Sarah sent a message to Kenneth Burdick – CEO of WellCare Health Plans – Email Address that said:
Cindy Bemis and Saylor Prather,
I would like to express my great displeasure over the ordeal that has ensued in trying to get my credentials switched from Eye Care Arkansas to Family Eye Clinic. With most insurances (including Medicare), switching clinics was not an issue and was a seamless process. Unfortunately, this was not the case with Wellcare.
We originally began this process in March of 2015 (I joined Family Eye Clinic in February 2015).
We were told by Saylor in October of 2015 that "Sarah Lundsford credentialed with WellCare but not linked to that NPI. Since she is fully credentialed she will not have to do a full cred app. She can fill out the attached paperwork and be linked to your NP" then "She is linked to the correct NPI, but the TIN is for Eye Care Arkansas. Sorry for that. NPI is correct, TIN is wrong" and that "Credentialing a provider usually takes 6 months to complete. Since we are just adding you to a group, it shouldn’t take that long. As soon as I get an update from the cred team, I will let you know."
In December we were told that "Dr. Lunsford,Your application is going through the credentialing process now.
I will keep you updated on the progress of your application."
After checking numerous times, we are told yesterday that "Dr. Lunsford is PAR in our Network under PID 121101 effective 5/19/2016."
It would have been appropriate to have notified us of this change in the status instead of us finding out two months after the fact; and only after we asked again about the status.
I currently have 10 patients that I saw with Wellcare insurance (because I stopped seeing them after realizing the problems we were having) with balances. I hope that my office manager is able to back date their claims so that these people are not responsible personally for the balances incurred.
All of this said, I am still not addressing the issues our office has concurrently been having with receiving payments for the Wellcare patients that Dr. Roger Neal has been providing care for.
I am disappointed with the way that this has been handled and hope that we can backdate and refile the 10 claims of mine and that we can get paid for the 8 claims of Dr. Neals that have not been paid. The total for both amounts to $6083.00 in outstanding claims, and I expect a resolution much quicker than what has happened to date.
Thank you and please feel free to contact me at the office with any questions you may have.
Sarah
