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Delivery-date: Fri, 29 Jun 2018 14:28:58 -0500
From: "Geoff Lusty" <geoffl@webhstech.com>
To: "'Chris Farrugia, DDS'" <info@smbdu.com>
Cc: "'Christie Bell'" <christie.cpf@bellsouth.net>,
	"'Amanda Cantelmi'" <amandac@webhstech.com>
References: <CAGJ=7XGsQLaxA+ri_C_Uwz9nXHp5-HbMquapoOzT7PWNxbLtBQ@mail.gmail.com> <00cc01d40a4d$52195b20$f64c1160$@webhstech.com> <44C3FC00-CEDC-46BF-AABE-BE0FD9274E96@smbdu.com> <004501d40ee9$76f31d00$64d95700$@webhstech.com> <1767527854.4242265.1530209517295@mail.yahoo.com> <9D80FB84-C809-4CA0-91FE-4267017BB165@smbdu.com> <005b01d40fc2$ebaa8500$c2ff8f00$@webhstech.com> <AE6E2AD6-5A65-415E-82CA-5467EDAB838A@smbdu.com>
In-Reply-To: <AE6E2AD6-5A65-415E-82CA-5467EDAB838A@smbdu.com>
Subject: RE: Covatto Claims
Date: Fri, 29 Jun 2018 15:28:11 -0400
Organization: Healthcare Support Technologies, Inc.
Message-ID: <008d01d40fdf$51d03430$f5709c90$@webhstech.com>
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Content-Language: en-us
 
 Content preview:  Haha, that’s too funny. At least I checked 😊 Geoff Lusty
    [...] 
 
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Haha, that=E2=80=99s too funny.

=20

At least I checked =F0=9F=98=8A

=20

Geoff Lusty

Vice President =E2=80=93 HST

geoffl@webhstech.com <mailto:geoffl@webhstech.com> =20

ph. (724) 304-4864

=20

From: Chris Farrugia, DDS <info@smbdu.com>=20
Sent: Friday, June 29, 2018 2:28 PM
To: Geoff Lusty <geoffl@webhstech.com>
Cc: Christie Bell <christie.cpf@bellsouth.net>; Amanda Cantelmi =
<amandac@webhstech.com>
Subject: Re: Covatto Claims

=20

I freely admit that math is not my strength....

Sent from Chris's Excellent iPhone


On Jun 29, 2018, at 12:04 PM, Geoff Lusty <geoffl@webhstech.com =
<mailto:geoffl@webhstech.com> > wrote:

Passing this on to Dr. C in a few moments.  This is great feedback and =
info/guidance =E2=80=93 thanks!

=20

Just looking/checking your math and may have found a mistake (would it =
be $14,692.53 instead of $12,155)?

=20

Wouldn=E2=80=99t it be $14,692.53?

=20

(1450 x 6 + 3455) + 2537.53 =3D 14,692.53

=20

The $12,155 was the first part (not adding in the patient portion) but =
if you add in the patient portion then it jumps to $14,692.53?

=20

=20

Geoff Lusty

Vice President =E2=80=93 HST

geoffl@webhstech.com <mailto:geoffl@webhstech.com> =20

ph. (724) 304-4864

=20

From: Chris Farrugia, DDS <info@smbdu.com <mailto:info@smbdu.com> >=20
Sent: Thursday, June 28, 2018 3:40 PM
To: Christie Bell <christie.cpf@bellsouth.net =
<mailto:christie.cpf@bellsouth.net> >
Cc: Geoff Lusty <geoffl@webhstech.com <mailto:geoffl@webhstech.com> >; =
Amanda Cantelmi <amandac@webhstech.com <mailto:amandac@webhstech.com> >
Subject: Re: Covatto Claims

=20

Thanks, Christie.

=20

I would add that Dr.C may find higher reimbursement if the surgery on =
the mandible is done via two separate bilateral partial surgeries =
(21248) and grafts. Of course, he will need to determine if that is =
clinically acceptable and warranted. I would also recommend that he =
allocate portions of his case fee to the surgical codes to reflect the =
difficulty of the procedures. On his treatment plan/predetermination =
request, I did not see an interim prosthesis (aka a temporary denture or =
flipper) or surgical guide (21085). There may be additional =
reimbursement available for these. As this is a beta case and he is =
anxious to get started, it may be best for Dr. C to do the treatment =
based on the information below with the expectation of the allowances =
below and then sort out the actual claim and documentation from his =
clinical notes, using that as a teaching moment. Note: if the patient =
has dental insurance Dr. C can receive additional payment from dental =
insurance but as in network medical provider he can not collect more =
from the patient than the $2537.53 indicated below. Total expected =
benefits (f my math is correct=E2=80=A6. please check it!) would be =
$12155 (2537.53 patient + [1450 x 6 plus 3455])

=20

Geoff,

Will you be passing this on to Dr. Covatto?

