Wednesday, August 01, 2012

Medicaid Waiver: 45 Pages of Information Required to Get Re-credentialed for Already Medicaid Provider at WHN LME: Goddess, Please let SMC LME take-over WHN LME

I just sent in 45 pages associated with re-credentialing (I am already a Medicaid provider) for Western Highlands Network (WHN) LME, which is the mental health authority sandwiched between the two regions for Smoky Mountain Center (SMC) LME.  Goddess: please allow SMC LME to take over WHN LME.

This does not even take into account the 10+ pages I had to fill out as associated with ONE MEDI CAID CLIENT for outpatient services.

This is what I have discovered about the two LME's over the past several months:

1. WHN LME required me to send in a tax return, an attestation associated with how my clients could get me after hours, tax returns for last year, and an outline of what kind of clients I see PRIOR TO ANY APPLICATION PROCESS even as an Out of Network provider.

2. Today, and yesterday, when I called SMC LME regarding a cerebral palsy client of mine, as associated with the client being possibly able to work at the sheltered workshop in Waynesville, I got almost immediate call-backs from SMC LME personnel. When I call WHN LME, it could be days/ weeks before I get an answer back.

So, the CEO of WHN LME was fired last week and they now have an interim CEO.  I pray that the powers that be 'make it so' that WHN LME be subsumed by SMC LME.  Given the better organization of SMC LME under this Medicaid waiver, let the 'best man win' and that entity would be SMC LME.


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