad', NULL, NULL, '2021-12-20 17:04:57', '2021-12-20 17:04:57'),
(8609, 19067, 12503, NULL, '2022-01-05 00:00:00.000', 'In Process', 'Email sent to: HumanaHoustonPD@humana.com  Subject: Enrollment Status || Providers || SNBCARE || || HUMANA ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Providers.  Group Name	Right Step Medical Center LLC Tax ID	85-3252700 Group NPI	1063008084 Provider Name	NPI	Location Ani Stephen	1588959118	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Ancy Kurian	1316558935	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Glory Abraham	1194206490	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300 Ramegowda Belakere	1235166687	11925 Southwest Freeway, Suite 12 Stafford, TX 77477-2300   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-29 14:12:53', '2021-12-29 14:12:53'),
(8610, 19067, 12503, NULL, '2022-01-13 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Enrollment Query || Group & Provider || RSM || Humana  Thank you for your interest in joining Humana as a participating provider.  Please complete and return the attached document, in its original excel format, along with a W-9. Include all providers in the practice that wish to participate on the professional network roster, listing each service location on a separate line.     Please make sure CAQH is updated for all providers to prevent any delays in the contracting process. Additionally, ensure that Humana is included in the “List of Authorized Organizations” in order for Humana to have on-line access to the provider’s CAQH account and the provider has granted access to Humana to view the CAQH credentialing information.     Completion of this information is not a guarantee of participation. Look forward to receiving your documents for review and determination.     HumanaHoustonPD', NULL, NULL, '2022-01-06 18:01:15', '2022-01-06 18:01:15'),
(8611, 19067, 12503, NULL, '2022-02-01 00:00:00.000', 'In Process', 'Email sent to: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Group & Provider || RSM || Humana   Greetings!  Hope this email finds you well.  Kindly see the attached Roster and W9 as requested.  Don\'t hesitate to contact me if you need anything.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-25 14:27:14', '2022-01-25 14:27:14'),
(8612, 19067, 12503, NULL, '2022-02-15 00:00:00.000', 'In Process', 'Secure email received from: MDuffee@humana.com  Subject: Secured: FW: Enrollment Query || Group & Provider || RSM || Humana    Shybi Varghese – State License needed, Medicare information required, and full hospital privileges are needed.  In lieu of the midlevel having privilege’s,  we will accept a covering provider however it does need to be documented within CAQH.  Please notify me when all information has been updated and the documents needed are viewable.  If you have any further questions, please let me know.  Thank you.', NULL, NULL, '2022-02-08 16:28:09', '2022-02-08 16:28:09'),
(8613, 19067, 12503, NULL, '2022-02-25 00:00:00.000', 'In Process', 'Secure email received from: MDuffee@humana.com  Subject: Secured: FW: Enrollment Query || Group & Provider || RSM || Humana    Good morning Hammad,  2 providers on your roster will need credentialing and each will need updates to their CAQH information. Please note the following:  Ancy Kurian – CAQH is not complete.  Shybi Varghese – State License needed, Medicare information required, and full hospital privileges are needed.  In lieu of the midlevel having privilege’s,  we will accept a covering provider however it does need to be documented within CAQH.  Please notify me when all information has been updated and the documents needed are viewable.  If you have any further questions, please let me know.  Thank you.   ', NULL, NULL, '2022-02-18 11:51:14', '2022-02-18 11:51:14'),
(8614, 19067, 12503, NULL, '2022-03-03 00:00:00.000', 'In Process', 'Email sent to: MDuffee@humana.com  Subject: Re: Secured: FW: Enrollment Query || Group & Provider || RSM || Humana   Hi,  Thanks for the update.   Shybi Varghese & Ancy Kurian\'s CAQH has been updated.   If you need any document or information don\'t hesitate to reach out to me directly.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-24 10:50:16', '2022-02-24 10:50:16'),
(8615, 19067, 12503, NULL, '2022-03-18 00:00:00.000', 'In Process', 'Secure email received from: noreply@onlinesecuremail.com  Subject: RE: Enrollment Query || Group & Provider || RSM || Humana    Your request has been in process for over 60 days (since 12/20/21) and the necessary information has not been supplied.     Shybi Varghese’s CAQH record still does not have a proper state license posted.  Ancy  Kurian is non par for Medicare and does not have full hospital privileges listed in the Provider Profile.  Humana’s credentialing department only uses CAQH, therefore these items must be updated and reflecting in CAQH.  This market office will not submit your request in this incomplete condition for credentialing as the providers will be denied.  Once denied, the process to resubmit becomes complicated.      If this information isn’t supplied and resolved by 2/28/2022, the file will be permanently closed and a new application will be required.  As always, it is the responsibility of the applicant to notify us if/when this is addressed as we do not audit applicants for follow up actions.     Thank you for your immediate attention to this matter,     HumanaHoustonPD', NULL, NULL, '2022-03-11 13:43:46', '2022-03-11 13:43:46'),
(8616, 19067, 12503, NULL, '2022-03-18 00:00:00.000', 'In Process', 'Secure email sent to: HumanaHoustonPD@humana.com  Subject: Re: RE: Enrollment Query || Group & Provider || RSM || Humana   Hi,  Shybi Varghese\'s CAQH has been updated.  Ancy Kurian is Par from Medicare. Her Medicare number is 1X8153. CAQH has been updated.  Thanks.', NULL, NULL, '2022-03-11 13:46:05', '2022-03-11 13:46:05'),
(8617, 1006, 12504, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 16:51:11', '2021-01-05 16:51:11'),
(8618, 1006, 12504, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Submitted initiation request email @ NMRT networkhelp@uhc.com as per my discussion with UHC representative: \"Hello,   We wish to get out group & providers enrolled with UHC, the information is as follows: Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Please let me know what is required from our end to get this completed ASAP.  Thank you. \"', NULL, NULL, '2021-01-05 16:52:49', '2021-01-05 16:52:49'),
(8619, 1006, 12504, NULL, '2021-01-14 00:00:00.000', 'In Process', 'Received following reply from NMRT networkhelp@uhc.com: \"Good morning Brad,  We do not credential groups. Those request go to demographics. Please submit the request to the demographic department (hpdemo@uhc.com) for assistance. Please use your letterhead.  Ask to have group linked to your tin and contracted.\"  Submitted LOI to hpdemo, attached for reference.  ', NULL, NULL, '2021-01-06 10:00:50', '2021-01-06 10:00:50'),
(8620, 1006, 12504, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Sent a follow-up email @ hpdemo@uhc.com for status. ', NULL, NULL, '2021-01-19 11:52:47', '2021-01-19 11:52:47'),
(8621, 1006, 12504, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Received the following email from United_Healthcare_Provider_Operations@uhc.com: \" UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Jan 6, 2021 9:12:06 AM. Your request was assigned reference number PR-5671036 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations\"  Sent an email to network help asking for update on enrollment. ', NULL, NULL, '2021-02-09 17:29:09', '2021-02-09 17:29:09'),
(8622, 1006, 12504, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Received the following reply from UHC: \"Hello,     Thank you for contacting the Network Management Resource Team. All 3 providers are linked to the group TIN but there is no group or single provider contracts. All 4 accounts (group + providers) are currently out-of-network. There was a pending request but it was closed without loading a contract. Unfortunately, my team does not have an explanation for this. If you were in communication with anyone during this process â€“ possibly in the local contract team â€“ please reach out to them to discuss the matter.     The only thing my team (NMRT at networkhelp@uhc.com) can do going forward is to accept a new contract request and process it. If you would like to start a new contract request, please send an email to networkhelp@uhc.com with the TIN, all 4 NPIs and the request itself. We will evaluate the request and advise accordingly.        David Russell  Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)\"  Resending request @ networkhelp@uhc.com for contracting of group. ', NULL, NULL, '2021-02-11 17:12:11', '2021-02-11 17:12:11'),
(8623, 1006, 12504, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ NMRT networkhelp@uhc.com:  \"Hello,   I wanted to follow-up on the status of my request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-03-08 15:55:46', '2021-03-08 15:55:46'),
(8624, 1006, 12504, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com regarding status of enrollment.', NULL, NULL, '2021-03-18 14:43:26', '2021-03-18 14:43:26'),
(8625, 1006, 12504, NULL, '2021-04-05 00:00:00.000', 'In Process', 'Received following reply from nelly_tully@uhc.com:  \"Good morning,   Please be advised that the current taxonomy of RIGHT STEP MEDICAL CENTER shows ag clinic/center which does not allow for a group contract. Kindly let us know if you would like to proceed with individual contracts or if you will be updating the taxonomy to group.   Taxonomy update questions - 800.465.3203 or email  customerservice@npienumerator.com (link: mailto:customerservice@npienumerator.com)   (image)   Thank you     Nelly Tully   Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Informed them that I\'ve updated group taxonomy to multi-specialty clinic. ', NULL, NULL, '2021-03-29 08:41:46', '2021-03-29 08:41:46'),
(8626, 1006, 12504, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Received the following reply from Nelly on the UHC portal:  Sub: RE: Secure Message from nelly_tully@uhc.com  \"Good morning,   I have submitted a request to create a group record in our system so the author team can send out a group contract.   I am a bit nervous because the taxonomy still shows clinic instead of \"group\" but I will let you know if I get any push back from the loading team.  Thank you for your assistance!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent her the following reply:   \"Hello Nelly,   I hope you\'re doing well, just wanted to check in with you to see if there were any updates on the group contract?  Thank you.\"', NULL, NULL, '2021-04-05 17:17:37', '2021-04-05 17:17:37'),
(8627, 1006, 12504, NULL, '2021-04-13 00:00:00.000', 'In Process', 'Received the following response onUHC secure message portal from Nelly @ nelly_tully@uhc.com:  Sub: Secure Message from nelly_tully@uhc.com  \"Hello,   Thank you for this information.  It looks like my request for group record was successful. They have authored and emailed the contract via DocuSign and it has been signed on 4/6 by Jobi Ponraj. From here, the contract will get signed internally and the effective date is 15 days from internal signature.   Please be advised that I cannot give you a date of when the contract will be signed internally. Things have been taking longer since Covid and we are asking for your patience.   Thank you and hope this helps!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"', NULL, NULL, '2021-04-06 10:20:11', '2021-04-06 10:20:11'),
(8628, 1006, 12504, NULL, '2021-05-19 00:00:00.000', 'In Process', 'Sent f/u email @ nelly_tully@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello Nelly,  I hope you\'re doing well, I wanted to get an update on the enrollment/contracting status for our group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-03 10:50:26', '2021-05-03 10:50:26'),
(8629, 1006, 12504, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I wanted to get an update on the enrollment status for the following group & providers:   Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991    Please get back to me on the status of these as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-26 13:46:57', '2021-05-26 13:46:57'),
(8630, 1006, 12504, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: Secure Message from tammye_bosley@uhc.com  \"Thank you for contacting the Network Management Resource Team.  The initial credentialing request for Ramegowda Belakere (NPI# 1235166687), Glory Abraham (NPI# 1194206490) and Shybi Varghese (NPI# 1285270991) are currently in process.  General turnaround time for credentialing (demographic loading) is 30 days with an additional 30-45 days for contracting.  Please allow more time for the request to process and complete.  Please let us know if we can assist further via email.  Thank you,  Tammye Bosley| Network Management Resource Team  This was sent by a general email box. \"Reply\" messages are automatically deleted and will not receive a response. Please direct all replies, questions, or concerns to Network Management to Networkhelp@uhc.com  Please Note:  Credentialing approval does not imply or guarantee participation with the health plans.  Approved and signed physician contracts are required for participation.  For questions related to credentialing, benefits or claim status, please utilize www.uhcprovider.com. For all Mental Health contracting issues, please contact United Behavioral Health at 877-614-0484. For all Chiropractic, Physical Therapy, Occupational Therapy, and Speech Therapy contracting issues, please contact Optum Physical Health at 800-873-4575.\"', NULL, NULL, '2021-05-27 11:16:25', '2021-05-27 11:16:25'),
(8631, 1006, 12504, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-06-16 15:30:48', '2021-06-16 15:30:48'),
(8632, 1006, 12504, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Sent another f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-07-05 17:11:41', '2021-07-05 17:11:41'),
(8633, 1006, 12504, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent new f/u email @ \"Tully, Nelly\" nelly_tully@uhc.com & networkhelp@uhc.com', NULL, NULL, '2021-07-27 17:29:14', '2021-07-27 17:29:14'),
(8634, 1006, 12504, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Received following reply from Tully, Nelly nelly_tully@uhc.com>:  Sub; Enrollment Status - RSM - UHC  \"Good morning,  For any provider status inquiry, please email cat_central@uhc.com  Thank you  Nelly Tully   Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent f/u to given email. ', NULL, NULL, '2021-07-28 09:51:41', '2021-07-28 09:51:41');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(8635, 1006, 12504, NULL, '2021-08-04 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: RE: Secure Message from lashall.s.johnson-penn@uhc.com  \"Good morning,   Thank you for contacting the Network Management Resource Team. I’ve attached a report that shows the demographic, credentialing, and contracting status for the providers requested.   Ramegowda Belakere – This provider’s credentialing is delegated so any credentialing needs must go through the delegated entity. No contracts loaded.   Glory Abraham – Provider is credentialed but there’s no contracts loaded.   Shybi Varghese – Provider is credentialed & contracted.\"  Replied:  \"Hello,   I appreciate the update, what is required to get Ramegowda Belakere & Glory Abraham loaded under our group? As this request has been on hold for quite a while.  Thank you. \"  ', NULL, NULL, '2021-07-28 12:20:57', '2021-07-28 12:20:57'),
(8636, 1006, 12504, NULL, '2021-08-06 00:00:00.000', 'In Process', 'We received the following update from networkhelp@uhc.com :  Sub: RE: Secure Message from gabriel_olvera@uhc.com  \"Hello Brad,  In regards to your inquiry, currently the TIN does not have a group contract, and at this time there is an ongoing request for the group and providers to get contracted under a group contract agreement, reference number for this request is PR-5826077. This process is currently waiting on the group contract that was sent to the email rsm@claimsmedinc.com on 6/18/2021 for corrections needed to be signed and sent back to United Healthcare. If this contract was not received, please reach back to our team with the email address and the name of the signer of this group contract so that our team can submit a re-mail request.  &nbsp; Thank you!&nbsp; &nbsp;  Gabriel Olvera UnitedHealthcare Network Management Resource Team (NMRT)\"  Replied:  \"Hello,   We have not received any contracts recently, although a contract that we signed prior was voided, and we received the notification for that. Please send us a new contract @ rsm@claimsmedinc.com for signed Jobi Ponraj.   Please get back to me.  Thank you.\"', NULL, NULL, '2021-07-30 17:13:58', '2021-07-30 17:13:58'),
(8637, 1006, 12504, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  PR-5826077 is in process, it looked like they were waiting on the signed contract, it was received and there a few questions that needed to be asked to get providers loaded.  I have sent a request to loading asking if all was good to go and that group has been waiting for the providers to be loaded.  Please feel free to check back anytime on the status of this request.  Thank you, Lisa marketcares Team\"  Sent reply: \"Hello,   I appreciate the update, please let me know what the expected time frame is for this to be completed?  Thank you. \" ', NULL, NULL, '2021-08-02 13:51:06', '2021-08-02 13:51:06'),
(8638, 1006, 12504, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  I am not sure on the timeframe for completion, but you can check back as often as you like for updates.  Thank you,  Lisa marketcares Team\"', NULL, NULL, '2021-08-03 14:22:22', '2021-08-03 14:22:22'),
(8639, 1006, 12504, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Sent f/u email @ aa@claimsmedinc.com:  Sub: RE: Secure Message from cat_central@uhc.com  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for the following PR-5826077.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-18 16:06:34', '2021-08-18 16:06:34'),
(8640, 1006, 12504, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Received the following approval confirmation from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  Effective date for group is 8/4/21 and for providers Glory Abraham, Ramegowda Belakere  Eff date is 5/17/21 for Shybi Varghese.  Thank you,  Lisa marketcares Team\"  Approval confirmation is attached. ', NULL, NULL, '2021-08-20 10:03:53', '2021-08-20 10:03:53'),
(8641, 1006, 12505, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 16:51:40', '2021-01-05 16:51:40'),
(8642, 1006, 12505, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Submitted initiation request email @ NMRT networkhelp@uhc.com as per my discussion with UHC representative: \"Hello,   We wish to get out group & providers enrolled with UHC, the information is as follows: Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Please let me know what is required from our end to get this completed ASAP.  Thank you. \"', NULL, NULL, '2021-01-05 16:52:35', '2021-01-05 16:52:35'),
(8643, 1006, 12505, NULL, '2021-01-14 00:00:00.000', 'In Process', 'Received following reply from NMRT networkhelp@uhc.com: \"Good morning Brad,  We do not credential groups. Those request go to demographics. Please submit the request to the demographic department (hpdemo@uhc.com) for assistance. Please use your letterhead.  Ask to have group linked to your tin and contracted.\"  Submitted LOI to hpdemo, attached for reference.  ', NULL, NULL, '2021-01-06 10:00:49', '2021-01-06 10:00:49'),
(8644, 1006, 12505, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Sent a follow-up email @ hpdemo@uhc.com for status. ', NULL, NULL, '2021-01-19 11:52:52', '2021-01-19 11:52:52'),
(8645, 1006, 12505, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Sent follow-up @ providerservicestx@uhc.com', NULL, NULL, '2021-01-20 10:26:21', '2021-01-20 10:26:21'),
(8646, 1006, 12505, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Received the following email from United_Healthcare_Provider_Operations@uhc.com: \" UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Jan 6, 2021 9:12:06 AM. Your request was assigned reference number PR-5671036 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations\"  Sent an email to network help asking for update on enrollment. ', NULL, NULL, '2021-02-09 17:29:14', '2021-02-09 17:29:14'),
(8647, 1006, 12505, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Received the following reply from UHC: \"Hello,     Thank you for contacting the Network Management Resource Team. All 3 providers are linked to the group TIN but there is no group or single provider contracts. All 4 accounts (group + providers) are currently out-of-network. There was a pending request but it was closed without loading a contract. Unfortunately, my team does not have an explanation for this. If you were in communication with anyone during this process â€“ possibly in the local contract team â€“ please reach out to them to discuss the matter.     The only thing my team (NMRT at networkhelp@uhc.com) can do going forward is to accept a new contract request and process it. If you would like to start a new contract request, please send an email to networkhelp@uhc.com with the TIN, all 4 NPIs and the request itself. We will evaluate the request and advise accordingly.        David Russell  Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)\"  Resending request @ networkhelp@uhc.com for contracting of group. ', NULL, NULL, '2021-02-11 17:12:17', '2021-02-11 17:12:17'),
(8648, 1006, 12505, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ NMRT networkhelp@uhc.com:  \"Hello,   I wanted to follow-up on the status of my request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-03-08 15:55:57', '2021-03-08 15:55:57'),
(8649, 1006, 12505, NULL, '2021-03-16 00:00:00.000', 'In Process', 'I was informed to submit RFP enrollment requests for all providers, submitted and informed UHC.   Received the following reply:  \"Great!! The credentialing process can take up to 30 days and once credentialing is approved the contracting can take up to 45 business days.  Please let us know if we can assist further via email.  Thank you, UnitedHealthcare Network Management Resource Team\"', NULL, NULL, '2021-03-09 14:36:52', '2021-03-09 14:36:52'),
(8650, 1006, 12505, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com regarding status of enrollment.', NULL, NULL, '2021-03-18 14:43:20', '2021-03-18 14:43:20'),