=20

Chris

Chris Farrugia, DDS

=20

On Jun 28, 2018, at 1:11 PM, Christie Bell <christie.cpf@bellsouth.net =
<mailto:christie.cpf@bellsouth.net> > wrote:






I called on Steve Gulla's insurance on 6/26/18 to get an updated =
pre-auth. since Dr. Covatto was an in-network provider.

There is a $0.00 deductible with $3425.00 out of pocket ($887.47 met) =
and then insurance will cover 100% of their allowance.

=20

I called insurance again today to get the allowance amount for the 21249 =
(6 bone stabilizers) & 21215 (bone graph). The in-network allowance is =
21249 $1450.00 (individual stabilizer) & 21215 $3455.00.

I have attached the updated Insurance Verification of Eligibility & =
Benefits.

=20

Christie
SMB
Dr. Chris Farrugia
850-261-5613

This message contains confidential information and is intended only for =
the individual named. If you are not the named addressee you should not =
disseminate, distribute or copy this e-mail. Please notify the sender =
immediately by e-mail if you have received this e-mail by mistake and =
delete this e-mail from your system. E-mail transmission cannot be =
guaranteed to be secure or error-free as information could be =
intercepted, corrupted, lost, destroyed, arrive late or incomplete, or =
contain viruses. The sender therefore does not accept liability for any =
errors or omissions in the contents of this message, which arise as a =
result of e-mail transmission. If verification is required please =
request a hard-copy version.

=20

On Thursday, June 28, 2018 9:08 AM, Geoff Lusty <geoffl@webhstech.com =
<mailto:geoffl@webhstech.com> > wrote:

=20

Hi Christie,

=20

Normally Amanda would be sending along this information but since she is =
away I thought I=E2=80=99d reach out (it is fairly urgent).

=20

Dr. Covatto finally received his welcome letter for BCBS.  So, the =
patient (Gulla) will need a predetermination call (I believe).  He has =
been in some pain and pushing Dr. Covatto to be seen but without the =
welcome letter he couldn=E2=80=99t treat the patient.

=20

The effective date is 6/19 and Dr. Covatto would like to move forward =
with this patient.  Can you make a call for us to get a feel for net =
allowances?  The patients portion (out of pocket) max is $2000 plus $250 =
deductible but we can=E2=80=99t determine benefits payable to the =
practice without provider ID.

=20

Geoff Lusty

Vice President =E2=80=93 HST

geoffl@webhstech.com <mailto:geoffl@webhstech.com>=20

ph. (724) 304-4864

=20

From: Geoff Lusty <geoffl@webhstech.com <mailto:geoffl@webhstech.com> >=20
Sent: Thursday, June 28, 2018 9:45 AM
To: 'Chris Farrugia, DDS' <info@smbdu.com <mailto:info@smbdu.com> >; =
'Amanda Cantelmi' <amandac@webhstech.com <mailto:amandac@webhstech.com> =
>
Cc: 'Dave Novak' <davenovak@webhstech.com =
<mailto:davenovak@webhstech.com> >; 'Ryan Wakim' =
<ryanwakim@fortunemgmt.com <mailto:ryanwakim@fortunemgmt.com> >
Subject: RE: Covatto Claims
Importance: High

=20

Hi Chris & Amanda,


We just got the welcome letter for BCBS for Dr. Covatto so would =
Christie now contact them for predetermination of benefits?

=20

Attached is the BCBS welcome letter.  Effective date 6/19!

