Education: University of California, Los Angeles have hearing loss, Community Care Network Region 1 (authorized), Community Care Network Region 2 (authorized), Community Care Network Region 3 (authorized), Community Care Network Region 4 (authorized), Patient Centered Community Care (PC3) Network (authorized), Unauthorized Emergent Care (unauthorized). amanda.barraza@welbehealth.com 6 0 obj
Dr. Robinson is passionate about providing personalized care to patients of all ages, including seniors. If you need another copy of our contract please contact Rena Wright at (336) 550-4057 or Rena.Wright@pacetriad.org. Residency: Baylor College of Medicine The following information should help you understand who to submit claims to and the requirements you must follow when submitting claims. To find an in-network urgent care location, use the VA Facility Locator Tool. Cathys passion is addressing difficult people challenges using data-driven analysis and innovative thinking. For paper claim submission, mail claims to: WelbeHealth Dr. Alexander doesnt shy away from tough conversations and her patients know she will help keep them on track. Press Done and save the ecompleted template to your computer. Electronic Data Interchange (EDI): Payer ID for medical and dental claims is VA CCN. Contracted providers are an essential part of delivering quality care to our members. When not working I enjoy working on my chili pepper and tomato garden with my family and creating delicious meals with them and for them. To enter and activate the submenu links, hit the down arrow. Care Management Referrals. Board Certification: American Osteopathic Board of Internal Medicine P.O. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. Most recently he was at Evolent Health, where he teamed with providers to enable their transition in value-based care. Information you send and receive via email over the Internet can be intercepted and read by individuals other than the intended recipient. Her compassion for seniors and her focus on providing quality care are very appreciated among the participants at WelbeHealth. Yordanos is a real go-getter! She brings that dedication to WelbeHealth as she cares for a diverse population of seniors. Board Certification: Family Medicine, Hospice and Palliative Care, Wound Care This year, our Falls Committee is ahead of the game. Eagan, MN 55121. He actively pursues better solutions in senior housing and health care. There are three routes for filing claims for authorized care which depend on your status in VAs network and how the care was authorized: All non-urgent and non-emergent care requires authorization from VA in advance. In advance of that, please review our Welcome Packet and other links below. Family-oriented and passionate about caring for people as if they were her own family, Linda is the proud mom of 6 grown children (all boys!) As a former Director of On Lok PACEpartners Consulting and former COO of the Center for Elders Independence, Elizabeth has spent 20 years launching new centers and leading and improving existing PACE organizations. Dental claims must be filed via 837 EDI transaction or using the most current. Education: Kennesaw State University Authorization requests must be submitted either via the Provider Portal or a completed Authorization Request Form faxed to (209) 729-5854. Education: California State University, Fresno, Fresno Pacific University Location: Pasadena 4 0 obj
Kathy has been caring for patients for 25 years. Residency: University of California, Davis Sutter Health Family Medicine Languages Spoken: English, Arabic, I hope that everyone is able to achieve their health wish. Languages Spoken: English, German, Persian, You treat your participants as if theyre your favorite family members. Cathy joined WelbeHealth in 2022. Box 30760 Tampa, FL 33630-3760 For claims status, please call: 866-386-4447 Electronic claims payer ID: 27034 We Want to Hear from You! P.O. As a part of this goal, the committee decided Posted by Adria Smith on Sep 4, 2015 in Providers | 0 comments. The center contains a medical clinic, rehabilitation gym, recreation space, and a separate space for dementia care. Role: Chief Medical Officer 7 0 obj
*New vendors must submit a W-9 to Peak TPA for payment. Richard Gurleys professional passion is improving quality of service and reducing costs in the US healthcare system. I hope every one of my patients trust me to partner in their treatment and healing.. She brings her experience to our participants and puts smiles on their faces. This improves claim accuracy and reduces the amount of time it takes for us to process claim determinations. Education: Ryerson University, Canada; National University, San Diego To enter and activate the submenu links, hit the down arrow. I see how everything works together to make someone feel better and healthy. Location: Pasadena Representative spent time with our staff and our participants on Friday, August 14, 2015 in our Adult Day Health Center. 5 0 obj