(8651, 1006, 12505, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Received the following reply from Nelly on the UHC portal:  Sub: RE: Secure Message from nelly_tully@uhc.com  \"Good morning,   I have submitted a request to create a group record in our system so the author team can send out a group contract.   I am a bit nervous because the taxonomy still shows clinic instead of \"group\" but I will let you know if I get any push back from the loading team.  Thank you for your assistance!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent her the following reply:   \"Hello Nelly,   I hope you\'re doing well, just wanted to check in with you to see if there were any updates on the group contract?  Thank you.\"', NULL, NULL, '2021-04-05 17:17:44', '2021-04-05 17:17:44'),
(8652, 1006, 12505, NULL, '2021-04-13 00:00:00.000', 'In Process', 'Received the following response onUHC secure message portal from Nelly @ nelly_tully@uhc.com:  Sub: Secure Message from nelly_tully@uhc.com  \"Hello,   Thank you for this information.  It looks like my request for group record was successful. They have authored and emailed the contract via DocuSign and it has been signed on 4/6 by Jobi Ponraj. From here, the contract will get signed internally and the effective date is 15 days from internal signature.   Please be advised that I cannot give you a date of when the contract will be signed internally. Things have been taking longer since Covid and we are asking for your patience.   Thank you and hope this helps!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"', NULL, NULL, '2021-04-06 10:20:17', '2021-04-06 10:20:17'),
(8653, 1006, 12505, NULL, '2021-05-19 00:00:00.000', 'In Process', 'Sent f/u email @ nelly_tully@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello Nelly,  I hope you\'re doing well, I wanted to get an update on the enrollment/contracting status for our group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-03 10:50:22', '2021-05-03 10:50:22'),
(8654, 1006, 12505, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I wanted to get an update on the enrollment status for the following group & providers:   Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991    Please get back to me on the status of these as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-26 13:47:08', '2021-05-26 13:47:08'),
(8655, 1006, 12505, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: Secure Message from tammye_bosley@uhc.com  \"Thank you for contacting the Network Management Resource Team.  The initial credentialing request for Ramegowda Belakere (NPI# 1235166687), Glory Abraham (NPI# 1194206490) and Shybi Varghese (NPI# 1285270991) are currently in process.  General turnaround time for credentialing (demographic loading) is 30 days with an additional 30-45 days for contracting.  Please allow more time for the request to process and complete.  Please let us know if we can assist further via email.  Thank you,  Tammye Bosley| Network Management Resource Team  This was sent by a general email box. \"Reply\" messages are automatically deleted and will not receive a response. Please direct all replies, questions, or concerns to Network Management to Networkhelp@uhc.com  Please Note:  Credentialing approval does not imply or guarantee participation with the health plans.  Approved and signed physician contracts are required for participation.  For questions related to credentialing, benefits or claim status, please utilize www.uhcprovider.com. For all Mental Health contracting issues, please contact United Behavioral Health at 877-614-0484. For all Chiropractic, Physical Therapy, Occupational Therapy, and Speech Therapy contracting issues, please contact Optum Physical Health at 800-873-4575.\"', NULL, NULL, '2021-05-27 11:16:31', '2021-05-27 11:16:31'),
(8656, 1006, 12505, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-06-16 15:30:56', '2021-06-16 15:30:56'),
(8657, 1006, 12505, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Sent another f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-07-05 17:11:57', '2021-07-05 17:11:57'),
(8658, 1006, 12505, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent new f/u email @ \"Tully, Nelly\" nelly_tully@uhc.com & networkhelp@uhc.com', NULL, NULL, '2021-07-27 17:29:18', '2021-07-27 17:29:18'),
(8659, 1006, 12505, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Received following reply from Tully, Nelly nelly_tully@uhc.com>:  Sub; Enrollment Status - RSM - UHC  \"Good morning,  For any provider status inquiry, please email cat_central@uhc.com  Thank you  Nelly Tully   Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent f/u to given email. ', NULL, NULL, '2021-07-28 09:51:37', '2021-07-28 09:51:37'),
(8660, 1006, 12505, NULL, '2021-08-04 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: RE: Secure Message from lashall.s.johnson-penn@uhc.com  \"Good morning,   Thank you for contacting the Network Management Resource Team. I’ve attached a report that shows the demographic, credentialing, and contracting status for the providers requested.   Ramegowda Belakere – This provider’s credentialing is delegated so any credentialing needs must go through the delegated entity. No contracts loaded.   Glory Abraham – Provider is credentialed but there’s no contracts loaded.   Shybi Varghese – Provider is credentialed & contracted.\"  Replied:  \"Hello,   I appreciate the update, what is required to get Ramegowda Belakere & Glory Abraham loaded under our group? As this request has been on hold for quite a while.  Thank you. \"  ', NULL, NULL, '2021-07-28 12:21:04', '2021-07-28 12:21:04'),
(8661, 1006, 12505, NULL, '2021-08-06 00:00:00.000', 'In Process', 'We received the following update from networkhelp@uhc.com :  Sub: RE: Secure Message from gabriel_olvera@uhc.com  \"Hello Brad,  In regards to your inquiry, currently the TIN does not have a group contract, and at this time there is an ongoing request for the group and providers to get contracted under a group contract agreement, reference number for this request is PR-5826077. This process is currently waiting on the group contract that was sent to the email rsm@claimsmedinc.com on 6/18/2021 for corrections needed to be signed and sent back to United Healthcare. If this contract was not received, please reach back to our team with the email address and the name of the signer of this group contract so that our team can submit a re-mail request.  &nbsp; Thank you!&nbsp; &nbsp;  Gabriel Olvera UnitedHealthcare Network Management Resource Team (NMRT)\"  Replied:  \"Hello,   We have not received any contracts recently, although a contract that we signed prior was voided, and we received the notification for that. Please send us a new contract @ rsm@claimsmedinc.com for signed Jobi Ponraj.   Please get back to me.  Thank you.\"', NULL, NULL, '2021-07-30 17:14:06', '2021-07-30 17:14:06'),
(8662, 1006, 12505, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  PR-5826077 is in process, it looked like they were waiting on the signed contract, it was received and there a few questions that needed to be asked to get providers loaded.  I have sent a request to loading asking if all was good to go and that group has been waiting for the providers to be loaded.  Please feel free to check back anytime on the status of this request.  Thank you, Lisa marketcares Team\"  Sent reply: \"Hello,   I appreciate the update, please let me know what the expected time frame is for this to be completed?  Thank you. \" ', NULL, NULL, '2021-08-02 13:51:16', '2021-08-02 13:51:16'),
(8663, 1006, 12505, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  I am not sure on the timeframe for completion, but you can check back as often as you like for updates.  Thank you,  Lisa marketcares Team\"', NULL, NULL, '2021-08-03 14:22:34', '2021-08-03 14:22:34'),
(8664, 1006, 12505, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Sent f/u email @ aa@claimsmedinc.com:  Sub: RE: Secure Message from cat_central@uhc.com  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for the following PR-5826077.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-18 16:06:30', '2021-08-18 16:06:30'),
(8665, 1006, 12505, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Received the following approval confirmation from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  Effective date for group is 8/4/21 and for providers Glory Abraham, Ramegowda Belakere  Eff date is 5/17/21 for Shybi Varghese.  Thank you,  Lisa marketcares Team\"  Approval confirmation is attached.  ', NULL, NULL, '2021-08-20 10:05:41', '2021-08-20 10:05:41'),
(8666, 1006, 12506, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 16:51:41', '2021-01-05 16:51:41'),
(8667, 1006, 12506, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Submitted initiation request email @ NMRT networkhelp@uhc.com as per my discussion with UHC representative: \"Hello,   We wish to get out group & providers enrolled with UHC, the information is as follows: Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Please let me know what is required from our end to get this completed ASAP.  Thank you. \"', NULL, NULL, '2021-01-05 16:52:41', '2021-01-05 16:52:41'),
(8668, 1006, 12506, NULL, '2021-01-14 00:00:00.000', 'In Process', 'Received following reply from NMRT networkhelp@uhc.com: \"Good morning Brad,  We do not credential groups. Those request go to demographics. Please submit the request to the demographic department (hpdemo@uhc.com) for assistance. Please use your letterhead.  Ask to have group linked to your tin and contracted.\"  Submitted LOI to hpdemo, attached for reference.  ', NULL, NULL, '2021-01-06 10:00:47', '2021-01-06 10:00:47'),
(8669, 1006, 12506, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Sent a follow-up email @ hpdemo@uhc.com for status. ', NULL, NULL, '2021-01-19 11:52:57', '2021-01-19 11:52:57'),
(8670, 1006, 12506, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Sent follow-up @ providerservicestx@uhc.com ', NULL, NULL, '2021-01-20 10:26:30', '2021-01-20 10:26:30'),
(8671, 1006, 12506, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Received the following email from United_Healthcare_Provider_Operations@uhc.com: \" UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Jan 6, 2021 9:12:06 AM. Your request was assigned reference number PR-5671036 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations\"  Sent an email to network help asking for update on enrollment. ', NULL, NULL, '2021-02-09 17:29:19', '2021-02-09 17:29:19'),
(8672, 1006, 12506, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Received the following reply from UHC: \"Hello,     Thank you for contacting the Network Management Resource Team. All 3 providers are linked to the group TIN but there is no group or single provider contracts. All 4 accounts (group + providers) are currently out-of-network. There was a pending request but it was closed without loading a contract. Unfortunately, my team does not have an explanation for this. If you were in communication with anyone during this process â€“ possibly in the local contract team â€“ please reach out to them to discuss the matter.     The only thing my team (NMRT at networkhelp@uhc.com) can do going forward is to accept a new contract request and process it. If you would like to start a new contract request, please send an email to networkhelp@uhc.com with the TIN, all 4 NPIs and the request itself. We will evaluate the request and advise accordingly.        David Russell  Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)\"  Resending request @ networkhelp@uhc.com for contracting of group. ', NULL, NULL, '2021-02-11 17:12:21', '2021-02-11 17:12:21'),
(8673, 1006, 12506, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ NMRT networkhelp@uhc.com:  \"Hello,   I wanted to follow-up on the status of my request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-03-08 15:56:05', '2021-03-08 15:56:05'),
(8674, 1006, 12506, NULL, '2021-03-16 00:00:00.000', 'In Process', 'I was informed to submit RFP enrollment requests for all providers, submitted and informed UHC.   Received the following reply:  \"Great!! The credentialing process can take up to 30 days and once credentialing is approved the contracting can take up to 45 business days.  Please let us know if we can assist further via email.  Thank you, UnitedHealthcare Network Management Resource Team\"', NULL, NULL, '2021-03-09 14:37:22', '2021-03-09 14:37:22'),
(8675, 1006, 12506, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com regarding status of enrollment.', NULL, NULL, '2021-03-18 14:43:23', '2021-03-18 14:43:23'),
(8676, 1006, 12506, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Received the following reply from Nelly on the UHC portal:  Sub: RE: Secure Message from nelly_tully@uhc.com  \"Good morning,   I have submitted a request to create a group record in our system so the author team can send out a group contract.   I am a bit nervous because the taxonomy still shows clinic instead of \"group\" but I will let you know if I get any push back from the loading team.  Thank you for your assistance!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent her the following reply:   \"Hello Nelly,   I hope you\'re doing well, just wanted to check in with you to see if there were any updates on the group contract?  Thank you.\"', NULL, NULL, '2021-04-05 17:17:47', '2021-04-05 17:17:47'),
(8677, 1006, 12506, NULL, '2021-04-13 00:00:00.000', 'In Process', 'Received the following response onUHC secure message portal from Nelly @ nelly_tully@uhc.com:  Sub: Secure Message from nelly_tully@uhc.com  \"Hello,   Thank you for this information.  It looks like my request for group record was successful. They have authored and emailed the contract via DocuSign and it has been signed on 4/6 by Jobi Ponraj. From here, the contract will get signed internally and the effective date is 15 days from internal signature.   Please be advised that I cannot give you a date of when the contract will be signed internally. Things have been taking longer since Covid and we are asking for your patience.   Thank you and hope this helps!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"', NULL, NULL, '2021-04-06 10:20:20', '2021-04-06 10:20:20'),
(8678, 1006, 12506, NULL, '2021-05-19 00:00:00.000', 'In Process', 'Sent f/u email @ nelly_tully@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello Nelly,  I hope you\'re doing well, I wanted to get an update on the enrollment/contracting status for our group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-03 10:50:18', '2021-05-03 10:50:18'),
(8679, 1006, 12506, NULL, '2021-06-02 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I wanted to get an update on the enrollment status for the following group & providers:   Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991    Please get back to me on the status of these as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-26 13:47:13', '2021-05-26 13:47:13'),
(8680, 1006, 12506, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: Secure Message from tammye_bosley@uhc.com  \"Thank you for contacting the Network Management Resource Team.  The initial credentialing request for Ramegowda Belakere (NPI# 1235166687), Glory Abraham (NPI# 1194206490) and Shybi Varghese (NPI# 1285270991) are currently in process.  General turnaround time for credentialing (demographic loading) is 30 days with an additional 30-45 days for contracting.  Please allow more time for the request to process and complete.  Please let us know if we can assist further via email.  Thank you,  Tammye Bosley| Network Management Resource Team  This was sent by a general email box. \"Reply\" messages are automatically deleted and will not receive a response. Please direct all replies, questions, or concerns to Network Management to Networkhelp@uhc.com  Please Note:  Credentialing approval does not imply or guarantee participation with the health plans.  Approved and signed physician contracts are required for participation.  For questions related to credentialing, benefits or claim status, please utilize www.uhcprovider.com. For all Mental Health contracting issues, please contact United Behavioral Health at 877-614-0484. For all Chiropractic, Physical Therapy, Occupational Therapy, and Speech Therapy contracting issues, please contact Optum Physical Health at 800-873-4575.\"', NULL, NULL, '2021-05-27 11:16:37', '2021-05-27 11:16:37'),
(8681, 1006, 12506, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-06-16 15:30:59', '2021-06-16 15:30:59'),
(8682, 1006, 12506, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Sent another f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-07-05 17:11:54', '2021-07-05 17:11:54'),
(8683, 1006, 12506, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent new f/u email @ \"Tully, Nelly\" nelly_tully@uhc.com & networkhelp@uhc.com', NULL, NULL, '2021-07-27 17:29:21', '2021-07-27 17:29:21'),
(8684, 1006, 12506, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Received following reply from Tully, Nelly nelly_tully@uhc.com>:  Sub; Enrollment Status - RSM - UHC  \"Good morning,  For any provider status inquiry, please email cat_central@uhc.com  Thank you  Nelly Tully   Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent f/u to given email. ', NULL, NULL, '2021-07-28 09:51:34', '2021-07-28 09:51:34'),
(8685, 1006, 12506, NULL, '2021-08-04 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: RE: Secure Message from lashall.s.johnson-penn@uhc.com  \"Good morning,   Thank you for contacting the Network Management Resource Team. I’ve attached a report that shows the demographic, credentialing, and contracting status for the providers requested.   Ramegowda Belakere – This provider’s credentialing is delegated so any credentialing needs must go through the delegated entity. No contracts loaded.   Glory Abraham – Provider is credentialed but there’s no contracts loaded.   Shybi Varghese – Provider is credentialed & contracted.\"  Replied:  \"Hello,   I appreciate the update, what is required to get Ramegowda Belakere & Glory Abraham loaded under our group? As this request has been on hold for quite a while.  Thank you. \"  ', NULL, NULL, '2021-07-28 12:21:08', '2021-07-28 12:21:08'),
(8686, 1006, 12506, NULL, '2021-08-06 00:00:00.000', 'In Process', 'We received the following update from networkhelp@uhc.com :  Sub: RE: Secure Message from gabriel_olvera@uhc.com  \"Hello Brad,  In regards to your inquiry, currently the TIN does not have a group contract, and at this time there is an ongoing request for the group and providers to get contracted under a group contract agreement, reference number for this request is PR-5826077. This process is currently waiting on the group contract that was sent to the email rsm@claimsmedinc.com on 6/18/2021 for corrections needed to be signed and sent back to United Healthcare. If this contract was not received, please reach back to our team with the email address and the name of the signer of this group contract so that our team can submit a re-mail request.  &nbsp; Thank you!&nbsp; &nbsp;  Gabriel Olvera UnitedHealthcare Network Management Resource Team (NMRT)\"  Replied:  \"Hello,   We have not received any contracts recently, although a contract that we signed prior was voided, and we received the notification for that. Please send us a new contract @ rsm@claimsmedinc.com for signed Jobi Ponraj.   Please get back to me.  Thank you.\"', NULL, NULL, '2021-07-30 17:14:09', '2021-07-30 17:14:09'),
(8687, 1006, 12506, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  PR-5826077 is in process, it looked like they were waiting on the signed contract, it was received and there a few questions that needed to be asked to get providers loaded.  I have sent a request to loading asking if all was good to go and that group has been waiting for the providers to be loaded.  Please feel free to check back anytime on the status of this request.  Thank you, Lisa marketcares Team\"  Sent reply: \"Hello,   I appreciate the update, please let me know what the expected time frame is for this to be completed?  Thank you. \" ', NULL, NULL, '2021-08-02 13:51:23', '2021-08-02 13:51:23'),
(8688, 1006, 12506, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  I am not sure on the timeframe for completion, but you can check back as often as you like for updates.  Thank you,  Lisa marketcares Team\"', NULL, NULL, '2021-08-03 14:22:41', '2021-08-03 14:22:41'),
(8689, 1006, 12506, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Sent f/u email @ aa@claimsmedinc.com:  Sub: RE: Secure Message from cat_central@uhc.com  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for the following PR-5826077.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-18 16:06:25', '2021-08-18 16:06:25'),
(8690, 1006, 12506, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Received the following approval confirmation from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  Effective date for group is 8/4/21 and for providers Glory Abraham, Ramegowda Belakere  Eff date is 5/17/21 for Shybi Varghese.  Thank you,  Lisa marketcares Team\"  Approval confirmation is attached.  ', NULL, NULL, '2021-08-20 10:06:12', '2021-08-20 10:06:12'),
(8691, 1006, 12507, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-05 16:51:42', '2021-01-05 16:51:42'),
(8692, 1006, 12507, NULL, '2021-01-12 00:00:00.000', 'Initiated', 'Submitted initiation request email @ NMRT networkhelp@uhc.com as per my discussion with UHC representative: \"Hello,   We wish to get out group & providers enrolled with UHC, the information is as follows: Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Shybi Varghese NPI# 1285270991  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Ramegowda Belakere NPI# 1235166687  Please let me know what is required from our end to get this completed ASAP.  Thank you. \"', NULL, NULL, '2021-01-05 16:52:45', '2021-01-05 16:52:45'),
(8693, 1006, 12507, NULL, '2021-01-14 00:00:00.000', 'In Process', 'Received following reply from NMRT networkhelp@uhc.com: \"Good morning Brad,  We do not credential groups. Those request go to demographics. Please submit the request to the demographic department (hpdemo@uhc.com) for assistance. Please use your letterhead.  Ask to have group linked to your tin and contracted.\"  Submitted LOI to hpdemo, attached for reference.  ', NULL, NULL, '2021-01-06 10:00:46', '2021-01-06 10:00:46'),
(8694, 1006, 12507, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Sent a follow-up email @ hpdemo@uhc.com for status. ', NULL, NULL, '2021-01-19 11:53:02', '2021-01-19 11:53:02'),
(8695, 1006, 12507, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Sent follow-up @ providerservicestx@uhc.com ', NULL, NULL, '2021-01-20 10:26:35', '2021-01-20 10:26:35'),