=20

This is for pt Steve (who was the one in the most pain)

=20

Geoff Lusty

Vice President =E2=80=93 HST

geoffl@webhstech.com <mailto:geoffl@webhstech.com>=20

ph. (724) 304-4864

=20

From: Chris Farrugia, DDS < <mailto:info@smbdu.com> info@smbdu.com>=20
Sent: Friday, June 22, 2018 2:16 PM
To: Geoff Lusty < <mailto:geoffl@webhstech.com> geoffl@webhstech.com>
Cc: Amanda Cantelmi < <mailto:amandac@webhstech.com> =
amandac@webhstech.com>
Subject: Re: Covatto Claims

=20

The delay had been his application to go in network with all payers =
including BCBS (patient Gulla). there is no reason to proceed as OON if =
he is going in Net. We have been waiting for the credentialing process =
to finish. It is my understanding that he has been recently approved as =
in Net but We have not yet received his provider ID. The surgical =
procedure codes provided to us for thus case do not require preauth but =
there is a request for predetermination of benefits in the information =
forwarded to us With the provider ID we can attempt to get the in Net =
allowances if that is required to move forward. The patients portion =
(out of pocket) max is $2000 plus $250 deductible but we can=E2=80=99t =
determine benefits payable to the practice without provider ID.

=20

Regarding the patient Hample (TMD), he has an in Net application pending =
with Aetna. I have asked Christie to call and see if there are in Net =
providers and to get a gap exception if possible, to proceed as OON.=20

=20

Sent from Chris's Excellent iPhone


On Jun 22, 2018, at 12:20 PM, Geoff Lusty < =
<mailto:geoffl@webhstech.com> geoffl@webhstech.com> wrote:

Hi Chris,

=20

I got a text from him today:

=20

=E2=80=9C Hey Geoff, I am trying to determine if we are making any gains =
in medical submission.  I sent 2 cases and Dr. Farrugia was looking over =
them.  It=E2=80=99s been 1-2 months so far=E2=80=9D

=20

I don=E2=80=99t know all the details on this, but his impression is =
he=E2=80=99s waiting on feedback from you  (probably on the notes and =
whether they support medical necessity and whether they will pay)?=20

=20

Is this something you are working on or should I get in touch with =
Christie?

=20

Thanks!

=20

Geoff Lusty

Vice President =E2=80=93 HST

geoffl@webhstech.com <mailto:geoffl@webhstech.com>=20

ph. (724) 304-4864

=20

From: Amanda Cantelmi < <mailto:amandac@webhstech.com> =
amandac@webhstech.com>=20
Sent: Wednesday, June 20, 2018 5:15 PM
To: Chris Farrugia, DDS < <mailto:info@smbdu.com> info@smbdu.com>
Cc: Geoff Lusty < <mailto:geoffl@webhstech.com> geoffl@webhstech.com>
Subject: Covatto Claims

=20

I just got another voicemail from Dr. Covatto.  I believe I sent you =
everything I have on these two patients, Steve Gulla and Carrie Hample.  =


=20

The Gulla case is the most pressing as this patient is in significant =
pain.  Christie has all of Covatto's credentialing information, =
including his office phone, so I believe she can move forward without =
interruption. =20

=20

Do you know if any progress has been made on this one?  I believe Dr. =
Covatto is a little frustrated as when I spoke to him last week, I =
assured him now that we are all on the same page, things should move =
more quickly.

=20

I will be back in the office the first week of July.  I'm hoping that is =
no reason for this to be delayed.

=20

Thanks so much!  He would be more than happy to speak with Christie, so =
if she is working on this and wants to reach out directly to him - =
that'd be great.  If she does anything, just ask her to update the =
Dropbox spreadsheet so I know what has been done and where we are in the =
process since he calls me directly quite a bit.

=20

=20

Amanda Cantelmi

Executive Assistant

=20

  =
<https://docs.google.com/uc?export=3Ddownload&id=3D0B_Ejq69JjdFnc3pNNlQ5Y=
21mU00&revid=3D0B_Ejq69JjdFnYm55Qkp5ektpSWtRTFVmcEtUVkN6dDg3NzZJPQ>=20

315 Ninth Street

New Brighton, PA 15066

Direct

: 724-906-4832

Toll Free: 800-372-7790 Ext. 24

=20

Confidentiality Notice: This e-mail message, including any attachments, =
is for the sole use of the intended recipient(s) and may contain =
confidential and privileged information. Any unauthorized review, use, =
disclosure or distribution is prohibited. If you are not the intended =
recipient, please contact the sender by reply e-mail and destroy all =
copies of the original message.

