Medigold is the Medicare associated health insurance tied to Mt.
Carmel Health Partners, a major system in central Ohio. In Ohio, Certified Nurse
Practitioners (CNPs) are required to have a collaborating physician, but most
CNPs practice independently of them. Most insurances such as Caresource
recognize and reimburse CNPs as a primary care providers. Most physicians work
for hospital systems that have signed legal contracts that contain “no compete
clauses” that prohibit them from signing collaborative agreements with CNPs that
are not hired by their system. This creates a “catch 22” for CNPs that are
providing care independent of hospital health systems. The primary care
shortage is well known and in our office we turn new patients away daily.
My story: Even though I am credentialed with all the appropriate
agencies and have physician agreements in place, since the main physicians has dropped
her credentialing, Mt. Carmel will not reimburse or recognize me. I will no
longer be able to provide care to my Medigold patients that I have been seeing
several years. I am personally boycotting Mt. Carmel referrals and services until
they recognize CNPs as primary care providers. If you would like to further voice
your concern please contact:
Renee Sudimack
Provider Relations Specialist
Mount Carmel Health System | A Member of
Trinity Health
O: 614-546-4259 | F: 614-546-4269
[email protected]
Kelley Compson
Manager Provider Engagement
Mount Carmel Health Partners
(O) 614-546-4769
(C) 614-774-6400
[email protected]
Dr. Daniel Wendorff
[email protected]
Please sign the petition below to tell Mt. Carmel Health
Partners and Medigold to recognize and reimburse CNPs as primary care providers
regardless of whether the collaborating physicians are in-network.
This is so wrong. It is time the Family Nurse Practitioners get a fair shake. The insurance companies need to knock down these road blocks for access to good care.