(8696, 1006, 12507, NULL, '2021-02-16 00:00:00.000', 'In Process', 'Received the following email from United_Healthcare_Provider_Operations@uhc.com: \" UnitedHealthcare Insurance Company  Good news! We’ve completed the provider/group updates you requested on Jan 6, 2021 9:12:06 AM. Your request was assigned reference number PR-5671036 .  Please see the attached report for details. For your convenience, your original submission is also attached.  For questions pertaining to this communication, contact us at submission_inquiry@uhc.com.  Please include the reference number in the subject line of your email.  Thank you.  UnitedHealthcare Provider Operations\"  Sent an email to network help asking for update on enrollment. ', NULL, NULL, '2021-02-09 17:29:24', '2021-02-09 17:29:24'),
(8697, 1006, 12507, NULL, '2021-02-18 00:00:00.000', 'In Process', 'Received the following reply from UHC: \"Hello,     Thank you for contacting the Network Management Resource Team. All 3 providers are linked to the group TIN but there is no group or single provider contracts. All 4 accounts (group + providers) are currently out-of-network. There was a pending request but it was closed without loading a contract. Unfortunately, my team does not have an explanation for this. If you were in communication with anyone during this process â€“ possibly in the local contract team â€“ please reach out to them to discuss the matter.     The only thing my team (NMRT at networkhelp@uhc.com) can do going forward is to accept a new contract request and process it. If you would like to start a new contract request, please send an email to networkhelp@uhc.com with the TIN, all 4 NPIs and the request itself. We will evaluate the request and advise accordingly.        David Russell  Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)\"  Resending request @ networkhelp@uhc.com for contracting of group. ', NULL, NULL, '2021-02-11 17:12:26', '2021-02-11 17:12:26'),
(8698, 1006, 12507, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Sent a follow-up email @ NMRT networkhelp@uhc.com:  \"Hello,   I wanted to follow-up on the status of my request, please get back to me as soon as possible.  Thank you.\" ', NULL, NULL, '2021-03-08 15:59:24', '2021-03-08 15:59:24'),
(8699, 1006, 12507, NULL, '2021-03-16 00:00:00.000', 'In Process', 'I was informed to submit RFP enrollment requests for all providers, submitted and informed UHC.   Received the following reply:  \"Great!! The credentialing process can take up to 30 days and once credentialing is approved the contracting can take up to 45 business days.  Please let us know if we can assist further via email.  Thank you, UnitedHealthcare Network Management Resource Team\"', NULL, NULL, '2021-03-09 14:37:37', '2021-03-09 14:37:37'),
(8700, 1006, 12507, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Received the following email from UHC National Credentialing Team national_credentialing@uhc.com:  3/12/2021  SHYBI VARGHESE rsm@claimsmedinc.com  CAQH ID#: 15053019  MPIN:7591864  Re: We’re Ready to Review Your Credentialing Application  Dear SHYBI VARGHESE:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your completed Council for Affordable Quality Healthcare (CAQH) ProView® application and will now begin verifying your credentials. Here are the next steps in the process:  Verifying credentials takes approximately 30 days to complete. During this time, you may be contacted by our staff or by our credentialing verification vendor (Aperture, Inc.). This outreach would only occur if your application has missing or out-of-date information.  Additional information may be requested. During the verification process, we may request more information to address any specific credentialing requirements based on your location, care provider type or specialty. If we ask for additional information, we will supply the required forms and instructions (a list of state-specific information that may be requested is at the bottom of this letter).', NULL, NULL, '2021-03-12 16:04:31', '2021-03-12 16:04:31'),
(8701, 1006, 12507, NULL, '2021-03-25 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com regarding status of enrollment.', NULL, NULL, '2021-03-18 14:43:13', '2021-03-18 14:43:13'),
(8702, 1006, 12507, NULL, '2021-03-29 00:00:00.000', 'In Process', 'Received the following email from Aperture regarding provider: \"Health Plan(s) Requesting Information: United HealthCare of Houston  Credentials Request for: VARGHESE, SHYBI  Attention: Credentialing  Information Requested: Please provide who admits on your behalf, or the name of the covering colleague, or hospitalist group name?\"  Informed them that Ramegowda would admit on her behalf. ', NULL, NULL, '2021-03-22 08:38:10', '2021-03-22 08:38:10'),
(8703, 1006, 12507, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Received the following reply from Nelly on the UHC portal:  Sub: RE: Secure Message from nelly_tully@uhc.com  \"Good morning,   I have submitted a request to create a group record in our system so the author team can send out a group contract.   I am a bit nervous because the taxonomy still shows clinic instead of \"group\" but I will let you know if I get any push back from the loading team.  Thank you for your assistance!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent her the following reply:   \"Hello Nelly,   I hope you\'re doing well, just wanted to check in with you to see if there were any updates on the group contract?  Thank you.\"', NULL, NULL, '2021-04-05 17:17:51', '2021-04-05 17:17:51'),
(8704, 1006, 12507, NULL, '2021-04-13 00:00:00.000', 'In Process', 'Received the following response onUHC secure message portal from Nelly @ nelly_tully@uhc.com:  Sub: Secure Message from nelly_tully@uhc.com  \"Hello,   Thank you for this information.  It looks like my request for group record was successful. They have authored and emailed the contract via DocuSign and it has been signed on 4/6 by Jobi Ponraj. From here, the contract will get signed internally and the effective date is 15 days from internal signature.   Please be advised that I cannot give you a date of when the contract will be signed internally. Things have been taking longer since Covid and we are asking for your patience.   Thank you and hope this helps!  Nelly Tully   Sr. Provider Data Analyst  Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"', NULL, NULL, '2021-04-06 10:20:24', '2021-04-06 10:20:24'),
(8705, 1006, 12507, NULL, '2021-05-19 00:00:00.000', 'In Process', 'Sent f/u email @ nelly_tully@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello Nelly,  I hope you\'re doing well, I wanted to get an update on the enrollment/contracting status for our group and providers:  Group Name: Right Step Medical Center LLC NPI# 1063008084  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-05-03 10:50:10', '2021-05-03 10:50:10'),
(8706, 1006, 12507, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Received the following email from Tully, Nelly nelly_tully@uhc.com:  Sub: Secure Message from nelly_tully@uhc.com  \"Good morning,  Please provide the Medicare ID for SHYBI VARGHESE in order for the product to be loaded. Tax ID 853252700  Thank you  Nelly Tully Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Answered with her PTAN', NULL, NULL, '2021-05-25 08:36:42', '2021-05-25 08:36:42'),
(8707, 1006, 12507, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: Secure Message from tammye_bosley@uhc.com  \"Thank you for contacting the Network Management Resource Team.  The initial credentialing request for Ramegowda Belakere (NPI# 1235166687), Glory Abraham (NPI# 1194206490) and Shybi Varghese (NPI# 1285270991) are currently in process.  General turnaround time for credentialing (demographic loading) is 30 days with an additional 30-45 days for contracting.  Please allow more time for the request to process and complete.  Please let us know if we can assist further via email.  Thank you,  Tammye Bosley| Network Management Resource Team  This was sent by a general email box. \"Reply\" messages are automatically deleted and will not receive a response. Please direct all replies, questions, or concerns to Network Management to Networkhelp@uhc.com  Please Note:  Credentialing approval does not imply or guarantee participation with the health plans.  Approved and signed physician contracts are required for participation.  For questions related to credentialing, benefits or claim status, please utilize www.uhcprovider.com. For all Mental Health contracting issues, please contact United Behavioral Health at 877-614-0484. For all Chiropractic, Physical Therapy, Occupational Therapy, and Speech Therapy contracting issues, please contact Optum Physical Health at 800-873-4575.\"', NULL, NULL, '2021-05-27 11:16:41', '2021-05-27 11:16:41'),
(8708, 1006, 12507, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-06-16 15:31:02', '2021-06-16 15:31:02'),
(8709, 1006, 12507, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Sent another f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - RSM - UHC  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the enrollment status for our group and providers, their information is below:  Group Name: Right Step Medical Center LLC NPI# 1063008084 TIN# 85-3252700  Provider Name: Ramegowda Belakere NPI# 1235166687  Provider Name: Glory Abraham NPI# 1194206490  Provider Name: Shybi Varghese NPI# 1285270991  Please get back to me as soon as possible as this request has been in progress since the start of the year.   Thank you!\"', NULL, NULL, '2021-07-05 17:11:48', '2021-07-05 17:11:48'),
(8710, 1006, 12507, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Sent new f/u email @ \"Tully, Nelly\" nelly_tully@uhc.com & networkhelp@uhc.com', NULL, NULL, '2021-07-27 17:29:24', '2021-07-27 17:29:24'),
(8711, 1006, 12507, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Received following reply from Tully, Nelly nelly_tully@uhc.com>:  Sub; Enrollment Status - RSM - UHC  \"Good morning,  For any provider status inquiry, please email cat_central@uhc.com  Thank you  Nelly Tully   Sr. Provider Data Analyst Contract Analytics Team – Central Region TX & KY UnitedHealth Group\"  Sent f/u to given email. ', NULL, NULL, '2021-07-28 09:51:30', '2021-07-28 09:51:30'),
(8712, 1006, 12507, NULL, '2021-08-04 00:00:00.000', 'In Process', 'We received the following reply from NMRT networkhelp@uhc.com:  Sub: RE: Secure Message from lashall.s.johnson-penn@uhc.com  \"Good morning,   Thank you for contacting the Network Management Resource Team. I’ve attached a report that shows the demographic, credentialing, and contracting status for the providers requested.   Ramegowda Belakere – This provider’s credentialing is delegated so any credentialing needs must go through the delegated entity. No contracts loaded.   Glory Abraham – Provider is credentialed but there’s no contracts loaded.   Shybi Varghese – Provider is credentialed & contracted.\"  Replied:  \"Hello,   I appreciate the update, what is required to get Ramegowda Belakere & Glory Abraham loaded under our group? As this request has been on hold for quite a while.  Thank you. \"  ', NULL, NULL, '2021-07-28 12:21:12', '2021-07-28 12:21:12');
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
(8713, 1006, 12507, NULL, '2021-08-06 00:00:00.000', 'In Process', 'We received the following update from networkhelp@uhc.com :  Sub: RE: Secure Message from gabriel_olvera@uhc.com  \"Hello Brad,  In regards to your inquiry, currently the TIN does not have a group contract, and at this time there is an ongoing request for the group and providers to get contracted under a group contract agreement, reference number for this request is PR-5826077. This process is currently waiting on the group contract that was sent to the email rsm@claimsmedinc.com on 6/18/2021 for corrections needed to be signed and sent back to United Healthcare. If this contract was not received, please reach back to our team with the email address and the name of the signer of this group contract so that our team can submit a re-mail request.  &nbsp; Thank you!&nbsp; &nbsp;  Gabriel Olvera UnitedHealthcare Network Management Resource Team (NMRT)\"  Replied:  \"Hello,   We have not received any contracts recently, although a contract that we signed prior was voided, and we received the notification for that. Please send us a new contract @ rsm@claimsmedinc.com for signed Jobi Ponraj.   Please get back to me.  Thank you.\"', NULL, NULL, '2021-07-30 17:14:12', '2021-07-30 17:14:12'),
(8714, 1006, 12507, NULL, '2021-08-09 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  PR-5826077 is in process, it looked like they were waiting on the signed contract, it was received and there a few questions that needed to be asked to get providers loaded.  I have sent a request to loading asking if all was good to go and that group has been waiting for the providers to be loaded.  Please feel free to check back anytime on the status of this request.  Thank you, Lisa marketcares Team\"  Sent reply: \"Hello,   I appreciate the update, please let me know what the expected time frame is for this to be completed?  Thank you. \" ', NULL, NULL, '2021-08-02 13:51:27', '2021-08-02 13:51:27'),
(8715, 1006, 12507, NULL, '2021-08-10 00:00:00.000', 'In Process', 'We received the following update from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  I am not sure on the timeframe for completion, but you can check back as often as you like for updates.  Thank you,  Lisa marketcares Team\"', NULL, NULL, '2021-08-03 14:22:46', '2021-08-03 14:22:46'),
(8716, 1006, 12507, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Sent f/u email @ aa@claimsmedinc.com:  Sub: RE: Secure Message from cat_central@uhc.com  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding the credentialing/contracting status for the following PR-5826077.  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-18 16:06:17', '2021-08-18 16:06:17'),
(8717, 1006, 12507, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Received the following approval confirmation from cat_central@uhc.com:  Sub: Secure Message from cat_central@uhc.com  \"Brad  Effective date for group is 8/4/21 and for providers Glory Abraham, Ramegowda Belakere  Eff date is 5/17/21 for Shybi Varghese.  Thank you,  Lisa marketcares Team\"  Approval confirmation is attached.  ', NULL, NULL, '2021-08-20 10:07:22', '2021-08-20 10:07:22'),
(8718, 3040, 12508, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-06 14:38:08', '2021-01-06 14:38:08'),
(8719, 3040, 12508, NULL, '2021-01-13 00:00:00.000', 'Initiated', 'We submitted the online application form on 01/06/2021.  Application Status: Submitted  PEP Ticket Number: 17495632 		 ', NULL, NULL, '2021-01-06 14:39:23', '2021-01-06 14:39:23'),
(8720, 3040, 12508, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Had a word with (Anilisa) Medicaid representative and she advised the application is still in process.  ', NULL, NULL, '2021-01-13 10:48:42', '2021-01-13 10:48:42'),
(8721, 3040, 12508, NULL, '2021-01-25 00:00:00.000', 'Approved', 'Approved.   Waiting for the welcome letter.  See attachment. ', NULL, NULL, '2021-01-18 15:04:10', '2021-01-18 15:04:10'),
(8722, 3040, 12509, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-06 14:39:46', '2021-01-06 14:39:46'),
(8723, 3040, 12509, NULL, '2021-01-13 00:00:00.000', 'Initiated', 'We submitted the online application form on 01/06/2021.  Application Status: Submitted  PEP Ticket Number: 17495632', NULL, NULL, '2021-01-06 14:40:01', '2021-01-06 14:40:01'),
(8724, 3040, 12509, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Had a word with (Anilisa) Medicaid representative and she advised the application is still in process. ', NULL, NULL, '2021-01-13 10:48:49', '2021-01-13 10:48:49'),
(8725, 3040, 12509, NULL, '2021-01-25 00:00:00.000', 'Approved', 'Approved.   Waiting for the welcome letter.  See attachment', NULL, NULL, '2021-01-18 15:05:12', '2021-01-18 15:05:12'),
(8726, 3040, 12510, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-06 14:40:20', '2021-01-06 14:40:20'),
(8727, 3040, 12510, NULL, '2021-01-13 00:00:00.000', 'Initiated', 'We submitted the online application form on 01/06/2021.  Application Status: Submitted  PEP Ticket Number: 17495632', NULL, NULL, '2021-01-06 14:40:36', '2021-01-06 14:40:36'),
(8728, 3040, 12510, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Had a word with (Anilisa) Medicaid representative and she advised the application is still in process. ', NULL, NULL, '2021-01-13 10:48:55', '2021-01-13 10:48:55'),
(8729, 3040, 12510, NULL, '2021-01-25 00:00:00.000', 'Approved', 'Approved.   Waiting for the welcome letter.  See attachment', NULL, NULL, '2021-01-18 15:06:21', '2021-01-18 15:06:21'),
(8730, 3040, 12511, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-06 15:20:21', '2021-01-06 15:20:21'),
(8731, 3040, 12511, NULL, '2021-01-13 00:00:00.000', 'Initiated', 'We submitted the online application form 01/06/2021.  Application Status: Submitted PEP Ticket Number: 17495977', NULL, NULL, '2021-01-06 15:21:58', '2021-01-06 15:21:58'),
(8732, 3040, 12511, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Had a word with (Anilisa) Medicaid representative and she advised the application is still in process. ', NULL, NULL, '2021-01-13 10:49:06', '2021-01-13 10:49:06'),
(8733, 3040, 12511, NULL, '2021-01-26 00:00:00.000', 'Approved', 'Approved.   Waiting for the welcome letter.  See attachment.', NULL, NULL, '2021-01-19 12:55:06', '2021-01-19 12:55:06'),
(8734, 3040, 12512, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 12:26:43', '2021-01-07 12:26:43'),
(8735, 3040, 12512, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Enrollment request submitted.  See attachment.', NULL, NULL, '2021-01-07 12:27:29', '2021-01-07 12:27:29'),
(8736, 3040, 12512, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Greetings,  Hope you are doing well. Please find the attached CAQH access form along with W9 form as requested.   If you need any additional information please call or email me. Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-01-13 15:54:37', '2021-01-13 15:54:37'),
(8737, 3040, 12512, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Email sent to: 	pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Greetings,  Hope you are doing well. I am really sorry for the inconvenience. Please find the attached CAQH access form including with the updated demographic information along with the W9.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-19 14:37:05', '2021-01-19 14:37:05'),
(8738, 3040, 12512, NULL, '2021-02-02 00:00:00.000', 'In Process', 'Email rcvd from: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Greetings,  Hope you are doing well. This is a follow email regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider Details: Provider Name:  Fernandus, Limy Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-26 10:30:38', '2021-01-26 10:30:38'),
(8739, 3040, 12512, NULL, '2021-02-09 00:00:00.000', 'In Process', 'Email rcvd from: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Please give us more time to complete this request.  It can take 45 to 60 days', NULL, NULL, '2021-01-26 14:54:12', '2021-01-26 14:54:12'),
(8740, 3040, 12512, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Follow up email sent to: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Good Morning,  I just wanted to follow up regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider Details: Provider Name:  Fernandus, Limy Provider NPI# 1972005189  Please let me know once you get a chance. Waiting for your response.  Thanks ', NULL, NULL, '2021-02-10 10:25:20', '2021-02-10 10:25:20'),
(8741, 3040, 12512, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  Good Morning,  This is a follow up regarding the enrollment status of the below mentioned provider. Has there been any update?  Practice Details: Practice Name: Columbus Urgent Care PA Practice Tax ID# 47-1914151 Practice NPI# 1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider Details: Provider Name:  Fernandus, Limy Provider NPI# 1972005189  Please let me know once you get a chance. Waiting for your response.  Thanks', NULL, NULL, '2021-02-17 09:16:48', '2021-02-17 09:16:48'),
(8742, 3040, 12512, NULL, '2021-02-24 00:00:00.000', 'Approved', 'Email rcvd from: pr.south@healthsmart.com  Subject: HealthSmart.com - Join Our Network - Individual Provider - Fernandus  This has been updated. The effective date is 12/1/2020  ', NULL, NULL, '2021-02-17 09:45:26', '2021-02-17 09:45:26'),
(8743, 3040, 12513, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 13:14:55', '2021-01-07 13:14:55'),
(8744, 3040, 12513, NULL, '2021-01-21 00:00:00.000', 'Initiated', 'Provider enrollment form submitted online.   For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.', NULL, NULL, '2021-01-07 13:16:54', '2021-01-07 13:16:54'),
(8745, 3040, 12513, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Greetings,  Hope you are doing well. Please find the attached the demographic information form as requested.   If you need any additional information please call or email me. Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-01-13 15:21:35', '2021-01-13 15:21:35'),
(8746, 3040, 12513, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up email sent to: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Greetings,  Hope you are doing well. This a follow up email regarding the below mentioned provider. Has there been any update?  Practice Name: Longpoint Medical Center NPI# 1770763815 Tax ID# 76-0612416 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Name: Fernandus, Limy NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-20 12:48:49', '2021-01-20 12:48:49'),
(8747, 3040, 12513, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Provider Application – Fernandus  Greetings,  Hope you are doing well. I just wanted to follow up regarding the enrollment status of the below mentioned provider.  Practice Name: Long point Medical Center NPI# 1770763815 Tax ID# 76-0612416 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Name: Fernandus, Limy NPI# 1972005189  Please let me know if you need any additional information. Waiting for your response.   Thanks  ', NULL, NULL, '2021-01-27 11:03:57', '2021-01-27 11:03:57'),
(8748, 3040, 12513, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email rcvd from: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Adil,  Please allow us 30 to 45 days for this to be completed.  Thank you!', NULL, NULL, '2021-01-27 12:55:37', '2021-01-27 12:55:37'),
(8749, 3040, 12513, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Please allow us 30 to 45 days for this to be completed.', NULL, NULL, '2021-02-03 10:06:30', '2021-02-03 10:06:30'),
(8750, 3040, 12513, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Follow up email sent to: pr.south@healthsmart.com  Subject:  Provider Application – Fernandus  Good Morning,  This is a follow up email regarding the enrollment status of the below mentioned provider.   Practice Name: Long point Medical Center Practice NPI# 1770763815 Practice Tax ID# 76-0612416 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider Name: Fernandus, Limy NPI# 1972005189  Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-10 10:35:19', '2021-02-10 10:35:19'),