=20

=20

=20

=20

=20


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</o:shapelayout></xml><![endif]--></head><body lang=3DEN-US link=3Dblue =
vlink=3Dpurple><div class=3DWordSection1><p class=3DMsoNormal>Haha, =
that=E2=80=99s too funny.<o:p></o:p></p><p =
class=3DMsoNormal><o:p>&nbsp;</o:p></p><p class=3DMsoNormal>At least I =
checked <span style=3D'font-family:"Segoe UI =
Emoji",sans-serif'>&#128522;</span><o:p></o:p></p><p =
class=3DMsoNormal><o:p>&nbsp;</o:p></p><div><p class=3DMsoNormal>Geoff =
Lusty<o:p></o:p></p><p class=3DMsoNormal>Vice President =E2=80=93 =
HST<o:p></o:p></p><p class=3DMsoNormal><a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a> =
<o:p></o:p></p><p class=3DMsoNormal>ph. (724) =
304-4864<o:p></o:p></p></div><p =
class=3DMsoNormal><o:p>&nbsp;</o:p></p><div><div =
style=3D'border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in =
0in 0in'><p class=3DMsoNormal><b>From:</b> Chris Farrugia, DDS =
&lt;info@smbdu.com&gt; <br><b>Sent:</b> Friday, June 29, 2018 2:28 =
PM<br><b>To:</b> Geoff Lusty &lt;geoffl@webhstech.com&gt;<br><b>Cc:</b> =
Christie Bell &lt;christie.cpf@bellsouth.net&gt;; Amanda Cantelmi =
&lt;amandac@webhstech.com&gt;<br><b>Subject:</b> Re: Covatto =
Claims<o:p></o:p></p></div></div><p =
class=3DMsoNormal><o:p>&nbsp;</o:p></p><p class=3DMsoNormal =
style=3D'margin-bottom:12.0pt'>I freely admit that math is not my =
strength....<o:p></o:p></p><div id=3DAppleMailSignature><p =
class=3DMsoNormal>Sent from Chris's Excellent =
iPhone<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'margin-bottom:12.0pt'><br>On Jun 29, 2018, at 12:04 PM, Geoff =
Lusty &lt;<a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a>&gt; =
wrote:<o:p></o:p></p></div><blockquote =
style=3D'margin-top:5.0pt;margin-bottom:5.0pt'><div><p =
class=3DMsoNormal>Passing this on to Dr. C in a few moments.&nbsp; This =
is great feedback and info/guidance =E2=80=93 thanks!<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p class=3DMsoNormal>Just =
looking/checking your math and may have found a mistake (would it be =
$14,692.53 instead of $12,155)?<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p =
class=3DMsoNormal>Wouldn=E2=80=99t it be $14,692.53?<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p class=3DMsoNormal>(1450 x 6 + =
3455) + 2537.53 =3D 14,692.53<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p class=3DMsoNormal>The $12,155 =
was the first part (not adding in the patient portion) but if you add in =
the patient portion then it jumps to $14,692.53?<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><div><p class=3DMsoNormal>Geoff =
Lusty<o:p></o:p></p><p class=3DMsoNormal>Vice President =E2=80=93 =
HST<o:p></o:p></p><p class=3DMsoNormal><a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a> =
<o:p></o:p></p><p class=3DMsoNormal>ph. (724) =
304-4864<o:p></o:p></p></div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><div><div =
style=3D'border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in =
0in 0in'><p class=3DMsoNormal><b>From:</b> Chris Farrugia, DDS &lt;<a =
href=3D"mailto:info@smbdu.com">info@smbdu.com</a>&gt; <br><b>Sent:</b> =
Thursday, June 28, 2018 3:40 PM<br><b>To:</b> Christie Bell &lt;<a =
href=3D"mailto:christie.cpf@bellsouth.net">christie.cpf@bellsouth.net</a>=
&gt;<br><b>Cc:</b> Geoff Lusty &lt;<a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a>&gt;; =
Amanda Cantelmi &lt;<a =
href=3D"mailto:amandac@webhstech.com">amandac@webhstech.com</a>&gt;<br><b=
>Subject:</b> Re: Covatto Claims<o:p></o:p></p></div></div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><p class=3DMsoNormal>Thanks, =
Christie.<o:p></o:p></p><div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p></div><div><p class=3DMsoNormal>I =
would add that Dr.C may find higher reimbursement if the surgery on the =
mandible is done via two separate bilateral partial surgeries (21248) =
and grafts. Of course, he will need to determine if that is clinically =
acceptable and warranted. I would also recommend that he allocate =
portions of his case fee to the surgical codes to reflect the difficulty =
of the procedures. On his treatment plan/predetermination request, I did =
not see an interim prosthesis (aka a temporary denture or flipper) or =