Role: PACE Physician lesette.hernandez@welbehealth.com Board Certification: American Academy of Nurse Practitioners have hearing loss. Our objective is to make it easy to schedule care for WelbeHealth participants. 3. Location: Fresno Becky loves nature and would camp out in the woods for months if she could. CALL US. Through WelbeHealths Program of All-Inclusive Care for the Elderly (PACE), we provide full medical coverage and whole-person care. He also founded CalPACE, the first state association for PACE organizations. For appeals regarding authorization or payment of a claim for services rendered to WelbeHealth participants, within 30 calendar days of the denial, the provider should initiate an appeal by providing WelbeHelath with written information identifying the claim and specifically describing the disputed action. At CareVention HealthCare TM (CVHC), our client-tailored third party administration (TPA) service, PeakTPA TM, offers expertise in health plan management to help healthcare organizations stay focused on care delivery.We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. With over 20 years of clinical experience, Dr. Golden helps people lead a healthy life well into their golden years. If youre looking for a lecture, you wont get one! Education: California State University, Long Beach 11 0 obj
Languages Spoken: English, Russian, I respect all my patients and make sure theyre part of the decision-making process. Peak TPA. Board Certification: California Board of Registered Nursing Board Certification: American Academy of Nurse Practitioners Call our provider services line at (650) 336-0300 or email our scheduling team at welbehubrequest@welbehealth.com with any questions. Languages Spoken: English, Spanish, I pride myself on carefully listening to my patients. Location: Stockton Adetoun provides care to patients with the most complex and advanced medical needs. Please include your preferred method for VA's response in your message. She holds a Bachelors Degree from Monmouth College. The fulfillment she gets from talking to her patients reinforces her belief that she chose the right career. Contact Information Phone Numbers and Website Addresses WelbeHealth General Information Website: www.welbehealth.com Provider Relations (650) 336-0300 providers@welbehealth.com Scheduling (650) 336-0300 WelbeHubRequest@welbehealth.com Authorizations Fax: (209) 729-5854 Claims P.O. Other Health Insurance (OHI) and Explanation of Benefits (EOBs), Any other document type normally sent via paper in support of a Veteran unauthorized emergency claim. Education: Western University of Health Sciences For claims submissions*: EDI Payer ID: 27034. Emergent care patient liabilities not tied to copayments or deductibles will continue to be considered for secondary payment by VA. For additional questions, contact VA by phone, tollfree, at (877) 881-7618. The Veteran's full 9-digit social security number (SSN) may be used if the ICN is not available. Heather is passionate about creating a purposeful and impactful team member experience and believes that engaged and happy team members directly and positively impact the participants that we serve. To access the menus on this page please perform the following steps. Our customized offerings include accurate claims adjudication and payment, enrollment management, provider and member services, risk adjustment submission, encounter data submission and Medicare Part D reporting. Nutrition support, in-home services, and more. Languages Spoken: English, Spanish, I have a lot of patience. Lauren has worked in many clinical settings including the cardiovascular ICU, cardiac transplant ICU, PACU, orthopedics and internal medicine. Languages Spoken: English, Hmong, I love working with seniors because theres nothing more rewarding than walking into a room full of elderly people smiling and knowing youre the part of the reason why.. Posted by Adria Smith on Sep 9, 2015 in Providers | 0 comments. This improves our claims processing efficiency. Location: Pasadena Maily values taking the time to connect with her patients. Danny takes seriously the saying do no harm and works with each patient to deliver care suited to their unique circumstances. Role: Associate Medical Director For submission of claims electronically, use payer ID is WBHCA. PO Box 21631. stream
Dr. Lenartowicz received her geriatric fellowship training from University of California Los Angeles and completed her undergraduate medical training and residency at the University of Saskatchewan, Canada. Location: Stockton Location: Fresno %
Education: University of Ado-Ekiti, Nigeria, University of Texas at Austin, West Coast University Role: Associate Medical Director Box 30760 The deadline for claims submission is dependent upon which program the care has been authorized through or which program the emergency care will be considered under. When not working at WelbeHealth, Dr Robinson enjoys time with his family and hitting the occasional ace on the tennis court. Local Contract Submit to VA: . With 15 years of experience as a family medicine specialist, Dr. Villalba listens to her patients and provides compassionate, personalized care. With the exception of supplying remittance advice supporting documentation for timely filing purposes, these processes do not apply to authorized care. VA is the primary and sole payer when VA issues an authorization. Languages Spoken: English, Spanish, Cantonese, Mandarin, Vietnamese, Chinese (Chiu-Chow), Its a gift to love the elderly. When not working, I enjoy wanderlusting, skiing (not very good at it though). Box 30780 Tampa, FL 33630-3780, P2E Documentation Cover Sheet, VA Form 10-10143f. Include the claim, or a copy of the claim, on top of the supporting documentation that is mailed to the following address: Include a completed cover sheet with the supporting documentation that is mailed to the above address. Tampa, Florida 33630. You are strongly encouraged to electronically submit claims and required supporting documentation. 