(8751, 3040, 12513, NULL, '2021-02-17 00:00:00.000', 'Approved', 'Email rcvd from: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Fernandus, Limy- effective date 12/1/2020', NULL, NULL, '2021-02-10 17:28:13', '2021-02-10 17:28:13'),
(8752, 3040, 12514, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 13:19:00', '2021-01-07 13:19:00'),
(8753, 3040, 12514, NULL, '2021-01-21 00:00:00.000', 'Initiated', 'Provider enrollment for submitted online.   For new provider applications, please allow 15 business days for a HealthSmart team member to contact you.', NULL, NULL, '2021-01-07 13:19:50', '2021-01-07 13:19:50'),
(8754, 3040, 12514, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email sent to:pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Greetings,  Hope you are doing well. Please find the attached the demographic information form as requested.   If you need any additional information please call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-13 15:32:11', '2021-01-13 15:32:11'),
(8755, 3040, 12514, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up email sent to: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Greetings,  Hope you are doing well. I wanted to know the status of enrollment for the below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2:   Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information:Provider Name: Limy FernandusProvider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-20 10:49:04', '2021-01-20 10:49:04'),
(8756, 3040, 12514, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Follow up sent to: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Greetings,  Hope you are doing well. I just wanted to know the enrollment status of the below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2:   Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy  Fernandus Provider NPI# 1972005189  Please reply to me as soon as you get a chance. Waiting for your response.  Thanks ', NULL, NULL, '2021-01-27 11:10:12', '2021-01-27 11:10:12'),
(8757, 3040, 12514, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email rcvd from: pr.south@healthsmart.com  Subject:  Provider Application – Fernandus  Adil,  Please allow 30 to 45 days for this to be completed.', NULL, NULL, '2021-01-27 12:57:38', '2021-01-27 12:57:38'),
(8758, 3040, 12514, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Please allow 30 to 45 days for this to be completed.', NULL, NULL, '2021-02-03 10:05:44', '2021-02-03 10:05:44'),
(8759, 3040, 12514, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Follow up email sent to: pr.south@healthsmart.com  Subject:  Provider Application – Fernandus  Good Morning,  This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2:   Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Information: Provider Name: Limy  Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-10 10:30:25', '2021-02-10 10:30:25'),
(8760, 3040, 12514, NULL, '2021-02-18 00:00:00.000', 'Approved', 'Email rcvd from: pr.south@healthsmart.com  Subject: Provider Application – Fernandus  Fernandus, Limy- effective date 12/1/2020', NULL, NULL, '2021-02-11 09:49:50', '2021-02-11 09:49:50'),
(8761, 3040, 12515, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 15:20:51', '2021-01-07 15:20:51'),
(8762, 3040, 12515, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Request form submitted online to add a provider to an existing group contract.  ', NULL, NULL, '2021-01-07 15:23:11', '2021-01-07 15:23:11'),
(8763, 3040, 12515, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Columbus Urgent Care PA|| Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please find the attached the provider application form for Limy Fernandus.  Please feel free to call or email me if you have any questions. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-11 14:29:38', '2021-01-11 14:29:38'),
(8764, 3040, 12515, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Columbus Urgent Care PA|| Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please update me regarding the enrollment status for the below provider.   Provider Name: Limy Fernandus  Provider NPI# 1972005189 Group Name: Columbus Urgent Care PA Group Tax-ID: 47-1914151 Group NPI#  215330501  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-18 12:47:39', '2021-01-18 12:47:39'),
(8765, 3040, 12515, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Columbus Urgent Care PA|| Limy Fernandus || Superior Healthplan  Greetings,  I am really sorry for the inconvenience and kindly disregard my previous email. Kindly advise me the enrollment status of the below mentioned provider.   Practice: Practice Name: Columbus Urgent Care PA Practice Tax-ID: 47-1914151 Practice NPI#  1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please feel free to ask if you need any additional information. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-25 12:02:05', '2021-01-25 12:02:05'),
(8766, 3040, 12515, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Email sent to: AM.Houston@superiorhealthplan.com  Subject: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||  Greetings,  Hope you are doing well. I wanted to know the enrollment status of the below mentioned provider.   Practice: Practice Name: Columbus Urgent Care PA Practice Tax-ID: 47-1914151 Practice NPI#  1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please feel free to ask if you need any additional information. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-02-01 16:36:37', '2021-02-01 16:36:37'),
(8767, 3040, 12515, NULL, '2021-02-15 00:00:00.000', 'In Process', 'Email rcvd from: AM.Houston@superiorhealthplan.com  Subject: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||_ REF # 24945  Good afternoon,   After reviewing the Credentialing status for the provider below, I see the application is under Credentialing status. Application was received on 1/11/2021.    Credentialing process can take between 60 -120 days. Please allow more time for application to process.     Thank you,   ', NULL, NULL, '2021-02-08 10:45:16', '2021-02-08 10:45:16'),
(8768, 3040, 12515, NULL, '2021-03-01 00:00:00.000', 'In Process', 'Still in process.  ', NULL, NULL, '2021-02-15 12:07:00', '2021-02-15 12:07:00'),
(8769, 3040, 12515, NULL, '2021-03-08 00:00:00.000', 'In Process', 'Email sent to:AM.Houston@superiorhealthplan.com  Subject: Re: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||_ REF # 24945  Greetings,  Hope you are doing well. Please advise me enrollment status for the below mentioned provider.   Practice: Practice Name: Columbus Urgent Care PA Practice Tax-ID: 47-1914151 Practice NPI#  1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-03-01 12:35:28', '2021-03-01 12:35:28'),
(8770, 3040, 12515, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Email rcvd from: AM.Houston@superiorhealthplan.com  Subject: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||_ REF # 24945  Good morning, Adil  Here is the information you requested for the following provider   Practice: Practice Name: Columbus Urgent Care PA Practice Tax-ID: 47-1914151 Practice NPI#  1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Limy Fernandus---- pending/Credentialing status  application was received on 1/11/2021 Provider NPI# 1972005189  Veronica Botello Rocha Provider Relations Coordinator II Provider Relations Department Nueces, Harris & Jefferson SDAs', NULL, NULL, '2021-03-08 12:07:30', '2021-03-08 12:07:30'),
(8771, 3040, 12515, NULL, '2021-03-22 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-03-15 10:09:50', '2021-03-15 10:09:50'),
(8772, 3040, 12515, NULL, '2021-03-22 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-15 10:15:29', '2021-03-15 10:15:29'),
(8773, 3040, 12515, NULL, '2021-05-24 00:00:00.000', 'In Process', 'Email sent to: AM.Houston@superiorhealthplan.com  Subject: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||_ REF # 24945  Hello,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider. As per your email the application was received on 01/11/2021.    Practice: Practice Name: Columbus Urgent Care PA Practice Tax-ID: 47-1914151 Practice NPI#  1215330501 Address: 926 Walnut St, Columbus , TX 78934-2215  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-17 09:25:09', '2021-05-17 09:25:09'),
(8774, 3040, 12515, NULL, '2021-05-24 00:00:00.000', 'Approved', 'Email rcvd from: AM.Houston@superiorhealthplan.com  Subject: Enrollment Status || Columbus Urgent Care PA || Limy Fernandus || Superior Health plan ||_ REF # 24945  Good morning,  After reviewing the Credentialing status for the provider below, I see the application has been approved. Provider effective date is 6/1/2021.   LIMY FERNANDUS NPI: 1972005189 TIN: 471914151  PAR products for provider effective 6/1/2021, will be:   ', NULL, NULL, '2021-05-17 10:36:30', '2021-05-17 10:36:30'),
(8775, 3040, 12516, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 15:24:04', '2021-01-07 15:24:04'),
(8776, 3040, 12516, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Request form submitted online to add a provider to an existing group contract.', NULL, NULL, '2021-01-07 15:24:13', '2021-01-07 15:24:13'),
(8777, 3040, 12516, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Longpoint Medical Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please find the attached the provider application form for Limy Fernandus.  Please feel free to call or email me if you have any questions. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-11 13:36:36', '2021-01-11 13:36:36'),
(8778, 3040, 12516, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Longpoint Medical Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please update me regarding the enrollment status for the below provider.   Provider Name: Limy Fernandus  Provider NPI# 1972005189 Group Name: Longpoint Medical Center Group Tax-ID: 76-0612416 Group NPI#  1770763815  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-18 12:50:36', '2021-01-18 12:50:36'),
(8779, 3040, 12516, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Columbus Urgent Care PA|| Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status for the below mentioned provider.  Practice: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI#  1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-25 11:54:59', '2021-01-25 11:54:59'),
(8780, 3040, 12516, NULL, '2021-02-08 00:00:00.000', 'In Process', 'Email sent to: AM.Houston@superiorhealthplan.com  Subject:  Longpoint Medical Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider.  Practice: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI#  1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-02-01 14:13:43', '2021-02-01 14:13:43'),
(8781, 3040, 12516, NULL, '2021-02-22 00:00:00.000', 'In Process', 'Email rcvd from: AM.Houston@superiorhealthplan.com  Subject:  Longpoint Medical Center || Limy Fernandus || Superior Healthplan _ REF # 24897  Good afternoon,  After reviewing the Credentialing status for the provider below, I see the application is under Credentialing status. Application was received on 1/11/2021.   Credentialing process can take between 60 -120 days. Please allow more time for application to process.  Thank you,   ', NULL, NULL, '2021-02-08 10:46:14', '2021-02-08 10:46:14'),
(8782, 3040, 12516, NULL, '2021-03-01 00:00:00.000', 'In Process', 'I see the application is under Credentialing status. Application was received on 1/11/2021.   Credentialing process can take between 60 -120 days. Please allow more time for application to process.', NULL, NULL, '2021-02-22 10:39:47', '2021-02-22 10:39:47'),
(8783, 3040, 12516, NULL, '2021-03-08 00:00:00.000', 'In Process', 'Email sent to: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Longpoint Medical Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please advise me the enrollment status for the below mentioned provider.   Practice: Practice Name: Longpoint Medical Center Practice Tax-ID: 76-0612416 Practice NPI#  1770763815 Address: 9504 LONG POINT RD STE E Houston , TX 77055-4226  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-03-01 15:49:31', '2021-03-01 15:49:31'),
(8784, 3040, 12516, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Email rcvd from: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Longpoint Medical Center || Limy Fernandus || Superior Healthplan  Hello  We received your completed application on 1/11/2021.  It is currently in credentialing.  Please note that we will notify you of acceptance / participation status within 90 days of receipt of completed application.  Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Thank you,  Leslie Gilchrist Intake Coordinator Contract Management Superior HealthPlan', NULL, NULL, '2021-03-08 12:18:52', '2021-03-08 12:18:52'),
(8785, 3040, 12516, NULL, '2021-03-22 00:00:00.000', 'In Process', 'Email rcvd from: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Hello  We received your completed application on 1/11/2021.  It is currently in credentialing.  Please note that we will notify you of acceptance / participation status within 90 days of receipt of completed application.  Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Thank you,  Leslie Gilchrist Intake Coordinator Contract Management Superior HealthPlan', NULL, NULL, '2021-03-15 15:47:46', '2021-03-15 15:47:46'),
(8786, 3040, 12516, NULL, '2021-05-19 00:00:00.000', 'Approved', 'Email rcvd from: ECMExecutionTeam@superiorhealthplan.com  Subject: LIMY FERNANDUS WELCOME LETTER  LIMY FERNANDUS LONG POINT MEDICAL CENTER LPMC@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:  06/01/2021                                                   C/47566', NULL, NULL, '2021-05-12 07:39:02', '2021-05-12 07:39:02'),
(8787, 3040, 12517, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 15:25:56', '2021-01-07 15:25:56'),
(8788, 3040, 12517, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Request form submitted online to add a provider to an existing group contract.', NULL, NULL, '2021-01-07 15:26:05', '2021-01-07 15:26:05'),
(8789, 3040, 12517, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. Please find the attached the provider application form for Limy Fernandus.  Please feel free to call or email me if you have any questions. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-11 13:58:19', '2021-01-11 13:58:19'),
(8790, 3040, 12517, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan   Greetings,  Hope you are doing well. Please update me regarding the enrollment status for the below provider.  Provider Name: Limy Fernandus Provider NPI# 1972005189 Group Name: Normandy Urgent Care Center Group Tax-ID: 27-0796429 Group NPI#  1407171077  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-18 12:55:01', '2021-01-18 12:55:01'),
(8791, 3040, 12517, NULL, '2021-02-01 00:00:00.000', 'In Process', 'Follow up email sent to: shp.networkdevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice 1:  Practice Name: Normandy Urgent Care Center Practice   Tax-ID: 27-0796429 Practice   NPI#  1407171077  Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2:  Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI#  1407171077  Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider:  Provider Name: Limy Fernandus Provider NPI# 1972005189  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-01-25 12:21:29', '2021-01-25 12:21:29'),
(8792, 3040, 12517, NULL, '2021-02-05 00:00:00.000', 'In Process', 'Email rcvd from: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Hello,  We received your completed application on (1/11/2021).  It is currently in credentialing.  Please note that we will notify you of acceptance / participation status within 90 days of receipt of completed application.  Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Thank you,  Sasha Henry', NULL, NULL, '2021-01-29 16:38:56', '2021-01-29 16:38:56'),
(8793, 3040, 12517, NULL, '2021-02-26 00:00:00.000', 'In Process', 'Application is still in process. ', NULL, NULL, '2021-02-05 12:45:08', '2021-02-05 12:45:08'),
(8794, 3040, 12517, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Application still in process. ', NULL, NULL, '2021-02-26 13:00:47', '2021-02-26 13:00:47'),
(8795, 3040, 12517, NULL, '2021-03-15 00:00:00.000', 'In Process', 'Email sent to: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Health plan ||   Hello,  Hope you are doing well. Please advise me the enrollment status for the below mentioned provider.  Practice 1: Practice Name: Normandy Urgent Care Center Practice   Tax-ID: 27-0796429 Practice   NPI#  1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI#  1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Waiting for your reply   Thank you  ', NULL, NULL, '2021-03-08 12:41:47', '2021-03-08 12:41:47'),
(8796, 3040, 12517, NULL, '2021-03-22 00:00:00.000', 'In Process', 'Email rcvd from: SHP.NetworkDevelopment@superiorhealthplan.com  Subject: Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Hello  We received your completed application on 1/11/2021.  It is currently in credentialing.  Please note that we will notify you of acceptance / participation status within 90 days of receipt of completed application.  Upon completion of this provider’s enrollment, your agreement will be executed and welcome packet will be sent.  Thank you,  Leslie Gilchrist Intake Coordinator Contract Management Superior HealthPlan', NULL, NULL, '2021-03-15 15:47:35', '2021-03-15 15:47:35'),
(8797, 3040, 12517, NULL, '2021-05-28 00:00:00.000', 'In Process', 'Email sent to: SHP.NetworkDevelopment@superiorhealthplan.com  Subject:  Normandy Urgent Care Center || Limy Fernandus || Superior Healthplan  Greetings,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider. Application received on 01/11/2021.   Practice 1: Practice Name: Normandy Urgent Care Center Practice   Tax-ID: 27-0796429 Practice   NPI#  1407171077 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice Tax-ID: 27-0796429 Practice NPI#  1407171077 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider: Provider Name: Limy Fernandus Provider NPI# 1972005189  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-21 14:01:57', '2021-05-21 14:01:57'),
(8798, 3040, 12517, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email sent to: SHP.NetworkDevelopment@superiorhealthplan.com  Subject:  Enrollment Status || Normandy Urgent Care Center, Imperial Valley Urgent Care Center || Superior Health Plan ||  Hello,  Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers in our group under below locations.  Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 270796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Provider 1: Provider Name: Fernandus, Limy  Provider NPI# 1972005189  Provider 2:   Provider Name: PAUL, SIGI Provider NPI# 1033623616  Provider 3: Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 4: Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 5: Provider Name: Thomas, Cini Provider NPI# 1134777238  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-06-10 09:25:36', '2021-06-10 09:25:36'),
(8799, 3040, 12517, NULL, '2021-07-05 00:00:00.000', 'Approved', 'Provider is participating with Superior Healthplan. Please see attachment. ', NULL, NULL, '2021-06-28 15:36:22', '2021-06-28 15:36:22'),
(8800, 3040, 12518, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 17:18:04', '2021-01-07 17:18:04'),
(8801, 3040, 12518, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Enrollment application submitted through online.   Service Case Number:	7472402 ', NULL, NULL, '2021-01-07 17:19:14', '2021-01-07 17:19:14'),
(8802, 3040, 12518, NULL, '2021-01-21 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Hospital Privileges || Fernandus, Limy || Columbus Urgent Care PA || Multiplan  Greetings,  Hope you are doing well. I had a word with (Jim) Multiplan representative regarding the application for below mentioned provider and he requested me to send the hospital privileges for the provider. The provider has admitting privileges under the supervising physician.    Practice Name: Columbus Urgent Care PA NPI# 1215330501 Tax ID# 47-1914151 Address:926 Walnut St, Columbus , TX 78934-2215  Provider Name:  Limy Fernandus Provider NPI# 1972005189  Facility Supervisor Name: Ramegowda Belakere Hospital Privileges: Memorial Specialty Hospital Address:  1201 W Frank Ave Lufkin, Texas, 75904  If you need any additional information please call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-14 17:27:15', '2021-01-14 17:27:15'),
(8803, 3040, 12518, NULL, '2021-01-26 00:00:00.000', 'In Process', 'Email sent to: appmissinginfo@multiplan.com  Subject: Regarding Fernandus, Limy, NP\'s MultiPlan Application – Reference: APP0008129547  Greetings,  Hope you are doing well. Please find the attached the additional information requested for Limy Fernandus.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-19 13:34:11', '2021-01-19 13:34:11'),
(8804, 3040, 12518, NULL, '2021-02-02 00:00:00.000', 'In Process', 'I had a word with (Jennifer) Multiplan representative and she said the application still in process. ', NULL, NULL, '2021-01-26 14:15:05', '2021-01-26 14:15:05'),
(8805, 3040, 12518, NULL, '2021-02-09 00:00:00.000', 'In Process', 'I had a word with (Anna) Multiplan representative and she said the provider is added in the group and Effective Date is 01/19/2021.  Waiting for the Welcome Letter', NULL, NULL, '2021-02-02 12:27:30', '2021-02-02 12:27:30'),
(8806, 3040, 12518, NULL, '2021-02-11 00:00:00.000', 'Approved', 'Welcome Letter Attached  Effective Date: 01/19/2021', NULL, NULL, '2021-02-04 09:54:13', '2021-02-04 09:54:13'),
(8807, 3040, 12519, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 17:23:12', '2021-01-07 17:23:12'),
(8808, 3040, 12519, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Enrollment application submitted through online to add provider an existing group.   Service Case Number:	7472410', NULL, NULL, '2021-01-07 17:24:59', '2021-01-07 17:24:59'),
(8809, 3040, 12519, NULL, '2021-01-21 00:00:00.000', 'In Process', 'Application received.   Need to follow up after 15 days.', NULL, NULL, '2021-01-14 17:28:29', '2021-01-14 17:28:29'),
(8810, 3040, 12519, NULL, '2021-02-02 00:00:00.000', 'In Process', 'I had a word with (Jennifer) Multiplan representative and she said the application still in process. ', NULL, NULL, '2021-01-26 14:15:02', '2021-01-26 14:15:02'),
(8811, 3040, 12519, NULL, '2021-02-09 00:00:00.000', 'Approved', 'Welcome Letter Attached  Effective Date: 01/19/2021', NULL, NULL, '2021-02-02 13:17:24', '2021-02-02 13:17:24'),
(8812, 3040, 12520, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 17:54:24', '2021-01-07 17:54:24'),