surgical guide (21085). There may be additional reimbursement available =
for these. As this is a beta case and he is anxious to get started, it =
may be best for Dr. C to do the treatment based on the information below =
with the expectation of the allowances below and then sort out the =
actual claim and documentation from his clinical notes, using that as a =
teaching moment. Note: if the patient has dental insurance Dr. C can =
receive additional payment from dental insurance but as in network =
medical provider he can not collect more from the patient than the =
$2537.53 indicated below. Total expected benefits (f my math is =
correct=E2=80=A6. please check it!) would be $12155 (2537.53 patient + =
[1450 x 6 plus 3455])<o:p></o:p></p></div><div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal>Geoff,<o:p></o:p></p></div><div><p =
class=3DMsoNormal>Will you be passing this on to Dr. =
Covatto?<o:p></o:p></p></div><div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal>Chris<o:p></o:p></p></div><div><p =
class=3DMsoNormal>Chris Farrugia, DDS<o:p></o:p></p></div><div><p =
class=3DMsoNormal>&nbsp;<o:p></o:p></p><div><div><p class=3DMsoNormal>On =
Jun 28, 2018, at 1:11 PM, Christie Bell &lt;<a =
href=3D"mailto:christie.cpf@bellsouth.net">christie.cpf@bellsouth.net</a>=
&gt; wrote:<o:p></o:p></p></div><p =
class=3DMsoNormal><br><br><br><o:p></o:p></p><blockquote =
style=3D'margin-top:5.0pt;margin-bottom:5.0pt'><div><div><div =
id=3D"yui_3_16_0_1_1530197283328_11594"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>I called =
on&nbsp;Steve&nbsp;Gulla's insurance on 6/26/18 to get an updated =
pre-auth. since Dr. Covatto was&nbsp;an in-network =
provider.</span><o:p></o:p></p></div><div =
id=3D"yui_3_16_0_1_1530197283328_11604"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>There =
is&nbsp;a $0.00 deductible with&nbsp;$3425.00 out of pocket ($887.47 =
met) and then insurance will cover 100% of their =
allowance.</span><o:p></o:p></p></div><div =
id=3D"yui_3_16_0_1_1530197283328_11605"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>&nbsp;</spa=
n><o:p></o:p></p></div><div id=3D"yui_3_16_0_1_1530197283328_11647"><p =
class=3DMsoNormal style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>I called =
insurance again today to get the allowance amount for the 21249 (6 bone =
stabilizers) &amp; 21215 (bone graph). The in-network allowance is 21249 =
$1450.00 (individual stabilizer) &amp; =
21215&nbsp;$3455.00.</span><o:p></o:p></p></div><div =
id=3D"yui_3_16_0_1_1530197283328_11616"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>I have =
attached the updated Insurance Verification&nbsp;of Eligibility &amp; =
Benefits.</span><o:p></o:p></p></div><div =
id=3D"yui_3_16_0_1_1530197283328_11606"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>&nbsp;</spa=
n><o:p></o:p></p></div><div id=3D"yui_3_16_0_1_1530197283328_11608"><div =
id=3D"yui_3_16_0_1_1530197283328_11607"><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>Christie<br=
>SMB<br>Dr. Chris Farrugia<br>850-261-5613<br><br></span><span =
style=3D'font-size:10.0pt;font-family:"Garamond",serif'>This message =
contains confidential information and is intended only for the =
individual named. If you are not the named addressee you should not =
disseminate, distribute or copy this e-mail. Please notify the sender =
immediately by e-mail if you have received this e-mail by mistake and =
delete this e-mail from your system. E-mail transmission cannot be =
guaranteed to be secure or error-free as information could be =
intercepted, corrupted, lost, destroyed, arrive late or incomplete, or =
contain viruses. The sender therefore does not accept liability for any =
errors or omissions in the contents of this message, which arise as a =
result of e-mail transmission. If verification is required please =
request a hard-copy version.</span><o:p></o:p></p></div></div><div><p =
class=3DMsoNormal style=3D'margin-bottom:12.0pt;background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>&nbsp;</spa=
n><o:p></o:p></p></div><div><div><div><div><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:10.0pt;font-family:"Arial",sans-serif'>On Thursday, =
June 28, 2018 9:08 AM, Geoff Lusty &lt;<a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a>&gt; =
wrote:</span><o:p></o:p></p></div><p class=3DMsoNormal =
