In October of 2008, I decided that I wanted to become a Community Care provider (La. Medicaid’s version of an HMO). I was told to apply because this area (New Orleans) was still considered a “provider shortage area” since Hurricane KATRINA and that “free-standing” Nurse Practitioner clinic’s would have no problem getting credentialed. So, I immediately filled out the paperwork and waited for a response while I ventured off to fight other battles. Alas, December 2008 arrived and I still have not heard a word from my “new” Provider Relations department. I pick up the phone and give them a call. I am now told that, “after reviewing your application Ms./Dr. Lawson-Baker, New Orleans is no longer a shortage area. We are only allowing physicians and/or NP’s if it is deemed a ‘provider shortage’ area.” “Oh”, is my response as my face becomes as flushed as a Louisiana Creole Tomato. Ms./Dr. Lawson-Baker, you are welcome to appeal, the attendant says… At this point, I am still speechless as I say, “Don’t worry, I will tell all my Medicaid Community Care patients to find another provider.” I hang up the phone.
Three months pass, and we are now in April of 2009. I muster the strength to appeal and discover that the program is now “under new management”. This could be good, I say to myself. Real good. Hence, I begin a renewed fervor round of calls and letters to the “new management team” to figure out the hierarchy and decide who to pester, in a pleasant, but consistent manner. I am given a name and I place my first call to the leader of the team in June of 2009. I am told that I should re-submit my application and “really explain” just what my practice entails. “No problem”, I say.
After a few application “do-overs” and phone calls (of course), on October, 1st, 2009, Advanced Clinical Consultants became the first NP-owned Community Care Clinic in the City of New Orleans. We were told that 1,000 patients may be assigned to our roster. We saw our first patient today and already have 9 patients “assigned” to the clinic. I still have my Armour on…HUMANA is still in view. I got to get that directory insanity fixed now. Stay Tuned…
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