(8813, 3040, 12520, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Enrollment application submitted through online.  Service Case Number:	7472447 ', NULL, NULL, '2021-01-07 17:55:10', '2021-01-07 17:55:10'),
(8814, 3040, 12520, NULL, '2021-01-21 00:00:00.000', 'In Process', 'Application received.   Need to follow up after 15 days ', NULL, NULL, '2021-01-14 17:28:35', '2021-01-14 17:28:35'),
(8815, 3040, 12520, NULL, '2021-01-28 00:00:00.000', 'In Process', 'Allow more time to received the application.  ', NULL, NULL, '2021-01-21 10:37:38', '2021-01-21 10:37:38'),
(8816, 3040, 12520, NULL, '2021-02-05 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Requested Provider Application Materials 1/25/2021  Greetings,  Hope you are doing well. Please find the attached the Practitioner application and TIN authorization as per previous email requested.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-29 15:42:53', '2021-01-29 15:42:53'),
(8817, 3040, 12520, NULL, '2021-02-12 00:00:00.000', 'In Process', 'Email sent to: 	registrar@multiplan.com  Subject: Requested Provider Application Materials 1/25/2021  Greetings,  Hope you are doing well. Please advise me the enrollment status of the below mentioned provider.   Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID#  27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID#  27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Name:  Limy Fernandus Provider NPI# 1972005189  If you need any additional information please let me know. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-05 10:33:27', '2021-02-05 10:33:27'),
(8818, 3040, 12520, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Jeff) Multiplan representative and he said the application is still in process. ', NULL, NULL, '2021-02-12 09:50:12', '2021-02-12 09:50:12'),
(8819, 3040, 12520, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a word with (Jennifer) Multiplan representative and she said the application is still in process and It will take 60 days. Application rcvd on 01/29/2021.', NULL, NULL, '2021-02-19 15:26:17', '2021-02-19 15:26:17'),
(8820, 3040, 12520, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-02-26 12:39:16', '2021-02-26 12:39:16'),
(8821, 3040, 12520, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-03-05 15:03:02', '2021-03-05 15:03:02'),
(8822, 3040, 12520, NULL, '2021-04-01 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-03-12 15:28:35', '2021-03-12 15:28:35'),
(8823, 3040, 12520, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Enrollment Status || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Group & Providers || Multiplan ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group and providers in Multiplan for our group under the below locations. Can you please send the roster.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-28 16:21:19', '2021-05-28 16:21:19'),
(8824, 3040, 12520, NULL, '2021-06-25 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Re: Enrollment Status || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Group & Providers || Multiplan ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Multiplan for our group under the below locations.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Provider 1:   Provider Name: Joseph, Molly Provider NPI# 1396380077  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 4:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 5:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 6:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 7:   Provider Name: Jose, Julie Provider NPI# 1447883061  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-18 08:51:32', '2021-06-18 08:51:32'),
(8825, 3040, 12520, NULL, '2021-07-13 00:00:00.000', 'In Process', 'I had a word with Dan Multiplan representative and he said under the group contract we have all three location  (NUCC, IVUC & LPMC). He advised to send the LOI through fax and they can process our request. Also he said LPMC is not contracted separately because that already coming under the NUCC tax ID .  Case # 7660656', NULL, NULL, '2021-07-06 11:57:31', '2021-07-06 11:57:31');
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
(8826, 3040, 12520, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Letter of Intent || NUCC, IVUC & LPMC || Providers || Multiplan ||  Greetings,   Hope you are doing well. Please find attached Letter of Intent as per request of (Sam) Multiplan representative and he advises to send it through email as per him Multiplan did not receive the fax.    Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name:Longpoint Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider 1:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 4:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 5:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 6:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 7:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 8:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 9:   Provider Name: Joseph, Molly  Provider NPI# 1396380077  Provider 10:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 11:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 12:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 13:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 14:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 15:   Provider Name: John, Jeny Provider NPI# 1073019493   Thank you  ', NULL, NULL, '2021-07-27 16:41:49', '2021-07-27 16:41:49'),
(8827, 11056, 12520, NULL, '2021-08-16 00:00:00.000', 'In Process', 'Email sent to : registrar@multiplan.com  Sub : Enrollment Status Query - NUCC - IVUC - LPMC - Multiplan  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the following providers and practices for the Multiplan.  Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name:Longpoint Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider Details: Provider 1:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 4:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 5:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 6:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 7:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 8:   Provider Name: PAUL, SIGI Provider NPI# 1033623616  Provider 9:   Provider Name: Joseph, Molly Provider NPI# 1396380077  Provider 10:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 11:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 12:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 13:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 14:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 15:   Provider Name: John, Jeny Provider NPI# 1073019493  If you need any information or documents feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-09 12:32:17', '2021-08-09 12:32:17'),
(8828, 3040, 12520, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Provider is participating with Multiplan. Please see attachment. ', NULL, NULL, '2021-08-20 16:45:32', '2021-08-20 16:45:32'),
(8829, 3040, 12521, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-07 17:55:41', '2021-01-07 17:55:41'),
(8830, 3040, 12521, NULL, '2021-01-14 00:00:00.000', 'Initiated', 'Enrollment application submitted through online  Service Case Number:	7472447 ', NULL, NULL, '2021-01-07 17:55:50', '2021-01-07 17:55:50'),
(8831, 3040, 12521, NULL, '2021-01-21 00:00:00.000', 'In Process', 'Application received.   Need to follow up after 15 days ', NULL, NULL, '2021-01-14 17:28:42', '2021-01-14 17:28:42'),
(8832, 3040, 12521, NULL, '2021-01-28 00:00:00.000', 'In Process', 'Allow more time to received the application.  ', NULL, NULL, '2021-01-21 10:37:49', '2021-01-21 10:37:49'),
(8833, 3040, 12521, NULL, '2021-02-05 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Requested Provider Application Materials 1/25/2021  Greetings,  Hope you are doing well. Please find the attached the Practitioner application and TIN authorization as per previous email requested.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-29 15:43:04', '2021-01-29 15:43:04'),
(8834, 3040, 12521, NULL, '2021-02-12 00:00:00.000', 'In Process', 'Email sent to: 	registrar@multiplan.com  Subject: Requested Provider Application Materials 1/25/2021  Greetings,  Hope you are doing well. Please advise me the enrollment status of the below mentioned provider.   Practice 1: Practice Name: Normandy Urgent Care Center Practice NPI# 1407171077 Practice Tax ID#  27-0796429 Address: 779 Normandy St Ste 114 Houston , TX 77015-3441  Practice 2: Practice Name: Imperial Valley Urgent Care Center Practice NPI# 1407171077 Practice Tax ID#  27-0796429 Address: 16272 IMPERIAL VALLEY DR STE K, Houston , TX 77060  Provider Name:  Limy Fernandus Provider NPI# 1972005189  If you need any additional information please let me know. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-02-05 10:33:33', '2021-02-05 10:33:33'),
(8835, 3040, 12521, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Jeff) Multiplan representative and he said the application is still in process. ', NULL, NULL, '2021-02-12 09:50:18', '2021-02-12 09:50:18'),
(8836, 3040, 12521, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a word with (Jennifer) Multiplan representative and she said the application is still in process and It will take 60 days. Application rcvd on 01/29/2021.', NULL, NULL, '2021-02-19 15:26:29', '2021-02-19 15:26:29'),
(8837, 3040, 12521, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-02-26 12:38:51', '2021-02-26 12:38:51'),
(8838, 3040, 12521, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-03-05 15:03:03', '2021-03-05 15:03:03'),
(8839, 3040, 12521, NULL, '2021-04-01 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 15:28:20', '2021-03-12 15:28:20'),
(8840, 3040, 12521, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Enrollment Status || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Group & Providers || Multiplan ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group and providers in Multiplan for our group under the below locations. Can you please send the roster.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Provider 1: Provider Name: George, Jeemol Provider NPI# 1497219067  Provider 2:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 3:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 4:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 5:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 6:   Provider Name: Chennemkara, Mini Philip Provider NPI# 1841755956  Provider 7:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 8:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 9:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 10:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 11:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 12:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 13:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 14:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 15:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-05-28 16:22:21', '2021-05-28 16:22:21'),
(8841, 3040, 12521, NULL, '2021-06-25 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Re: Enrollment Status || Normandy Urgent Care Center & Imperial Valley Urgent Care Center || Group & Providers || Multiplan ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Multiplan for our group under the below locations.   Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Provider 1:   Provider Name: Joseph, Molly Provider NPI# 1396380077  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 4:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 5:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 6:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 7:   Provider Name: Jose, Julie Provider NPI# 1447883061  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-18 08:51:28', '2021-06-18 08:51:28'),
(8842, 3040, 12521, NULL, '2021-07-13 00:00:00.000', 'In Process', 'I had a word with Dan Multiplan representative and he said under the group contract we have all three location  (NUCC, IVUC & LPMC). He advised to send the LOI through fax and they can process our request. Also he said LPMC is not contracted separately because that already coming under the NUCC tax ID .  Case # 7660656', NULL, NULL, '2021-07-06 11:57:30', '2021-07-06 11:57:30'),
(8843, 3040, 12521, NULL, '2021-08-03 00:00:00.000', 'In Process', 'Email sent to: registrar@multiplan.com  Subject: Letter of Intent || NUCC, IVUC & LPMC || Providers || Multiplan ||  Greetings,   Hope you are doing well. Please find attached Letter of Intent as per request of (Sam) Multiplan representative and he advises to send it through email as per him Multiplan did not receive the fax.    Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name:Longpoint Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider 1:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 4:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 5:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 6:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 7:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 8:   Provider Name: PAUL, SIGI  Provider NPI# 1033623616  Provider 9:   Provider Name: Joseph, Molly  Provider NPI# 1396380077  Provider 10:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 11:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 12:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 13:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 14:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 15:   Provider Name: John, Jeny Provider NPI# 1073019493   Thank you  ', NULL, NULL, '2021-07-27 16:41:50', '2021-07-27 16:41:50'),
(8844, 11056, 12521, NULL, '2021-08-16 00:00:00.000', 'In Process', 'Email sent to : registrar@multiplan.com  Sub : Enrollment Status Query - NUCC - IVUC - LPMC - Multiplan  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the following providers and practices for the Multiplan.  Practice Details: Practice Name: Normandy Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address: 779 Normandy St Ste 114  Houston , TX 77015-3441  Practice Name: Imperial Valley Urgent Care Center Practice Tax ID# 27-0796429 Practice NPI# 1407171077 Practice Address:16272 IMPERIAL VALLEY DR STE K,  Houston , TX 77060  Practice Name:Longpoint Medical Center Practice Tax ID# 76-0612416 Practice NPI# 1770763815 Practice Address: 9504 LONG POINT RD STE E  Houston , TX 77055-4226  Provider Details: Provider 1:   Provider Name: Brown, Brittany Provider NPI# 1275163537  Provider 2:   Provider Name: Stephen, Ani Provider NPI# 1588959118  Provider 3:   Provider Name: Thomas, Cini Provider NPI# 1134777238  Provider 4:   Provider Name: Rauf, Abdur Provider NPI# 1497726202  Provider 5:   Provider Name: Abraham, Jeena Provider NPI# 1467901587  Provider 6:   Provider Name: Fernandus, Limy Provider NPI# 1972005189  Provider 7:   Provider Name: Kourouma , Odette Tiranke Provider NPI# 1134525868  Provider 8:   Provider Name: PAUL, SIGI Provider NPI# 1033623616  Provider 9:   Provider Name: Joseph, Molly Provider NPI# 1396380077  Provider 10:   Provider Name: Jacob, Jaya Provider NPI# 1194336149  Provider 11:   Provider Name: Jose, Julie Provider NPI# 1447883061  Provider 12:   Provider Name: Piccione JR, James M Provider NPI# 1356321509  Provider 13:   Provider Name: Abraham, Glory Provider NPI# 1194206490  Provider 14:   Provider Name: Joseph, Vibitha Provider NPI# 1952931560  Provider 15:   Provider Name: John, Jeny Provider NPI# 1073019493  If you need any information or documents feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-09 12:44:11', '2021-08-09 12:44:11'),
(8845, 3040, 12521, NULL, '2021-08-27 00:00:00.000', 'Approved', 'Provider is participating with Multiplan. Please see attachment. ', NULL, NULL, '2021-08-20 16:45:33', '2021-08-20 16:45:33'),
(8846, 3040, 12522, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:21:34', '2021-01-08 15:21:34'),
(8847, 3040, 12522, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrolled through Cigna call center representative.   Below are the details:   Provider ID: 3297453 Application No: 12447328 ', NULL, NULL, '2021-01-08 15:23:30', '2021-01-08 15:23:30'),
(8848, 3040, 12522, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Under contract decision It will take 2 weeks in order to approved or get denied. ', NULL, NULL, '2021-01-15 09:47:51', '2021-01-15 09:47:51'),
(8849, 3040, 12522, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:54:47', '2021-01-22 12:54:47'),
(8850, 3040, 12522, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:49:46', '2021-01-29 13:49:46'),
(8851, 3040, 12522, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:34', '2021-02-05 10:45:34'),
(8852, 3040, 12522, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:08', '2021-02-12 13:36:08'),
(8853, 3040, 12522, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:32:00', '2021-02-19 16:32:00'),
(8854, 3040, 12522, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:30', '2021-02-26 13:06:30'),
(8855, 3040, 12522, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-05 14:36:59', '2021-03-05 14:36:59'),
(8856, 3040, 12522, NULL, '2021-03-16 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447328 Application complete: Credentialing process to begin Dear MOSES CAMPOS,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-09 12:56:23', '2021-03-09 12:56:23'),
(8857, 3040, 12522, NULL, '2021-03-23 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-03-16 13:57:56', '2021-03-16 13:57:56'),
(8858, 3040, 12522, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.  Provider Name: MOSES CAMPOS  Cigna ID: 3297453  Tax ID: 815123542  Effective date: 03/22/2021  ', NULL, NULL, '2021-04-12 13:27:36', '2021-04-12 13:27:36'),
(8859, 3040, 12523, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:23:46', '2021-01-08 15:23:46'),
(8860, 3040, 12523, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrolled through Cigna call center representative.   Below are the details:   Provider ID: 3297453 Application No: 12447328 ', NULL, NULL, '2021-01-08 15:23:57', '2021-01-08 15:23:57'),
(8861, 3040, 12523, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Under contract decision It will take 2 weeks in order to approved or get denied. ', NULL, NULL, '2021-01-15 09:47:53', '2021-01-15 09:47:53'),
(8862, 3040, 12523, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:50:32', '2021-01-22 12:50:32'),
(8863, 3040, 12523, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:49:27', '2021-01-29 13:49:27'),
(8864, 3040, 12523, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:28', '2021-02-05 10:45:28'),
(8865, 3040, 12523, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:16', '2021-02-12 13:36:16'),
(8866, 3040, 12523, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:31:34', '2021-02-19 16:31:34'),
(8867, 3040, 12523, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:34', '2021-02-26 13:06:34'),
(8868, 3040, 12523, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-08 15:33:16', '2021-03-08 15:33:16'),
(8869, 3040, 12523, NULL, '2021-03-16 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447328 Application complete: Credentialing process to begin Dear MOSES CAMPOS,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-09 12:56:29', '2021-03-09 12:56:29'),
(8870, 3040, 12523, NULL, '2021-03-23 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-03-16 13:58:00', '2021-03-16 13:58:00'),
(8871, 3040, 12523, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.  Provider Name: MOSES CAMPOS  Cigna ID: 3297453  Tax ID: 815123542  Effective date: 03/22/2021  ', NULL, NULL, '2021-04-12 13:27:38', '2021-04-12 13:27:38'),
(8872, 3040, 12524, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:24:06', '2021-01-08 15:24:06'),
(8873, 3040, 12524, NULL, '2021-01-15 00:00:00.000', 'In Process', 'Provider enrolled through Cigna call center representative.   Below are the details:   Provider ID: 3297453 Application No: 12447328 ', NULL, NULL, '2021-01-08 15:24:14', '2021-01-08 15:24:14'),
(8874, 3040, 12524, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Under contract decision It will take 2 weeks in order to approved or get denied.', NULL, NULL, '2021-01-15 10:07:39', '2021-01-15 10:07:39'),
(8875, 3040, 12524, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Under contract decision It will take 2 weeks in order to approved or get denied.', NULL, NULL, '2021-01-15 10:08:03', '2021-01-15 10:08:03'),
(8876, 3040, 12524, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:54:09', '2021-01-22 12:54:09'),
(8877, 3040, 12524, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:49:37', '2021-01-29 13:49:37'),
(8878, 3040, 12524, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:39', '2021-02-05 10:45:39'),
(8879, 3040, 12524, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:23', '2021-02-12 13:36:23'),
(8880, 3040, 12524, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:31:43', '2021-02-19 16:31:43'),
(8881, 3040, 12524, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:39', '2021-02-26 13:06:39'),
(8882, 3040, 12524, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-08 15:33:30', '2021-03-08 15:33:30'),
(8883, 3040, 12524, NULL, '2021-03-16 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447328 Application complete: Credentialing process to begin Dear MOSES CAMPOS,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-09 12:56:35', '2021-03-09 12:56:35'),
(8884, 3040, 12524, NULL, '2021-03-23 00:00:00.000', 'In Process', 'Still in process', NULL, NULL, '2021-03-16 13:58:05', '2021-03-16 13:58:05'),
(8885, 3040, 12524, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.  Provider Name: MOSES CAMPOS  Cigna ID: 3297453  Tax ID: 815123542  Effective date: 03/22/2021  ', NULL, NULL, '2021-04-12 13:27:39', '2021-04-12 13:27:39'),
(8886, 3040, 12525, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:26:04', '2021-01-08 15:26:04'),
(8887, 3040, 12525, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrolled through Cigna call center representative.   Provider ID: 6397238 Application No: 12447316', NULL, NULL, '2021-01-08 15:26:53', '2021-01-08 15:26:53'),
(8888, 3040, 12525, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:01', '2021-01-15 09:49:01'),
(8889, 3040, 12525, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:52:34', '2021-01-22 12:52:34'),
(8890, 3040, 12525, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: ONBEloquaNotice@cigna.com  Subject: Cigna Credentialing Status Update: Application Received  Re:	Reference number 12447316 Application to participate in the Cigna medical network Dear LARRY WRIGHT,  Thank you for submitting an application to join a Cigna network. We have received your application and are in the process of reviewing it.', NULL, NULL, '2021-01-28 14:37:54', '2021-01-28 14:37:54'),