style=3D'margin-bottom:12.0pt;background:white'><span =
style=3D'font-size:12.0pt;font-family:"Helvetica",sans-serif'>&nbsp;</spa=
n><o:p></o:p></p><div><div id=3Dyiv4455250997><div><div><p =
class=3DMsoNormal style=3D'background:white'>Hi =
Christie,<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Normally Amanda would be =
sending along this information but since she is away I thought =
I=E2=80=99d reach out (it is fairly urgent).<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Dr. Covatto finally =
received his welcome letter for BCBS.&nbsp; So, the patient (Gulla) will =
need a predetermination call (I believe).&nbsp; He has been in some pain =
and pushing Dr. Covatto to be seen but without the welcome letter he =
couldn=E2=80=99t treat the patient.<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>The effective date is 6/19 =
and Dr. Covatto would like to move forward with this patient.&nbsp; Can =
you make a call for us to get a feel for net allowances?&nbsp; The =
patients portion (out of pocket) max is $2000 plus $250 deductible but =
we can=E2=80=99t determine benefits payable to the practice without =
provider ID.<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>Geoff =
Lusty<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>Vice President =E2=80=93 =
HST<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'><a href=3D"mailto:geoffl@webhstech.com" =
target=3D"_blank">geoffl@webhstech.com</a><o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>ph. (724) =
304-4864<o:p></o:p></p></div></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><div =
style=3D'border:none;border-top:solid windowtext 1.0pt;padding:3.0pt 0in =
0in 0in;border-color:currentcolor currentcolor;border-image-source: =
none'><div><p class=3DMsoNormal =
style=3D'background:white'><b>From:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Geoff Lusty &lt;<a =
href=3D"mailto:geoffl@webhstech.com">geoffl@webhstech.com</a>&gt;<span =
class=3Dapple-converted-space>&nbsp;</span><br><b>Sent:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Thursday, June 28, 2018 9:45 =
AM<br><b>To:</b><span class=3Dapple-converted-space>&nbsp;</span>'Chris =
Farrugia, DDS' &lt;<a =
href=3D"mailto:info@smbdu.com">info@smbdu.com</a>&gt;; 'Amanda Cantelmi' =
&lt;<a =
href=3D"mailto:amandac@webhstech.com">amandac@webhstech.com</a>&gt;<br><b=
>Cc:</b><span class=3Dapple-converted-space>&nbsp;</span>'Dave Novak' =
&lt;<a =
href=3D"mailto:davenovak@webhstech.com">davenovak@webhstech.com</a>&gt;; =
'Ryan Wakim' &lt;<a =
href=3D"mailto:ryanwakim@fortunemgmt.com">ryanwakim@fortunemgmt.com</a>&g=
t;<br><b>Subject:</b><span =
class=3Dapple-converted-space>&nbsp;</span>RE: Covatto =
Claims<br><b>Importance:</b><span =
class=3Dapple-converted-space>&nbsp;</span>High<o:p></o:p></p></div></div=
></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Hi Chris &amp; =
Amanda,<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'><br>We just got the welcome letter for BCBS =
for Dr. Covatto so would Christie now contact them for predetermination =
of benefits?<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Attached is the BCBS =
welcome letter.&nbsp; Effective date 6/19!<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>This is for pt Steve (who =
was the one in the most pain)<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>Geoff =
Lusty<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>Vice President =E2=80=93 =
HST<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'><a href=3D"mailto:geoffl@webhstech.com" =
target=3D"_blank">geoffl@webhstech.com</a><o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>ph. (724) =
304-4864<o:p></o:p></p></div></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><div =
style=3D'border:none;border-top:solid windowtext 1.0pt;padding:3.0pt 0in =
0in 0in;border-color:currentcolor currentcolor;border-image-source: =
none'><div><p class=3DMsoNormal =
style=3D'background:white'><b>From:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Chris Farrugia, DDS &lt;<a =
href=3D"mailto:info@smbdu.com" target=3D"_blank"><span =
style=3D'color:#954F72'>info@smbdu.com</span></a>&gt;<span =
class=3Dapple-converted-space>&nbsp;</span><br><b>Sent:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Friday, June 22, 2018 2:16 =
