Ureh Lekwauwa, MD, at NC DMA is e mailing Directors of Medical Services at SMC & WHN re: Possible Use of CAQH instead of Credentialing Nightmare Currently in Place

I called Steven Jordan's office (Director of Mental Health) in Raleigh re: the absolute travesty associated with being credentialed by the petty fiefdoms also known as Western Highlands Network and Smoky Mountain Center LME-MCO.

Thank God I was passed to Ureh Lekwauwa, MD, a medical director there in his office and she indicated she was going to e mail the Medical Directors of the two LME's to see about putting more quickly into place the CAQH credentialing process which would dead stop all of these shenanigans immediately.  She is at: ureh.lekwauwa@dhhs.nc.gov; tel: 919 733 7011.

CAQH has ALL the data re: credentialing of providers and we, as citizens of the state, could save MILLIONs of dollars by utilizing what is already there instead of petty beaurocrats telling us to send in this piece of paper, and then that one.

I told her it was a complete nightmare out here.  She said, 'I know.'

Godalmighty: will not someone relieve us of this troublesome credentialing process?

Here is the letter I sent to her and mental health reporters and activists:


Marsha V. Hammond, PhD
Clinical / Health Psychology
NC Licensed Psychologist
cell: 828 772 1127
e mail: chomskysright@gmail.com
NC Mental Health Reform blogspot: http://madame-defarge.blogspot.com

June 14, 2012

RE: credentialing nightmares at SMC and WHN LME

Dear Dr. Lekwauwa in Mental Health at DMA/ NC:

I was so relieved to find someone who understands the massive impossibility of this credentialing nightmare taking place.  SMC LME states online in its FAQ's that was trying to process 600 applications MONTHS AGO.  If I sound a little agitated it is because I have spent dozens of hours trying to move this credentialing process forward----going to board meetings, driving to board meetings, asking for assistance, calling up Provider Relations for assistance---seldom getting any useful information back.  I have to see my clients, not blog-on about this hopeless system.

I've been a Medicaid provider for over 10 years.  I have kept people out of the hospital thru outpt therapy and saved the state thousands of dollars over that period of time.  My clients can call me anytime of the night or day.  I save the state $$$$$$$$$$.

We are now up against a July 1, 2012 deadline as re: SMC LME and I have CRITICALLY ILL patients who will could into the hospital if they cannot be seen on an outpatient basis.

PLEASE allow the LME's to utilize the CAQH credentialing in lieu of their demands of sending in 'official college transcripts' and 'letters of recommendation' and 'CV''s' , etc.

*WHN requires a tax return; SMC does not

*SMC requires a CV; WHN does not

*SMC requires two letters of recommendation from 'like' mental health providers; I don't KNOW any psychologists under SMC LME catchment area. I cannot even get the question answered by anyone in provider relations as to 'will a psychiatrist do' re: this letter.

*SMC requires an 'Official College Transcript'; WHN removed that rule when I challenged them last year.

We are DYING out here re: this Medicaid waiver.  There is no standardization anywhere.  All the Medicaid providers have thrown up their hands and run away.

Here is a list of the posts on my blog over the past year re: this mess.

PLEASE help us.  PLEASE.

All professional providers, known as LIP, Licensed Independent Practitioners, have been on CAQH FOR YEARS.

1. (TODAY'S POST:
Why Did NC Medicaid/ DMA Not Require LME's to Utilize Already in Place CAQH Provider Credentialing Process?: WHY?

2. WEDNESDAY, JUNE 13, 2012
Smoky Mountai Center LME Sets Medicaid Waiver Deadline of July 1, 2012 and Yet Providers Cannot Easily Communicate with the Provider Relations Department
FROM: Marsha V. Hammond, PhD

3. Under Medicaid Waiver, Smoky Mountain Center LME Requires Different Items to be Submitted vs WHN LME, Including an 'Official College Transcript'

4. Under Medicaid Waiver, Western Highland Network's Piecemeal Provider Application Process

5. WEDNESDAY, JUNE 06, 2012
NC Department of Medical Assistance (Medicaid) indicates Open Enrollment for Providers for 1 year but LME's Say Something Else

The Medicaid Waiver is Failing Miserably at the Level of Services and Costs to Taxpayers
Richard Craver who writes regularly on NC mental health issues, wrote the following article at the Winston-Salem Journal recently:

http://www2.journalnow.com/news/2012/mar/06/3/centerpoint-to-ask-for-153-million-from-forsyth-co-ar-2014773/#fbcomments

6. THURSDAY, MARCH 08, 2012
Soliciting Contact w/ the Federal Centers for Medicare & Medicaid Services (CMS) re: Inability to Be Paid to Work w/ Medicaid clients under WHN LME

7. TUESDAY, MARCH 06, 2012
Letter to NC Comm Co-Chairs:WHN LME Medicaid Providers Being Denied Access to Medicaid Authorizations: URGENT