(8891, 3040, 12525, NULL, '2021-02-11 00:00:00.000', 'In Process', 'I had a word with Cigna representative and he advised that application is still in process. ', NULL, NULL, '2021-02-04 12:08:24', '2021-02-04 12:08:24'),
(8892, 3040, 12525, NULL, '2021-02-18 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she advised the application was open from 01/08/2021 and still in process. ', NULL, NULL, '2021-02-11 12:50:10', '2021-02-11 12:50:10'),
(8893, 3040, 12525, NULL, '2021-02-25 00:00:00.000', 'In Process', 'I had a word with (Marques) Cigna representative and he said the application is still in process. ', NULL, NULL, '2021-02-18 13:36:27', '2021-02-18 13:36:27'),
(8894, 3040, 12525, NULL, '2021-03-04 00:00:00.000', 'In Process', 'I had a word with (Santana) Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-02-25 14:31:46', '2021-02-25 14:31:46'),
(8895, 3040, 12525, NULL, '2021-03-11 00:00:00.000', 'In Process', 'I had a word with (Ivan C) Cigna representative and he said the application is still in process.  ', NULL, NULL, '2021-03-04 15:37:09', '2021-03-04 15:37:09'),
(8896, 3040, 12525, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:51:05', '2021-03-12 16:51:05'),
(8897, 3040, 12525, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:54:05', '2021-03-19 15:54:05'),
(8898, 3040, 12525, NULL, '2021-04-20 00:00:00.000', 'In Process', 'I had a word with Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-04-13 16:09:07', '2021-04-13 16:09:07'),
(8899, 3040, 12525, NULL, '2021-05-10 00:00:00.000', 'In Process', 'I checked on the provider directory and the provider still in process. ', NULL, NULL, '2021-05-03 14:36:13', '2021-05-03 14:36:13'),
(8900, 3040, 12525, NULL, '2021-06-03 00:00:00.000', 'In Process', 'I had a word with (RONNY) Cigna representative and he advised the application is still in process.   Ref: RONNY 05/27/2021', NULL, NULL, '2021-05-27 12:29:30', '2021-05-27 12:29:30'),
(8901, 3040, 12525, NULL, '2021-06-23 00:00:00.000', 'In Process', 'I had a word with (Ella G) Cigna representative and she send the email to the credentialing department why the application is still pending and they will contact us through email.   Ref: Ella G 06/16/2021', NULL, NULL, '2021-06-16 10:00:40', '2021-06-16 10:00:40'),
(8902, 3040, 12525, NULL, '2021-07-07 00:00:00.000', 'Approved', 'Email rcvd from: discovercigna@information.cigna.com  Subject: Welcome to the Cigna network  Dear LARRY WRIGHT ,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Jeff Panter	 Let’s get started Your effective date is 06/21/2021. Your provider identification number is‍ ‌6397238. Please take a moment to register for the Cigna for Health Care Professionals website (CignaforHCP.com).  ', NULL, NULL, '2021-06-30 14:54:37', '2021-06-30 14:54:37'),
(8903, 3040, 12526, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:27:11', '2021-01-08 15:27:11'),
(8904, 3040, 12526, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrolled through Cigna call center representative.   Provider ID: 6397238 Application No: 12447316', NULL, NULL, '2021-01-08 15:27:22', '2021-01-08 15:27:22'),
(8905, 3040, 12526, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:03', '2021-01-15 09:49:03'),
(8906, 3040, 12526, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:51:16', '2021-01-22 12:51:16'),
(8907, 3040, 12526, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: ONBEloquaNotice@cigna.com  Subject: Cigna Credentialing Status Update: Application Received  Re:	Reference number 12447316 Application to participate in the Cigna medical network Dear LARRY WRIGHT,  Thank you for submitting an application to join a Cigna network. We have received your application and are in the process of reviewing it.', NULL, NULL, '2021-01-28 14:38:00', '2021-01-28 14:38:00'),
(8908, 3040, 12526, NULL, '2021-02-11 00:00:00.000', 'In Process', 'I had a word with Cigna representative and he advised that application is still in process. ', NULL, NULL, '2021-02-04 12:08:19', '2021-02-04 12:08:19'),
(8909, 3040, 12526, NULL, '2021-02-18 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she advised the application was open from 01/08/2021 and still in process. ', NULL, NULL, '2021-02-11 12:50:15', '2021-02-11 12:50:15'),
(8910, 3040, 12526, NULL, '2021-02-25 00:00:00.000', 'In Process', 'I had a word with (Marques) Cigna representative and he said the application is still in process. ', NULL, NULL, '2021-02-18 13:36:33', '2021-02-18 13:36:33'),
(8911, 3040, 12526, NULL, '2021-03-04 00:00:00.000', 'In Process', 'I had a word with (Santana) Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-02-25 14:31:52', '2021-02-25 14:31:52'),
(8912, 3040, 12526, NULL, '2021-03-11 00:00:00.000', 'In Process', 'I had a word with (Ivan C) Cigna representative and he said the application is still in process.  ', NULL, NULL, '2021-03-04 15:37:14', '2021-03-04 15:37:14'),
(8913, 3040, 12526, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:51:09', '2021-03-12 16:51:09'),
(8914, 3040, 12526, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:54:10', '2021-03-19 15:54:10'),
(8915, 3040, 12526, NULL, '2021-04-20 00:00:00.000', 'In Process', 'I had a word with Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-04-13 16:09:07', '2021-04-13 16:09:07'),
(8916, 3040, 12526, NULL, '2021-05-10 00:00:00.000', 'In Process', 'I checked on the provider directory and the provider still in process. ', NULL, NULL, '2021-05-03 14:36:07', '2021-05-03 14:36:07'),
(8917, 3040, 12526, NULL, '2021-06-03 00:00:00.000', 'In Process', 'I had a word with (RONNY) Cigna representative and he advised the application is still in process.   Ref: RONNY 05/27/2021', NULL, NULL, '2021-05-27 12:28:45', '2021-05-27 12:28:45'),
(8918, 3040, 12526, NULL, '2021-06-23 00:00:00.000', 'In Process', 'I had a word with (Ella G) Cigna representative and she send the email to the credentialing department why the application is still pending and they will contact us through email.   Ref: Ella G 06/16/2021', NULL, NULL, '2021-06-16 10:00:34', '2021-06-16 10:00:34'),
(8919, 3040, 12526, NULL, '2021-07-07 00:00:00.000', 'Approved', 'Email rcvd from: discovercigna@information.cigna.com  Subject: Welcome to the Cigna network  Dear LARRY WRIGHT ,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Jeff Panter	 Let’s get started Your effective date is 06/21/2021. Your provider identification number is‍ ‌6397238. Please take a moment to register for the Cigna for Health Care Professionals website (CignaforHCP.com).  ', NULL, NULL, '2021-06-30 14:54:43', '2021-06-30 14:54:43'),
(8920, 3040, 12527, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 15:27:35', '2021-01-08 15:27:35'),
(8921, 3040, 12527, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrolled through Cigna call center representative.   Provider ID: 6397238 Application No: 12447316', NULL, NULL, '2021-01-08 15:27:45', '2021-01-08 15:27:45'),
(8922, 3040, 12527, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:07', '2021-01-15 09:49:07'),
(8923, 3040, 12527, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:54:13', '2021-01-22 12:54:13'),
(8924, 3040, 12527, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: ONBEloquaNotice@cigna.com  Subject: Cigna Credentialing Status Update: Application Received  Re:	Reference number 12447316 Application to participate in the Cigna medical network Dear LARRY WRIGHT,  Thank you for submitting an application to join a Cigna network. We have received your application and are in the process of reviewing it.', NULL, NULL, '2021-01-28 14:38:06', '2021-01-28 14:38:06'),
(8925, 3040, 12527, NULL, '2021-02-11 00:00:00.000', 'In Process', 'I had a word with Cigna representative and he advised that application is still in process. ', NULL, NULL, '2021-02-04 12:08:30', '2021-02-04 12:08:30'),
(8926, 3040, 12527, NULL, '2021-02-18 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she advised the application was open from 01/08/2021 and still in process. ', NULL, NULL, '2021-02-11 12:50:23', '2021-02-11 12:50:23'),
(8927, 3040, 12527, NULL, '2021-02-25 00:00:00.000', 'In Process', 'I had a word with (Marques) Cigna representative and he said the application is still in process. ', NULL, NULL, '2021-02-18 13:36:38', '2021-02-18 13:36:38'),
(8928, 3040, 12527, NULL, '2021-03-04 00:00:00.000', 'In Process', 'I had a word with (Santana) Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-02-25 14:31:57', '2021-02-25 14:31:57'),
(8929, 3040, 12527, NULL, '2021-03-11 00:00:00.000', 'In Process', 'I had a word with (Ivan C) Cigna representative and he said the application is still in process.  ', NULL, NULL, '2021-03-04 15:37:19', '2021-03-04 15:37:19'),
(8930, 3040, 12527, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:51:14', '2021-03-12 16:51:14'),
(8931, 3040, 12527, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:54:17', '2021-03-19 15:54:17'),
(8932, 3040, 12527, NULL, '2021-04-20 00:00:00.000', 'In Process', 'I had a word with Cigna representative and she said the application is still in process. ', NULL, NULL, '2021-04-13 16:09:08', '2021-04-13 16:09:08'),
(8933, 3040, 12527, NULL, '2021-05-10 00:00:00.000', 'In Process', 'I checked on the provider directory and the provider still in process. ', NULL, NULL, '2021-05-03 14:36:04', '2021-05-03 14:36:04'),
(8934, 3040, 12527, NULL, '2021-06-03 00:00:00.000', 'In Process', 'I had a word with (RONNY) Cigna representative and he advised the application is still in process.   Ref: RONNY 05/27/2021', NULL, NULL, '2021-05-27 12:29:24', '2021-05-27 12:29:24'),
(8935, 3040, 12527, NULL, '2021-06-23 00:00:00.000', 'In Process', 'I had a word with (Ella G) Cigna representative and she send the email to the credentialing department why the application is still pending and they will contact us through email.   Ref: Ella G 06/16/2021', NULL, NULL, '2021-06-16 10:00:29', '2021-06-16 10:00:29'),
(8936, 3040, 12527, NULL, '2021-07-07 00:00:00.000', 'Approved', 'Email rcvd from: discovercigna@information.cigna.com  Subject: Welcome to the Cigna network  Dear LARRY WRIGHT ,  Congratulations! Your application to participate in the Cigna network has been approved. Our shared focus is on the health and well-being of every person we serve. Working together, we can help them live a healthy life.  Jeff Panter  Vice President  Provider Relations & Solutions Management  Jeff Panter	 Let’s get started Your effective date is 06/21/2021. Your provider identification number is‍ ‌6397238. Please take a moment to register for the Cigna for Health Care Professionals website (CignaforHCP.com).  ', NULL, NULL, '2021-06-30 14:54:48', '2021-06-30 14:54:48'),
(8937, 3040, 12528, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:18:51', '2021-01-08 17:18:51'),
(8938, 3040, 12528, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrollment request initiated through Cigna call center representative.   Provider ID: 9264556 Application no: 12447473', NULL, NULL, '2021-01-08 17:21:34', '2021-01-08 17:21:34'),
(8939, 3040, 12528, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:25', '2021-01-15 09:49:25'),
(8940, 3040, 12528, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:52:41', '2021-01-22 12:52:41'),
(8941, 3040, 12528, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:50:09', '2021-01-29 13:50:09'),
(8942, 3040, 12528, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:50', '2021-02-05 10:45:50'),
(8943, 3040, 12528, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:37', '2021-02-12 13:36:37'),
(8944, 3040, 12528, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:32:15', '2021-02-19 16:32:15'),
(8945, 3040, 12528, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:44', '2021-02-26 13:06:44'),
(8946, 3040, 12528, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-05 14:37:04', '2021-03-05 14:37:04'),
(8947, 3040, 12528, NULL, '2021-03-17 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447473 Application complete: Credentialing process to begin Dear DEBORAH POTTER,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-10 13:40:50', '2021-03-10 13:40:50'),
(8948, 3040, 12528, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:53:43', '2021-03-19 15:53:43'),
(8949, 3040, 12528, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.   Provider Name: DEBORAH POTTER  Cigna ID: 8546348  Tax ID: 815123542  Effective date: 03/23/2021', NULL, NULL, '2021-04-12 13:27:32', '2021-04-12 13:27:32'),
(8950, 3040, 12529, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:21:46', '2021-01-08 17:21:46'),
(8951, 3040, 12529, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrollment request initiated through Cigna call center representative.   Provider ID: 9264556 Application no: 12447473', NULL, NULL, '2021-01-08 17:21:54', '2021-01-08 17:21:54'),
(8952, 3040, 12529, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:46', '2021-01-15 09:49:46'),
(8953, 3040, 12529, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:51:48', '2021-01-22 12:51:48'),
(8954, 3040, 12529, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:49:56', '2021-01-29 13:49:56'),
(8955, 3040, 12529, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:44', '2021-02-05 10:45:44'),
(8956, 3040, 12529, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:48', '2021-02-12 13:36:48'),
(8957, 3040, 12529, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:32:08', '2021-02-19 16:32:08'),
(8958, 3040, 12529, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:49', '2021-02-26 13:06:49'),
(8959, 3040, 12529, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-08 15:34:33', '2021-03-08 15:34:33'),
(8960, 3040, 12529, NULL, '2021-03-17 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447473 Application complete: Credentialing process to begin Dear DEBORAH POTTER,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-10 13:41:02', '2021-03-10 13:41:02');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(8961, 3040, 12529, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:53:38', '2021-03-19 15:53:38'),
(8962, 3040, 12529, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.   Provider Name: DEBORAH POTTER  Cigna ID: 8546348  Tax ID: 815123542  Effective date: 03/23/2021', NULL, NULL, '2021-04-12 13:27:33', '2021-04-12 13:27:33'),
(8963, 3040, 12530, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:22:04', '2021-01-08 17:22:04'),
(8964, 3040, 12530, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Provider enrollment request initiated through Cigna call center representative.   Provider ID: 9264556 Application no: 12447473', NULL, NULL, '2021-01-08 17:22:11', '2021-01-08 17:22:11'),
(8965, 3040, 12530, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Application is under contract decision. It will take 2 weeks.', NULL, NULL, '2021-01-15 09:49:56', '2021-01-15 09:49:56'),
(8966, 3040, 12530, NULL, '2021-01-29 00:00:00.000', 'In Process', 'The application is still under contract decision.  ', NULL, NULL, '2021-01-22 12:54:18', '2021-01-22 12:54:18'),
(8967, 3040, 12530, NULL, '2021-02-05 00:00:00.000', 'In Process', 'I had a word with (EMELY) Cigna Representative and she said the application moved on 01/28/2021 to medical on boarding team. ', NULL, NULL, '2021-01-29 13:50:04', '2021-01-29 13:50:04'),
(8968, 3040, 12530, NULL, '2021-02-12 00:00:00.000', 'In Process', 'I had a word with (Lynette W) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-02-05 10:45:55', '2021-02-05 10:45:55'),
(8969, 3040, 12530, NULL, '2021-02-19 00:00:00.000', 'In Process', 'I had a word with (Shyla) Cigna representative and she said the application is under credentialing department.  It will take 60-90 days from 01/28/2021. ', NULL, NULL, '2021-02-12 13:36:42', '2021-02-12 13:36:42'),
(8970, 3040, 12530, NULL, '2021-02-26 00:00:00.000', 'In Process', 'I had a a word with Cigna representative and she said the application is still in process Application was rcvd on 01/08/2021 ', NULL, NULL, '2021-02-19 16:32:26', '2021-02-19 16:32:26'),
(8971, 3040, 12530, NULL, '2021-03-05 00:00:00.000', 'In Process', 'Email sent to: intake_pdm@cigna.com, psscentral@cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Greetings,   Hope you are doing well. Please advise me the enrollment status for the below mentioned providers.   Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 1:  Provider Name: Campos, Moses Provider NPI# 1558680009  Provider 2: Provider Name: Potter, Deborah Provider NPI# 1861914053  If you need any additional information please feel free to call or email me. Waiting to hear form you soon .  Thanks', NULL, NULL, '2021-02-26 13:06:55', '2021-02-26 13:06:55'),
(8972, 3040, 12530, NULL, '2021-03-12 00:00:00.000', 'In Process', 'I had a word with (Kris) Cigna representative and she said the application is still in process.', NULL, NULL, '2021-03-08 15:34:25', '2021-03-08 15:34:25'),
(8973, 3040, 12530, NULL, '2021-03-17 00:00:00.000', 'In Process', 'Email rcvd from: 9psscent@cigna.com  Subject: Cigna Credentialing Status Update: Credentialing Verification  Re:	Reference number 12447473 Application complete: Credentialing process to begin Dear DEBORAH POTTER,  We have confirmed that your application is complete, and have forwarded it for credentialing review', NULL, NULL, '2021-03-10 13:41:07', '2021-03-10 13:41:07'),
(8974, 3040, 12530, NULL, '2021-03-26 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-19 15:53:48', '2021-03-19 15:53:48'),
(8975, 3040, 12530, NULL, '2021-04-19 00:00:00.000', 'Approved', 'Email rcvd from: 9PSSCENT@Cigna.com  Subject: Enrollment Status || Campos, Moses & Potter, Deborah || Valley Med Urgent Care PLLC || Cigna ||  Thank you for contacting Cigna.   Our records indicate that your providers are credentialed under the below tax id with the basic lines of businesses offered in that region, which include OAP, PPO and HMO. Please ensure the member’s plan is offered in the region. If you have any additional questions, please visit our website at www.cignaforhcp.com or contact the Provider Services Unit at 800.882.4462.   Provider Name: DEBORAH POTTER  Cigna ID: 8546348  Tax ID: 815123542  Effective date: 03/23/2021', NULL, NULL, '2021-04-12 13:27:35', '2021-04-12 13:27:35'),
(8976, 3040, 12531, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:53:20', '2021-01-08 17:53:20'),
(8977, 3040, 12531, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:55:26', '2021-01-08 17:55:26'),
(8978, 3040, 12531, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 16:56:49', '2021-01-11 16:56:49'),
(8979, 3040, 12531, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Re: Request for Credentialing  Dear Moses Campos:  UnitedHealthcare’s National Credentialing Center received your request for credentialing; however we are unable to process your request due to missing TAX ID information. Please resubmit request with provider\'s TAX ID information.', NULL, NULL, '2021-01-13 14:45:22', '2021-01-13 14:45:22'),
(8980, 3040, 12531, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Campos, Moses || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC. I already submitted the request for participation form for the provider.   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider Name:  Moses Campos Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-20 14:52:00', '2021-01-20 14:52:00'),
(8981, 3040, 12531, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I received an email from UHC and its stated that they received the application from the provider and the Tax ID is missing. Kindly find the attached request for participation form and TIN is already listed.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-27 14:00:07', '2021-01-27 14:00:07'),
(8982, 3040, 12531, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I wanted to follow up regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 10:52:18', '2021-02-03 10:52:18'),
(8983, 3040, 12531, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  2/3/2021  Moses Campos adil@claimsmedinc.com Re: Your Credentialing Application Has Been Received  Dear Moses Campos:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials.', NULL, NULL, '2021-02-03 12:22:53', '2021-02-03 12:22:53'),
(8984, 3040, 12531, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  2/3/2021  Moses Campos adil@claimsmedinc.com Re: Your Credentialing Application Has Been Received  Dear Moses Campos:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials.', NULL, NULL, '2021-02-03 12:22:54', '2021-02-03 12:22:54'),
(8985, 3040, 12531, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-03 17:26:46', '2021-02-03 17:26:46'),
(8986, 3040, 12531, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-02-10 12:48:45', '2021-02-10 12:48:45'),
(8987, 3040, 12531, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-24 12:21:57', '2021-02-24 12:21:57'),
(8988, 3040, 12531, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Hello,  This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:51:32', '2021-03-03 13:51:32'),
(8989, 3040, 12531, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from gburns@uhc.com   Thank you for contacting the Network Management Resource Team.  The provider’s credentialing completed on 3/3/21 and the contract request is now in process under reference number PR-5733857. This process can take between 30 and 45 business days.  If you have any questions or concerns about the content of this email, please do not reply to this email but rather email directly to: networkhelp@uhc.com for further assistance.  Gary M Burns Jr. Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-03-04 13:19:28', '2021-03-04 13:19:28'),
(8990, 3040, 12531, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:37:52', '2021-03-12 16:37:52'),
(8991, 3040, 12531, NULL, '2021-06-08 00:00:00.000', 'Not Eligible', 'provider is no longer working with VMUC', NULL, NULL, '2021-06-01 10:54:36', '2021-06-01 10:54:36'),
(8992, 3040, 12532, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:54:14', '2021-01-08 17:54:14'),
(8993, 3040, 12532, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:55:19', '2021-01-08 17:55:19'),
(8994, 3040, 12532, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 16:56:59', '2021-01-11 16:56:59'),
(8995, 3040, 12532, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Re: Request for Credentialing  Dear Moses Campos:  UnitedHealthcare’s National Credentialing Center received your request for credentialing; however we are unable to process your request due to missing TAX ID information. Please resubmit request with provider\'s TAX ID information.', NULL, NULL, '2021-01-13 14:45:32', '2021-01-13 14:45:32'),
(8996, 3040, 12532, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Campos, Moses || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC. I already submitted the request for participation form for the provider.   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider Name:  Moses Campos Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-20 14:51:37', '2021-01-20 14:51:37'),