PM<br><b>To:</b><span class=3Dapple-converted-space>&nbsp;</span>Geoff =
Lusty &lt;<a href=3D"mailto:geoffl@webhstech.com" =
target=3D"_blank"><span =
style=3D'color:#954F72'>geoffl@webhstech.com</span></a>&gt;<br><b>Cc:</b>=
<span class=3Dapple-converted-space>&nbsp;</span>Amanda Cantelmi &lt;<a =
href=3D"mailto:amandac@webhstech.com" target=3D"_blank"><span =
style=3D'color:#954F72'>amandac@webhstech.com</span></a>&gt;<br><b>Subjec=
t:</b><span class=3Dapple-converted-space>&nbsp;</span>Re: Covatto =
Claims<o:p></o:p></p></div></div></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>The delay had been his =
application to go in network with all payers including BCBS (patient =
Gulla). there is no reason to proceed as OON if he is going in Net. We =
have been waiting for the credentialing process to finish. It is my =
understanding that he has been recently approved as in Net but We have =
not yet received his provider ID. The surgical procedure codes provided =
to us for thus case do not require preauth but there is a request for =
predetermination of benefits in the information forwarded to us With the =
provider ID we can attempt to get the in Net allowances if that is =
required to move forward. The patients portion (out of pocket) max is =
$2000 plus $250 deductible but we can=E2=80=99t determine benefits =
payable to the practice without provider =
ID.<o:p></o:p></p></div><div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>Regarding the patient =
Hample (TMD), he has an in Net application pending with Aetna. I have =
asked Christie to call and see if there are in Net providers and to get =
a gap exception if possible, to proceed as =
OON.&nbsp;<o:p></o:p></p></div></div><div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div =
id=3Dyiv4455250997AppleMailSignature><div><p class=3DMsoNormal =
style=3D'background:white'>Sent from Chris's Excellent =
iPhone<o:p></o:p></p></div></div><div><div =
style=3D'margin-bottom:12.0pt'><p class=3DMsoNormal =
style=3D'background:white'><br>On Jun 22, 2018, at 12:20 PM, Geoff Lusty =
&lt;<a href=3D"mailto:geoffl@webhstech.com" target=3D"_blank"><span =
style=3D'color:#954F72'>geoffl@webhstech.com</span></a>&gt; =
wrote:<o:p></o:p></p></div></div><blockquote =
style=3D'margin-top:5.0pt;margin-bottom:5.0pt'><div><p class=3DMsoNormal =
style=3D'background:white'>Hi Chris,<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>I got a text from him =
today:<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>=E2=80=9C Hey Geoff, I am =
trying to determine if we are making any gains in medical =
submission.&nbsp; I sent 2 cases and Dr. Farrugia was looking over =
them.&nbsp; It=E2=80=99s been 1-2 months so =
far=E2=80=9D<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>I don=E2=80=99t know all =
the details on this, but his impression is he=E2=80=99s waiting on =
feedback from you &nbsp;(probably on the notes and whether they support =
medical necessity and whether they will =
pay)?&nbsp;<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Is this something you are =
working on or should I get in touch with =
Christie?<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>Thanks!<o:p></o:p></p></div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>Geoff =
Lusty<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>Vice President =E2=80=93 =
HST<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'><a href=3D"mailto:geoffl@webhstech.com" =
target=3D"_blank">geoffl@webhstech.com</a><o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'>ph. (724) =
304-4864<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><p =
class=3DMsoNormal style=3D'background:white'><b>From:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Amanda Cantelmi &lt;<a =
href=3D"mailto:amandac@webhstech.com" target=3D"_blank"><span =
style=3D'color:#954F72'>amandac@webhstech.com</span></a>&gt;<span =
class=3Dapple-converted-space>&nbsp;</span><br><b>Sent:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Wednesday, June 20, 2018 5:15 =
PM<br><b>To:</b><span class=3Dapple-converted-space>&nbsp;</span>Chris =
Farrugia, DDS &lt;<a href=3D"mailto:info@smbdu.com" =
target=3D"_blank"><span =
style=3D'color:#954F72'>info@smbdu.com</span></a>&gt;<br><b>Cc:</b><span =