1-866-678-8355. lilian.bui@welbehealth.com Location: Stockton Role: Primary Care Provider Box108851Florence,SC 29502-8851, CCN Region 5(Kodiak, Alaska, only)Submit to TriWest, TriWest VA CCN ClaimsP.O. More information about submitting documentation for authorized care can be found at Request and Coordinate Care. Claims Submission, Correspondence and Contact Resources will stay the same for the Medicare line of business. When Im not working Jacqueline enjoys being with her loved ones, the sunshine, going on food adventures, arts & crafts and home renovation and design. Some of her specialties include acute care, transitional care and chronic disease management. Role: Primary Care Provider Robert is an experienced managed care leader and was most recently the CEO of On Lok, the originator of the PACE model of care. They need love and support to thrive. When she isnt at WelbeHealth, you can probably find her walking along the beach or trying out some really good food with her husband. Please contact the referring VAMC for e-fax number. I listen to our participants, respond to their concerns, and care for their needs.. Please visit Emergency Care Claims to learn more. 336-550-4040 Phone 336-550-4044 Fax Mail claims to: PACE of the Triad c/o Peak PACE Solutions P.O. Tampa, FL 33630-3760, For claims status, please call: For questions about durable medical equipment (DME), contact your local VA Prosthetic and Sensory Aids Service (PSAS) unit or your referring VA provider. Continue to learn more about PACE of the Triads Fraud, Waste and Abuse Program! Representative Johnson is a member of the Homeland Security Committee, Military and Veterans Affairs Committee, Education (Universities) Committee, and the Justice and Public Safety Appropriations Committee, among others. Questions, Reconsiderations and Old Claims. Jillian Simon has spent over 15 years focused on improving geriatric services with an emphasis on patient centered care. Its one way to encourage them to participate in their own care.. Please visit our Provider Education and Training page for upcoming events. Shes also an Adult-Gerontology Nurse Practitioner, which means she treats people from adolescents through adulthood and into advanced age. Residency: George Washington University Internal Medicine Residency Board Certification: Adult-Gerontology Acute Care Nurse Practitioner (ACACNP-BC) from American Nurses Credentialing Center Dr. Cheryl Phillips is CEO of the Special Needs Plan Alliance, a national association for Medicare-Medicaid plans serving vulnerable adults. Our FWA Program: articulates our commitment to detecting, correcting, and preventing fraud, waste, and abuse in the administration of our Prescription Drug Plan; describes standards of conduct and compliance expectations that employees, and PACE of the Triad adopts several Quality Improvement Projects (QuIPs) each year. Should you want to review the WelbeHealth Grievance policy, contact your Provider Relations Representative and ask for policy QIC-GA-01. Role: Primary Care Provider 12 0 obj
Board Certification: American Academy of Nurse Practitioners I enjoy family time, hiking and collecting gnomes. Electronic Data Interchange (EDI): Payer ID for medical claims is 12115. Its a gift to admire them and have so much compassion for them that I felt like I needed to do this.. 1471 E. Cone Blvd. In January, the Falls Committee agreed to sponsor an annual Quality Improvement Project (QuIP) to build a better, more detailed falls program. Georgia (866) 515-4428; . endstream
Education: California State University Bakersfield, California State University Long Beach, UC Irvine Board Certification: American Academy of Nurse Practitioners She also worked in various finance leadership and expert roles at American Airlines, Sabre, and General Motors. PACE of the Triad must authorize all service to receive Posted by Adria Smith on Sep 2, 2015 in Providers | 0 comments. Education: Western University of Health Sciences, Johns Hopkins University Community providers have three options that allow for that linkage: Submit the claim electronically via 837 transaction and the supporting documentation via 275 transaction. She is involved in a number of professional organizations primarily related to health topics and professional womens advancement. Role: Primary Care Provider Remember: PACE of the Triad reimburses in accordance with the Medicare or Medicaid fee schedule for services rendered to participants. Education: Grand Canyon University, United States University If electronic capability isnot available, providers can submit claims by mail or secure fax. Box 30780 Tampa, FL 33630-3780. 866-386-4447. Veterans Crisis Line:
We encourage feedback from all our stake-holders. Apply for and manage the VA benefits and services you've earned as a Veteran, Servicemember, or family memberlike health care, disability, education, and more. Location: Stockton When shes not working, Maily enjoys spending time with her loved ones. VA CCN OptumP.O. Those options are: Utilize HealthShare Referral Manager (HSRM) for referrals, authorizations and documentation exchange. For authorized care, the referral number listed on the Billing and Other Referral Information form. She takes a collaborative approach ensuring they have the best quality of life. For questions or additional support, reach out to your designated provider relations representative. It helps me understand their perspectives and develop lasting patient-provider relationships.. P.O. She has put her skills to use in a variety of healthcare settings. We have a number of ways to answer your questions and provide the forms and other information you need to ensure you receive the best possible customer service. PO Box 30750, Tampa FL 33630-3750. Residency: UCSF Fresno Family & Community Medicine . You give them a voice when they dont have one.. PACE programs are required by federal regulations to have a Provider Network to meet the needs of our participants. I learn so much from them.. A busy mom of 3 kids all under 13, Adetoun still finds time to do what she enjoys, which is giving back to the community. We are PACE OF THE TRIAD
Laura loves bringing her children to her parents farm to see the chickens and goats, teach them to care for creatures other than themselves., Role: Medical Director Each senior has a unique set of vulnerabilities and goals that need to be identified and supported. You can also call call the IVC National Contact Center. Location: Pasadena You can also call the IVC National Contact Center. Ted enjoys serving his community and volunteering at his local food bank. endobj
Dr. Matt Patterson is dedicated to improving the value, accessibility, and experience of healthcare for all people and their caregivers. That really means something to me.. With 15 years of experience, Tam has a wealth of knowledge and skills. Existing Claim Inquiry. Board Certification: American Academy of Nurse Practitioners When shes not working, Sukhvinder enjoys spending time with family, traveling, camping, and cooking. Include the authorization number on the claim form for all non-emergent care. Previously, she was the Chairman of the Workforce Solutions of Greater Dallas, an Associate Board member of the Financial Partners Credit Union, and a Board Member of The Board Connection, a Dallas-based organization promoting the advancement of women on public company boards. Vendorizing Assistance (Vendor Information Updates) Phone: 512-460-5049 Fax: 512-460-5221. . Medical Degree: Tufts University School of Medicine Additional information is available regarding the VA Privacy Policy. Languages Spoken: English, Hindi, Punjabi, If you can help somebody in need, they will often come back to thank you. Paper claims and supporting documentation submitted to us are converted to Electronic Data Interchange (EDI) transactions. Have member ID number ready. Ensuring dignity for seniors is a core value for Elizabeth. Payer ID for dental claims is 12116. If you are submitting a paper claim, please review the Filing Paper Claims section below for paper claim requirements. Location: Pasadena Our team supports participants 24/7, and includes: At WelbeHealths PACE day centers, seniors can take art classes, join exercise groups, and attend special events. And you become their advocate. She was previously Chief Medical Officer of On Lok, the original PACE, and Founding Medical Director for Sutter Senior Care PACE, one of the earliest PACE replication sites. Location: Fresno She trained in internal medicine at the George Washington University, where she came to recognize her lifes mission of caring for individuals with medical and psychosocial complexities. She embraces the principles of the employee as a consumer (a person who makes the choice of where to work by considering a broadly defined value proposition, inclusive of financial, work, and social aspects of life) and agile organization (a workforce that continually evolves to meet the changing interests and needs of team members and customer.). Amy Shin is a passionate advocate for equitable healthcare, especially for vulnerable populations. Cathy earned her Bachelors degree in Business Administration from the University of Washington and an MBA from the University of Michigan. Your data is securely protected, because we keep to the most up-to-date . visit VeteransCrisisLine.net for more resources. She recently completed a prestigious fellowship at Stanford University with a focus on Redesigning Care for People in Late Life. She believes in focusing on her patients life goals to maximize their health and well-being. Dr. Golden tells her WelbeHealth participants, I never lecture on the first date., Role: Primary Care Provider
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