(8997, 3040, 12532, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I received an email from UHC and its stated that they received the application from the provider and the Tax ID is missing. Kindly find the attached request for participation form and TIN is already listed.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-27 14:00:16', '2021-01-27 14:00:16'),
(8998, 3040, 12532, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I wanted to follow up regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 10:51:56', '2021-02-03 10:51:56'),
(8999, 3040, 12532, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I wanted to follow up regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 10:51:56', '2021-02-03 10:51:56'),
(9000, 3040, 12532, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  2/3/2021  Moses Campos adil@claimsmedinc.com Re: Your Credentialing Application Has Been Received  Dear Moses Campos:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials.', NULL, NULL, '2021-02-03 12:22:45', '2021-02-03 12:22:45'),
(9001, 3040, 12532, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-03 17:26:53', '2021-02-03 17:26:53'),
(9002, 3040, 12532, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-02-10 12:48:33', '2021-02-10 12:48:33'),
(9003, 3040, 12532, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-24 12:22:03', '2021-02-24 12:22:03'),
(9004, 3040, 12532, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Hello,  This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:51:36', '2021-03-03 13:51:36'),
(9005, 3040, 12532, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from gburns@uhc.com   Thank you for contacting the Network Management Resource Team.  The provider’s credentialing completed on 3/3/21 and the contract request is now in process under reference number PR-5733857. This process can take between 30 and 45 business days.  If you have any questions or concerns about the content of this email, please do not reply to this email but rather email directly to: networkhelp@uhc.com for further assistance.  Gary M Burns Jr. Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-03-04 13:19:32', '2021-03-04 13:19:32'),
(9006, 3040, 12532, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:37:57', '2021-03-12 16:37:57'),
(9007, 1005, 12532, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'The provider Moses Campos is no longer with Valley Med Urgent Care', NULL, NULL, '2021-06-01 14:40:01', '2021-06-01 14:40:01'),
(9008, 3040, 12533, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:54:34', '2021-01-08 17:54:34'),
(9009, 3040, 12533, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:54:58', '2021-01-08 17:54:58'),
(9010, 3040, 12533, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 16:57:07', '2021-01-11 16:57:07'),
(9011, 3040, 12533, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Re: Request for Credentialing  Dear Moses Campos:  UnitedHealthcare’s National Credentialing Center received your request for credentialing; however we are unable to process your request due to missing TAX ID information. Please resubmit request with provider\'s TAX ID information.', NULL, NULL, '2021-01-13 14:45:40', '2021-01-13 14:45:40'),
(9012, 3040, 12533, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Campos, Moses || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC. I already submitted the request for participation form for the provider.   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider Name:  Moses Campos Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-20 14:51:43', '2021-01-20 14:51:43'),
(9013, 3040, 12533, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I received an email from UHC and its stated that they received the application from the provider and the Tax ID is missing. Kindly find the attached request for participation form and TIN is already listed.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.  Thanks', NULL, NULL, '2021-01-27 14:00:22', '2021-01-27 14:00:22'),
(9014, 3040, 12533, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Greetings,  Hope you are doing well. I wanted to follow up regarding the enrollment status of the below mentioned provider.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 11:01:13', '2021-02-03 11:01:13'),
(9015, 3040, 12533, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  2/3/2021  Moses Campos adil@claimsmedinc.com Re: Your Credentialing Application Has Been Received  Dear Moses Campos:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials.', NULL, NULL, '2021-02-03 12:22:58', '2021-02-03 12:22:58'),
(9016, 3040, 12533, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-03 17:26:59', '2021-02-03 17:26:59'),
(9017, 3040, 12533, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-02-10 12:48:53', '2021-02-10 12:48:53'),
(9018, 3040, 12533, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Still in process.', NULL, NULL, '2021-02-10 12:48:53', '2021-02-10 12:48:53'),
(9019, 3040, 12533, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com  Hello                       Our records show that credentialing was initiated as of today February 3rd 2021. This request can take up to 30 business days for completion you will be notified once this has been completed. Please let us know if there\'s anything else we can assist with.  Thank you!  Have a Blessed day. :)', NULL, NULL, '2021-02-24 12:22:12', '2021-02-24 12:22:12'),
(9020, 3040, 12533, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: UnitedHealthcare Credentialing Notice  Hello,  This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider: Provider Name:  Moses Campos, Provider NPI# 1558680009  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:51:40', '2021-03-03 13:51:40'),
(9021, 3040, 12533, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from gburns@uhc.com   Thank you for contacting the Network Management Resource Team.  The provider’s credentialing completed on 3/3/21 and the contract request is now in process under reference number PR-5733857. This process can take between 30 and 45 business days.  If you have any questions or concerns about the content of this email, please do not reply to this email but rather email directly to: networkhelp@uhc.com for further assistance.  Gary M Burns Jr. Associate Network Contractor United Healthcare Network Management Resource Team (NMRT)', NULL, NULL, '2021-03-04 13:19:41', '2021-03-04 13:19:41'),
(9022, 3040, 12533, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:01', '2021-03-12 16:38:01'),
(9023, 3040, 12533, NULL, '2021-06-08 00:00:00.000', 'Not Eligible', 'Provider is no longer working with VMUC', NULL, NULL, '2021-06-01 10:57:11', '2021-06-01 10:57:11'),
(9024, 3040, 12534, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:57:38', '2021-01-08 17:57:38'),
(9025, 3040, 12534, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:58:42', '2021-01-08 17:58:42'),
(9026, 3040, 12534, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online  Waiting for the PR no.', NULL, NULL, '2021-01-11 16:38:35', '2021-01-11 16:38:35'),
(9027, 3040, 12534, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  Re: Your Credentialing Application Has Been Received  Dear Arturo Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials. ', NULL, NULL, '2021-01-13 11:04:51', '2021-01-13 11:04:51'),
(9028, 3040, 12534, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email sent to: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Greetings,  Hope you are doing well. I updated the CAQH for Arturo Lira and the application re-submitted online.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-15 17:42:51', '2021-01-15 17:42:51'),
(9029, 3040, 12534, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Re: ACTION NEEDED: Information Required to Complete Credentialing Application  Dear ARTURO LIRA  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your CAQH credentialing application. Unfortunately, we found that some of the required information is missing. We can’t complete our review of your credentialing request until we have this information.  Here\'s what you need to do:  Update your CAQH application. Go to proview.CAQH.org/pr, log in and provide the following information: CAQH application missing place of service address for requested Tax-ID :  XXXXX-3542   Re-sign the attestation and authorization. Reattest that the information provided in your application is current, accurate and complete. Re-submit your application. We’ll automatically be notified that the application has been updated.', NULL, NULL, '2021-01-15 17:43:47', '2021-01-15 17:43:47'),
(9030, 3040, 12534, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Credentialing Application  MPIN#: 7494318 Re: We’re Ready to Review Your Credentialing Application  Dear Arturo Alejandro Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your completed application and will now begin verifying your credentials. Here’s what you need to know about the next steps:', NULL, NULL, '2021-01-20 09:14:58', '2021-01-20 09:14:58'),
(9031, 3040, 12534, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please let me know. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-27 14:18:15', '2021-01-27 14:18:15'),
(9032, 3040, 12534, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from katherine_k_floyd@uhc.com  Good morning Adil,  ARTURO LIRA was approved for credentialing 01/27/2021 for state of Texas.  Next step is contracting which can take up to 45 business days  from the credentialing approval date.  Please let us know if we can assist further via email.  Thank you.', NULL, NULL, '2021-01-28 17:25:54', '2021-01-28 17:25:54'),
(9033, 3040, 12534, NULL, '2021-02-25 00:00:00.000', 'In Process', 'Contracting is still in process.', NULL, NULL, '2021-02-04 13:39:38', '2021-02-04 13:39:38'),
(9034, 3040, 12534, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. Please advise me the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-25 14:20:41', '2021-02-25 14:20:41'),
(9035, 3040, 12534, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Hello,  Hope you are doing well. This is a follow up email regarding the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting for your reply.   Thank you', NULL, NULL, '2021-03-04 16:56:25', '2021-03-04 16:56:25'),
(9036, 3040, 12534, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Email rcvd from: robin_a_blocker@uhc.com  Subject: Secure Message from robin_a_blocker@uhc.com  Hello Adil,  Thank you for contacting the Network Management Resource Team. Credentialing has been completed for any future inquiries please reference PR-5692160 >GD-19910759 of which is currently in process for loading. Please  allow approximately 30-45 days for this completion to take place.  Sincerley,  Robin B.  Network Management Resource Team (NMRT) United HealthCare', NULL, NULL, '2021-03-05 18:06:21', '2021-03-05 18:06:21'),
(9037, 3040, 12534, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:10', '2021-03-12 16:38:10'),
(9038, 3040, 12534, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,   Hope you are doing great. Please note that I received an email from Robin and he said the credentialing has been completed and GD-19910759 is currently in process for loading allow 30 to 45 days. Can you please check and advise the status of the application for the below mentioned provider.    Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-04-16 07:56:35', '2021-04-16 07:56:35'),
(9039, 3040, 12534, NULL, '2021-05-04 00:00:00.000', 'Approved', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from corin_lett@uhc.com  Good morning,  Thank you for contacting the Network. We will be glad to assist regarding your inquiry. I have attached the product roster showing the demographic information, lines of business, and effective dates for the requested provider.    ', NULL, NULL, '2021-04-27 08:56:32', '2021-04-27 08:56:32'),
(9040, 3040, 12535, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:57:58', '2021-01-08 17:57:58'),
(9041, 3040, 12535, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:58:51', '2021-01-08 17:58:51'),
(9042, 3040, 12535, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online  Waiting for the PR no.', NULL, NULL, '2021-01-11 16:38:43', '2021-01-11 16:38:43'),
(9043, 3040, 12535, NULL, '2021-02-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  Re: Your Credentialing Application Has Been Received  Dear Arturo Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials. ', NULL, NULL, '2021-01-13 11:04:49', '2021-01-13 11:04:49'),
(9044, 3040, 12535, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email sent to: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Greetings,  Hope you are doing well. I updated the CAQH for Arturo Lira and the application re-submitted online.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-15 17:42:53', '2021-01-15 17:42:53'),
(9045, 3040, 12535, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Re: ACTION NEEDED: Information Required to Complete Credentialing Application  Dear ARTURO LIRA  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your CAQH credentialing application. Unfortunately, we found that some of the required information is missing. We can’t complete our review of your credentialing request until we have this information.  Here\'s what you need to do:  Update your CAQH application. Go to proview.CAQH.org/pr, log in and provide the following information: CAQH application missing place of service address for requested Tax-ID :  XXXXX-3542   Re-sign the attestation and authorization. Reattest that the information provided in your application is current, accurate and complete. Re-submit your application. We’ll automatically be notified that the application has been updated.', NULL, NULL, '2021-01-15 17:44:05', '2021-01-15 17:44:05'),
(9046, 3040, 12535, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Credentialing Application  MPIN#: 7494318 Re: We’re Ready to Review Your Credentialing Application  Dear Arturo Alejandro Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your completed application and will now begin verifying your credentials. Here’s what you need to know about the next steps:', NULL, NULL, '2021-01-20 09:15:17', '2021-01-20 09:15:17'),
(9047, 3040, 12535, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please let me know. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-27 14:18:24', '2021-01-27 14:18:24'),
(9048, 3040, 12535, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from katherine_k_floyd@uhc.com  Good morning Adil,  ARTURO LIRA was approved for credentialing 01/27/2021 for state of Texas.  Next step is contracting which can take up to 45 business days  from the credentialing approval date.  Please let us know if we can assist further via email.  Thank you.', NULL, NULL, '2021-01-28 17:25:47', '2021-01-28 17:25:47'),
(9049, 3040, 12535, NULL, '2021-02-25 00:00:00.000', 'In Process', 'Contracting is still in process.', NULL, NULL, '2021-02-04 13:39:28', '2021-02-04 13:39:28'),
(9050, 3040, 12535, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. Please advise me the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-25 14:20:46', '2021-02-25 14:20:46'),
(9051, 3040, 12535, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Hello,  Hope you are doing well. This is a follow up email regarding the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting for your reply.   Thank you', NULL, NULL, '2021-03-04 16:56:20', '2021-03-04 16:56:20'),
(9052, 3040, 12535, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Email rcvd from: robin_a_blocker@uhc.com  Subject: Secure Message from robin_a_blocker@uhc.com  Hello Adil,  Thank you for contacting the Network Management Resource Team. Credentialing has been completed for any future inquiries please reference PR-5692160 >GD-19910759 of which is currently in process for loading. Please  allow approximately 30-45 days for this completion to take place.  Sincerley,  Robin B.  Network Management Resource Team (NMRT) United HealthCare', NULL, NULL, '2021-03-05 18:06:26', '2021-03-05 18:06:26'),
(9053, 3040, 12535, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:15', '2021-03-12 16:38:15'),
(9054, 3040, 12535, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,   Hope you are doing great. Please note that I received an email from Robin and he said the credentialing has been completed and GD-19910759 is currently in process for loading allow 30 to 45 days. Can you please check and advise the status of the application for the below mentioned provider.    Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-04-16 07:56:41', '2021-04-16 07:56:41'),
(9055, 3040, 12535, NULL, '2021-05-04 00:00:00.000', 'Approved', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from corin_lett@uhc.com  Good morning,  Thank you for contacting the Network. We will be glad to assist regarding your inquiry. I have attached the product roster showing the demographic information, lines of business, and effective dates for the requested provider.    ', NULL, NULL, '2021-04-27 08:56:31', '2021-04-27 08:56:31'),
(9056, 3040, 12536, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 17:58:13', '2021-01-08 17:58:13');
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
(9057, 3040, 12536, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 17:58:34', '2021-01-08 17:58:34'),
(9058, 3040, 12536, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online  Waiting for the PR no.', NULL, NULL, '2021-01-11 16:38:51', '2021-01-11 16:38:51'),
(9059, 3040, 12536, NULL, '2021-01-20 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Request for Credentialing  Re: Your Credentialing Application Has Been Received  Dear Arturo Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your credentialing application and are reviewing it now to ensure we have everything needed to begin verifying your credentials. ', NULL, NULL, '2021-01-13 11:04:52', '2021-01-13 11:04:52'),
(9060, 3040, 12536, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email sent to: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Greetings,  Hope you are doing well. I updated the CAQH for Arturo Lira and the application re-submitted online.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-01-15 17:42:55', '2021-01-15 17:42:55'),
(9061, 3040, 12536, NULL, '2021-01-22 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: CAQH App Follow-up Request  Re: ACTION NEEDED: Information Required to Complete Credentialing Application  Dear ARTURO LIRA  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your CAQH credentialing application. Unfortunately, we found that some of the required information is missing. We can’t complete our review of your credentialing request until we have this information.  Here\'s what you need to do:  Update your CAQH application. Go to proview.CAQH.org/pr, log in and provide the following information: CAQH application missing place of service address for requested Tax-ID :  XXXXX-3542   Re-sign the attestation and authorization. Reattest that the information provided in your application is current, accurate and complete. Re-submit your application. We’ll automatically be notified that the application has been updated.', NULL, NULL, '2021-01-15 17:44:14', '2021-01-15 17:44:14'),
(9062, 3040, 12536, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: national_credentialing@uhc.com  Subject: Credentialing Application  MPIN#: 7494318 Re: We’re Ready to Review Your Credentialing Application  Dear Arturo Alejandro Lira:  Thank you for your interest in joining the UnitedHealthcare network. We’ve received your completed application and will now begin verifying your credentials. Here’s what you need to know about the next steps:', NULL, NULL, '2021-01-20 09:15:30', '2021-01-20 09:15:30'),
(9063, 3040, 12536, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.  Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please let me know. Waiting to hear from you soon.  Thanks ', NULL, NULL, '2021-01-27 14:18:30', '2021-01-27 14:18:30'),
(9064, 3040, 12536, NULL, '2021-02-04 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from katherine_k_floyd@uhc.com  Good morning Adil,  ARTURO LIRA was approved for credentialing 01/27/2021 for state of Texas.  Next step is contracting which can take up to 45 business days  from the credentialing approval date.  Please let us know if we can assist further via email.  Thank you.', NULL, NULL, '2021-01-28 17:25:59', '2021-01-28 17:25:59'),
(9065, 3040, 12536, NULL, '2021-02-25 00:00:00.000', 'In Process', 'Contracting is still in process.', NULL, NULL, '2021-02-04 13:39:48', '2021-02-04 13:39:48'),
(9066, 3040, 12536, NULL, '2021-03-04 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,  Hope you are doing well. Please advise me the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-25 14:20:51', '2021-02-25 14:20:51'),
(9067, 3040, 12536, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Hello,  Hope you are doing well. This is a follow up email regarding the enrollment status for the below mentioned provider.   Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting for your reply.   Thank you', NULL, NULL, '2021-03-04 16:56:16', '2021-03-04 16:56:16'),
(9068, 3040, 12536, NULL, '2021-03-12 00:00:00.000', 'In Process', 'Email rcvd from: robin_a_blocker@uhc.com  Subject: Secure Message from robin_a_blocker@uhc.com  Hello Adil,  Thank you for contacting the Network Management Resource Team. Credentialing has been completed for any future inquiries please reference PR-5692160 >GD-19910759 of which is currently in process for loading. Please  allow approximately 30-45 days for this completion to take place.  Sincerley,  Robin B.  Network Management Resource Team (NMRT) United HealthCare', NULL, NULL, '2021-03-05 18:06:31', '2021-03-05 18:06:31'),
(9069, 3040, 12536, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:39:46', '2021-03-12 16:39:46'),
(9070, 3040, 12536, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lira, Arturo Alejandro || UHC  Greetings,   Hope you are doing great. Please note that I received an email from Robin and he said the credentialing has been completed and GD-19910759 is currently in process for loading allow 30 to 45 days. Can you please check and advise the status of the application for the below mentioned provider.    Practice Name: Valley Med Urgent Care PLLC Practice NPI# 1518404631 Practice Tax ID# 81-5123542 Primary Address:2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Waiting to hear from you soon.   Thanks  ', NULL, NULL, '2021-04-16 07:56:48', '2021-04-16 07:56:48'),
(9071, 3040, 12536, NULL, '2021-05-04 00:00:00.000', 'Approved', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from corin_lett@uhc.com  Good morning,  Thank you for contacting the Network. We will be glad to assist regarding your inquiry. I have attached the product roster showing the demographic information, lines of business, and effective dates for the requested provider.    ', NULL, NULL, '2021-04-27 08:56:30', '2021-04-27 08:56:30'),