class=3Dapple-converted-space>&nbsp;</span>Geoff Lusty &lt;<a =
href=3D"mailto:geoffl@webhstech.com" target=3D"_blank"><span =
style=3D'color:#954F72'>geoffl@webhstech.com</span></a>&gt;<br><b>Subject=
:</b><span class=3Dapple-converted-space>&nbsp;</span>Covatto =
Claims<o:p></o:p></p></div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>I just got another =
voicemail from Dr. Covatto.&nbsp; I believe I sent you everything I have =
on these two patients, Steve Gulla and Carrie =
Hample.&nbsp;&nbsp;<o:p></o:p></p></div><div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>The Gulla case is the most =
pressing as this patient is in significant pain.&nbsp; Christie has all =
of Covatto's credentialing information, including his office phone, so I =
believe she can move forward without =
interruption.&nbsp;&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>Do you know if any progress =
has been made on this one?&nbsp; I believe Dr. Covatto is a little =
frustrated as when I spoke to him last week, I assured him now that we =
are all on the same page, things should move more =
quickly.<o:p></o:p></p></div></div><div><div><p class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>I will be back in the =
office the first week of July.&nbsp; I'm hoping that is no reason for =
this to be delayed.<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'>Thanks so much!&nbsp; He =
would be more than happy to speak with Christie, so if she is working on =
this and wants to reach out directly to him - that'd be great.&nbsp; If =
she does anything, just ask her to update the Dropbox spreadsheet so I =
know what has been done and where we are in the process since he calls =
me directly quite a bit.<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><di=
v><p class=3DMsoNormal style=3D'background:white'><b><span =
style=3D'font-size:13.5pt;font-family:"Trebuchet =
MS",sans-serif;color:#741B47'>Amanda =
Cantelmi</span></b><o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'><span =
style=3D'font-size:10.0pt;font-family:"Verdana",sans-serif;color:#741B47'=
>Executive Assistant</span><o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal =
style=3D'background:white'>&nbsp;<o:p></o:p></p></div></div><div><div><di=
v><div><p class=3DMsoNormal style=3D'background:white'><b><span =
style=3D'font-size:12.0pt;font-family:"Verdana",sans-serif;color:#274E13'=
><img border=3D0 width=3D200 height=3D37 =
style=3D'width:2.0833in;height:.3854in' =
id=3D"yiv4455250997_x005f_x0000_i1025" =
src=3D"https://docs.google.com/uc?export=3Ddownload&amp;id=3D0B_Ejq69JjdF=
nc3pNNlQ5Y21mU00&amp;revid=3D0B_Ejq69JjdFnYm55Qkp5ektpSWtRTFVmcEtUVkN6dDg=
3NzZJPQ" =
alt=3D"https://docs.google.com/uc?export=3Ddownload&amp;id=3D0B_Ejq69JjdF=
nc3pNNlQ5Y21mU00&amp;revid=3D0B_Ejq69JjdFnYm55Qkp5ektpSWtRTFVmcEtUVkN6dDg=
3NzZJPQ"></span></b><o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'><b><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif;color:#741B47'>=
315 Ninth Street</span></b><o:p></o:p></p></div></div><div><div><p =
class=3DMsoNormal style=3D'background:white'><b><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif;color:#741B47'>=
New Brighton, PA =
15066</span></b><o:p></o:p></p></div></div><div><div><div><p =
class=3DMsoNormal style=3D'background:white'><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif'>Direct</span><=
o:p></o:p></p></div></div><div><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif'>:</span><span =
style=3D'font-size:9.5pt'>&nbsp;</span><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif'>724-906-4832</=
span><o:p></o:p></p></div></div><div><div><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:10.0pt;font-family:"Verdana",sans-serif'>Toll =
Free:<b>&nbsp;</b>800-372-7790&nbsp;Ext. =
24</span><o:p></o:p></p></div></div></div><div><div><p class=3DMsoNormal =
style=3D'background:white'><span =
style=3D'font-size:9.5pt'>&nbsp;</span><o:p></o:p></p></div></div><div><d=
iv><p class=3DMsoNormal style=3D'background:white'><span =
style=3D'font-size:9.5pt;font-family:"Verdana",sans-serif'>Confidentialit=
y Notice: This e-mail message, including any attachments, is for the =
sole use of the intended recipient(s) and may contain confidential and =
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