(9072, 3040, 12537, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 18:02:18', '2021-01-08 18:02:18'),
(9073, 3040, 12537, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 18:02:40', '2021-01-08 18:02:40'),
(9074, 3040, 12537, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 17:19:59', '2021-01-11 17:19:59'),
(9075, 3040, 12537, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. I wanted to know the status of the below mentioned provider. I already submitted the request for participation online.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  If you need anything else from my side please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-18 16:41:25', '2021-01-18 16:41:25'),
(9076, 3040, 12537, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jd.mcdonald@uhc.com  Good afternoon Adil,  Thank you for contacting the Network Management Resource Team. We are showing that an online request for participation was received 01/14/21. Credentialing for Deborah Potter is already current for the state of Texas, no additional credentialing is required.  The request to have Ms. Potter added to Valley Med Urgent Care PLLC is currently in process. Turnaround time is 30 days for demographic updates with an additional 30-45 days for contractual updates. Please allow more time for the request to process.  Thanks,   ', NULL, NULL, '2021-01-20 09:48:15', '2021-01-20 09:48:15'),
(9077, 3040, 12537, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Please allow more time for the request to process.', NULL, NULL, '2021-01-27 14:37:55', '2021-01-27 14:37:55'),
(9078, 3040, 12537, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please let me know if you need any additional information. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 12:07:17', '2021-02-03 12:07:17'),
(9079, 3040, 12537, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from susan_k_isaacson@uhc.com  Under PR-5684470 started 1/18/2021 it is still in process. Please allow 30-45 Business days to complete.', NULL, NULL, '2021-02-03 17:28:17', '2021-02-03 17:28:17'),
(9080, 3040, 12537, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-10 13:09:35', '2021-02-10 13:09:35'),
(9081, 3040, 12537, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-02-17 17:33:53', '2021-02-17 17:33:53'),
(9082, 3040, 12537, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,              I took a look at the below email and I found that PR-5684470 is in process for contracting at this time. It looks like the request was submitted on 1/14/20210. The normal turn around time is 60-75 days. If you do not received confirmation of completion after that time frame please let us know. Thank you and have a blessed day.  please do not reply directly to me but rather email directly to: networkhelp@uhc.com for further assistance. thank you.  It was a pleasure helping you today.  If you have feedback or would like to give any kudos on my services today, please contact my Manager, Cynthia Curtner  via email at cynthia_curtner@uhc.com . Please include on the subject line:  Feedback Re: Cortney Johnson  Cortney Johnson United Healthcare Network Management Resource Team', NULL, NULL, '2021-02-24 12:24:37', '2021-02-24 12:24:37'),
(9083, 3040, 12537, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,  This is a follow up email regarding the enrollment status for the below mentioned provider.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:56:03', '2021-03-03 13:56:03'),
(9084, 3040, 12537, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is to in process you will be notified as soon as this request has been completed. Please let us know if there\'s anything else we can assist with.  PR-5684470  Thank you! Have a Blessed day. :) ', NULL, NULL, '2021-03-04 13:43:30', '2021-03-04 13:43:30'),
(9085, 3040, 12537, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:19', '2021-03-12 16:38:19'),
(9086, 3040, 12537, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing great. I wanted to know the enrollment status for the below mentioned provider. The application was received on 01/14/2021.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-16 08:33:53', '2021-04-16 08:33:53'),
(9087, 3040, 12537, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is almost completed. Last update was on 4/15/2021. Please allow some more time and you will be notified once completed.  GD-20248791  Thank you! Have a Blessed day. :)', NULL, NULL, '2021-04-16 12:53:04', '2021-04-16 12:53:04'),
(9088, 3040, 12537, NULL, '2021-05-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider. I received an email from Nathan and the person advised me that the last update on application was on 04/15/2021 and UHC will notify me once it\'s completed. Can you please check and advise.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-05-05 13:22:00', '2021-05-05 13:22:00'),
(9089, 3040, 12537, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Greetings,   Hope you are doing well. I wanted to add the provider in the UHC for our group Valley Med Urgent Care PLLC under below location.  Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-06 14:41:11', '2021-05-06 14:41:11'),
(9090, 3040, 12537, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email sent to : hpdemo@uhc.com   Subject: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Hello,   I wanted to add the additional location under the below mentioned provider in the UHC for our group Valley Med Urgent Care PLLC.  Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-06-01 10:59:49', '2021-06-01 10:59:49'),
(9091, 3040, 12537, NULL, '2021-06-09 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  UnitedHealthcare Insurance Company  We’ve completed our review of the submission that you sent on Jun 1, 2021 11:01:17 AM and determined that no action is needed at this time. Specifically, no action is needed because: We have previously received a copy of this request and it has been submitted for processing. The previous reference number PR-5897791. The subject of your original email submission was: Re: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||.  The request was assigned this reference number: PR-5939994. The original submission is attached for your reference.', NULL, NULL, '2021-06-02 16:20:20', '2021-06-02 16:20:20'),
(9092, 3040, 12537, NULL, '2021-06-29 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com, networkhelp@uhc.com  Subject: Re: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Greetings,   Hope you are doing well. I wanted to know the status for the additional location under the below mentioned provider in the UHC for our group Valley Med Urgent Care PLLC.  Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider 1: Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-22 11:08:22', '2021-06-22 11:08:22'),
(9093, 3040, 12537, NULL, '2021-06-30 00:00:00.000', 'Approved', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jamie_edmondson@uhc.com  Thank you for contacting the Network Management Resource Team. The additional locations have been added for Deborah Potter.  Please let us know if we can assist further via email.  Jamie Edmondson  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-06-23 13:32:59', '2021-06-23 13:32:59'),
(9094, 3040, 12538, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 18:02:53', '2021-01-08 18:02:53'),
(9095, 3040, 12538, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 18:03:07', '2021-01-08 18:03:07'),
(9096, 3040, 12538, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 17:20:05', '2021-01-11 17:20:05'),
(9097, 3040, 12538, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. I wanted to know the status of the below mentioned provider. I already submitted the request for participation online.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  If you need anything else from my side please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-18 16:41:39', '2021-01-18 16:41:39'),
(9098, 3040, 12538, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jd.mcdonald@uhc.com  Good afternoon Adil,  Thank you for contacting the Network Management Resource Team. We are showing that an online request for participation was received 01/14/21. Credentialing for Deborah Potter is already current for the state of Texas, no additional credentialing is required.  The request to have Ms. Potter added to Valley Med Urgent Care PLLC is currently in process. Turnaround time is 30 days for demographic updates with an additional 30-45 days for contractual updates. Please allow more time for the request to process.  Thanks, ', NULL, NULL, '2021-01-20 09:48:45', '2021-01-20 09:48:45'),
(9099, 3040, 12538, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Please allow more time for the request to process.', NULL, NULL, '2021-01-27 14:38:02', '2021-01-27 14:38:02'),
(9100, 3040, 12538, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please let me know if you need any additional information. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 12:07:25', '2021-02-03 12:07:25'),
(9101, 3040, 12538, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from susan_k_isaacson@uhc.com  Under PR-5684470 started 1/18/2021 it is still in process. Please allow 30-45 Business days to complete.', NULL, NULL, '2021-02-03 17:28:22', '2021-02-03 17:28:22'),
(9102, 3040, 12538, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-10 13:09:12', '2021-02-10 13:09:12'),
(9103, 3040, 12538, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-02-17 17:33:59', '2021-02-17 17:33:59'),
(9104, 3040, 12538, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,              I took a look at the below email and I found that PR-5684470 is in process for contracting at this time. It looks like the request was submitted on 1/14/20210. The normal turn around time is 60-75 days. If you do not received confirmation of completion after that time frame please let us know. Thank you and have a blessed day.  please do not reply directly to me but rather email directly to: networkhelp@uhc.com for further assistance. thank you.  It was a pleasure helping you today.  If you have feedback or would like to give any kudos on my services today, please contact my Manager, Cynthia Curtner  via email at cynthia_curtner@uhc.com . Please include on the subject line:  Feedback Re: Cortney Johnson  Cortney Johnson United Healthcare Network Management Resource Team', NULL, NULL, '2021-02-24 12:24:41', '2021-02-24 12:24:41'),
(9105, 3040, 12538, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,  This is a follow up email regarding the enrollment status for the below mentioned provider.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:56:08', '2021-03-03 13:56:08'),
(9106, 3040, 12538, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is to in process you will be notified as soon as this request has been completed. Please let us know if there\'s anything else we can assist with.  PR-5684470  Thank you! Have a Blessed day. :) ', NULL, NULL, '2021-03-04 13:43:35', '2021-03-04 13:43:35'),
(9107, 3040, 12538, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:55', '2021-03-12 16:38:55'),
(9108, 3040, 12538, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing great. I wanted to know the enrollment status for the below mentioned provider. The application was received on 01/14/2021.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-16 08:33:57', '2021-04-16 08:33:57'),
(9109, 3040, 12538, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is almost completed. Last update was on 4/15/2021. Please allow some more time and you will be notified once completed.  GD-20248791  Thank you! Have a Blessed day. :)', NULL, NULL, '2021-04-16 12:53:09', '2021-04-16 12:53:09'),
(9110, 3040, 12538, NULL, '2021-05-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider. I received an email from Nathan and the person advised me that the last update on application was on 04/15/2021 and UHC will notify me once it\'s completed. Can you please check and advise.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-05-05 13:21:52', '2021-05-05 13:21:52'),
(9111, 3040, 12538, NULL, '2021-05-13 00:00:00.000', 'Approved', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from gregory.s.carte@optum.com  Thank you for contacting the Network Management Resource Team. We will be glad to assist regarding your inquiry. I have included the product roster showing the demographic information, lines of business, and effective dates for the provider requested.', NULL, NULL, '2021-05-06 14:31:52', '2021-05-06 14:31:52'),
(9112, 3040, 12539, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 18:03:14', '2021-01-08 18:03:14'),
(9113, 3040, 12539, NULL, '2021-01-15 00:00:00.000', 'Initiated', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Lira, Arturo Alejandro, Campos, Moses, Wright, Larry Donald, Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. Please find below the information for practices and providers for enrollment in United Health care for our group Valley Med Urgent Care PLLC.  Provider 1: Provider Name: Arturo Alejandro Lira Provider NPI# 1245789502  Provider 2: Provider Name:  Moses Campos Provider NPI# 1558680009  Provider 3: Provider Name:  Larry Donald Wright Provider NPI# 1033769765  Provider 4: Provider Name:  Deborah Potter Provider NPI# 1861914053   Practice 1: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Thanks', NULL, NULL, '2021-01-08 18:03:27', '2021-01-08 18:03:27'),
(9114, 3040, 12539, NULL, '2021-01-18 00:00:00.000', 'In Process', 'Request For Participation Form submitted online.   Waiting for the PR no.', NULL, NULL, '2021-01-11 17:20:12', '2021-01-11 17:20:12'),
(9115, 3040, 12539, NULL, '2021-01-25 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. I wanted to know the status of the below mentioned provider. I already submitted the request for participation online.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  If you need anything else from my side please feel free to call or email me. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-01-18 16:41:53', '2021-01-18 16:41:53'),
(9116, 3040, 12539, NULL, '2021-01-27 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jd.mcdonald@uhc.com  Good afternoon Adil,  Thank you for contacting the Network Management Resource Team. We are showing that an online request for participation was received 01/14/21. Credentialing for Deborah Potter is already current for the state of Texas, no additional credentialing is required.  The request to have Ms. Potter added to Valley Med Urgent Care PLLC is currently in process. Turnaround time is 30 days for demographic updates with an additional 30-45 days for contractual updates. Please allow more time for the request to process.  Thanks, ', NULL, NULL, '2021-01-20 09:49:05', '2021-01-20 09:49:05'),
(9117, 3040, 12539, NULL, '2021-02-03 00:00:00.000', 'In Process', 'Please allow more time for the request to process.', NULL, NULL, '2021-01-27 14:38:07', '2021-01-27 14:38:07'),
(9118, 3040, 12539, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Follow up email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing well. This is a follow up email regarding the enrollment status of the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please let me know if you need any additional information. Waiting to hear from you soon.   Thanks', NULL, NULL, '2021-02-03 12:07:31', '2021-02-03 12:07:31'),
(9119, 3040, 12539, NULL, '2021-02-10 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from susan_k_isaacson@uhc.com  Under PR-5684470 started 1/18/2021 it is still in process. Please allow 30-45 Business days to complete.', NULL, NULL, '2021-02-03 17:28:28', '2021-02-03 17:28:28'),
(9120, 3040, 12539, NULL, '2021-02-17 00:00:00.000', 'In Process', 'Still in process. ', NULL, NULL, '2021-02-10 13:09:42', '2021-02-10 13:09:42'),
(9121, 3040, 12539, NULL, '2021-02-24 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-02-17 17:34:09', '2021-02-17 17:34:09'),
(9122, 3040, 12539, NULL, '2021-03-03 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject:  Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,              I took a look at the below email and I found that PR-5684470 is in process for contracting at this time. It looks like the request was submitted on 1/14/20210. The normal turn around time is 60-75 days. If you do not received confirmation of completion after that time frame please let us know. Thank you and have a blessed day.  please do not reply directly to me but rather email directly to: networkhelp@uhc.com for further assistance. thank you.  It was a pleasure helping you today.  If you have feedback or would like to give any kudos on my services today, please contact my Manager, Cynthia Curtner  via email at cynthia_curtner@uhc.com . Please include on the subject line:  Feedback Re: Cortney Johnson  Cortney Johnson United Healthcare Network Management Resource Team', NULL, NULL, '2021-02-24 12:24:46', '2021-02-24 12:24:46'),
(9123, 3040, 12539, NULL, '2021-03-10 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Re: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Hello,  This is a follow up email regarding the enrollment status for the below mentioned provider.  Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting for your reply.  Thank you', NULL, NULL, '2021-03-03 13:56:13', '2021-03-03 13:56:13'),
(9124, 3040, 12539, NULL, '2021-03-11 00:00:00.000', 'In Process', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is to in process you will be notified as soon as this request has been completed. Please let us know if there\'s anything else we can assist with.  PR-5684470  Thank you! Have a Blessed day. :) ', NULL, NULL, '2021-03-04 13:43:39', '2021-03-04 13:43:39'),
(9125, 3040, 12539, NULL, '2021-03-19 00:00:00.000', 'In Process', 'Still in process ', NULL, NULL, '2021-03-12 16:38:59', '2021-03-12 16:38:59'),
(9126, 3040, 12539, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  Hope you are doing great. I wanted to know the enrollment status for the below mentioned provider. The application was received on 01/14/2021.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-16 08:34:02', '2021-04-16 08:34:02'),
(9127, 3040, 12539, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Secure Message from nathan_riojas@uhc.com   Hello                  Our records show that this request is almost completed. Last update was on 4/15/2021. Please allow some more time and you will be notified once completed.  GD-20248791  Thank you! Have a Blessed day. :)', NULL, NULL, '2021-04-16 12:53:13', '2021-04-16 12:53:13'),
(9128, 3040, 12539, NULL, '2021-05-12 00:00:00.000', 'In Process', 'Email sent to: networkhelp@uhc.com  Subject: Enrollment || Potter, Deborah || Valley Med Urgent Care PLLC || UHC  Greetings,  I just wanted to follow up regarding the enrollment status for the below mentioned provider. I received an email from Nathan and the person advised me that the last update on application was on 04/15/2021 and UHC will notify me once it\'s completed. Can you please check and advise.   Practice: Practice Name: Valley Med Urgent Care PLLC   Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248    Provider: Provider Name:  Deborah Potter Provider NPI# 1861914053  Please get back to me as soon as you can get the chance. Waiting for your response.  Thanks', NULL, NULL, '2021-05-05 13:21:56', '2021-05-05 13:21:56'),
(9129, 3040, 12539, NULL, '2021-05-13 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com  Subject: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Greetings,   Hope you are doing well. I wanted to add the provider in the UHC for our group Valley Med Urgent Care PLLC under below location.  Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-05-06 14:41:05', '2021-05-06 14:41:05'),
(9130, 3040, 12539, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email sent to : hpdemo@uhc.com   Subject: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Hello,   I wanted to add the additional location under the below mentioned provider in the UHC for our group Valley Med Urgent Care PLLC.  Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-06-01 10:59:42', '2021-06-01 10:59:42'),
(9131, 3040, 12539, NULL, '2021-06-09 00:00:00.000', 'In Process', 'Email rcvd from: United_Healthcare_Provider_Operations@uhc.com  Subject: Secure message from United_Healthcare_Provider_Operations@uhc.com  UnitedHealthcare Insurance Company  We’ve completed our review of the submission that you sent on Jun 1, 2021 11:01:17 AM and determined that no action is needed at this time. Specifically, no action is needed because: We have previously received a copy of this request and it has been submitted for processing. The previous reference number PR-5897791. The subject of your original email submission was: Re: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||.  The request was assigned this reference number: PR-5939994. The original submission is attached for your reference.', NULL, NULL, '2021-06-02 16:20:14', '2021-06-02 16:20:14'),
(9132, 3040, 12539, NULL, '2021-06-29 00:00:00.000', 'In Process', 'Email sent to: hpdemo@uhc.com, networkhelp@uhc.com  Subject: Re: Additional Location || Valley Med Urgent Care PLLC || Potter, Deborah || UHC ||  Greetings,   Hope you are doing well. I wanted to know the status for the additional location under the below mentioned provider in the UHC for our group Valley Med Urgent Care PLLC.  Practice Details: Practice Name: Valley Med Urgent Care PLLC Practice Tax ID# 81-5123542 Practice NPI# 1518404631 Primary Address:  2534 Boca Chica Blvd. Brownsville, TX 78521-3496   Secondary Address:  101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Tertiary Address:  800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Provider 1: Provider Name: Potter, Deborah Provider NPI# 1861914053 Additional Location: 101 E. Expy 83 Ste. 170 McAllen, TX 78501-1166 Additional Location: 800 E. Alton Gloor Ave. Brownsville, TX 78521-3496  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-22 11:08:16', '2021-06-22 11:08:16'),
(9133, 3040, 12539, NULL, '2021-06-30 00:00:00.000', 'Approved', 'Email rcvd from: networkhelp@uhc.com  Subject: Secure Message from jamie_edmondson@uhc.com  Thank you for contacting the Network Management Resource Team. The additional locations have been added for Deborah Potter.  Please let us know if we can assist further via email.  Jamie Edmondson  UnitedHealthcare  Network Management Resource Team (NMRT)', NULL, NULL, '2021-06-23 13:33:07', '2021-06-23 13:33:07'),
(9134, 3040, 12540, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-01-08 18:04:44', '2021-01-08 18:04:44');
