Pediatric Integrated Care System

Information

 

Ped∙I∙Care Staff

Staff Member

Title

Phone #

Email Address

Responsibilities

 

 

(Main Numbers)

866-376-2456

352-334-1705

 

Ø        General Information

Ø        Provider Manual and Directory requests

Ø        Member Services

Nancy Giunta, MHA, FACMPE

Executive Director

352-334-1678

giuntmn@peds.ufl.edu

Ø        Executive Director

Nancy McCollough

Sr Secretary

352-334-0103

nancymc@peds.ufl.edu

Ø        Sr Secretary

Dave Jacobs, BSEE

Administrative Assistant

352-334-1681

jacobde@peds.ufl.edu

Ø        Provider Data Manager/Fiscal/HR

Tim Moody

Accountant

352-334-0108

ttmoody@peds.ufl.edu

Ø        Fiscal

Kati Breton, BS

Network Manager

352-334-1682

kbreton@peds.ufl.edu

Ø        Provider Recruitment & Enrollment

Ø        Provider Education

Aaron Majcen

Provider Relations Liaison (Gainesville)

352-334-1585

amajcen@peds.ufl.edu

Ø        Provider Recruitment

Ø        Provider Education

Shelly Mallory

Provider Relations Liaison (Ocala)

352-369-2563

352-334-1422

smallory@peds.ufl.edu

Ø        Provider Recruitment

Ø        Provider Education

India Kudla

Provider Relations Liaison (Jacksonville)

352-334-1364

904-360-7070 Ext 250

kudlais@peds.ufl.edu

Ø        Provider Recruitment

Ø        Provider Education

Megan Scherer

Provider Relations Liaison (Daytona)

386-238-4980 Ext 111

mscherer@peds.ufl.edu

Ø        Provider Recruitment

Ø        Provider Education

Orlando Cruz, MA, MEd

Member Services Coordinator

352-334-0100

ocruz@peds.ufl.edu

Ø        Member/Quality Reporting

Ø        Eligibility

Ø        EQRO/PIPs

Carissa Lee Mitchell

Member Services Manager

352-334-1706

leecr@peds.ufl.edu

Ø        Member Support

Ø        PCP & Demographic Changes

Ø        Eligibility

Consuelo Pastrana

Member Services

352-334-1591

pastrgc@peds.ufl.edu

Ø        Member Support

Ø        PCP & Demographic Changes

Ø        Eligibility

Sharla Brown

Member Services

352-334-1705 Ext 0

sharlabrown@peds.ufl.edu

Ø        Member Support

Ø        PCP & Demographic Changes

Ø        Eligibility

Bonnie Strickland

Contracting & Credentialing Manager

352-334-1587

stricbj@peds.ufl.edu

Ø        Provider Contracting & Credentialing

C.J. Partridge

CMS and Provider Relations Manager

352-334-1700

partrcj@peds.ufl.edu

Ø        Provider Support & Credentialing

Ø        Patient Specific Agreements

Betsy Westra

Contract and PSLOA Manager

352-334-0117

westraba@peds.ufl.edu

Ø        Provider Contract Processing

Ø        Network Updates

Rachel Jerkins

Utilization and Contracting

352-334-1627

jerkirm@peds.ufl.edu

Ø        Medical Director Review Coordination

Ø        Authorization Appeals

Pati Colvin

Credentialing Specialist

352-334-1583

pcolvin@peds.ufl.edu

Ø        Provider Credentialing

Nick Reynaud

Contracting and Credentialing Assistant

352-334-1587

reynaudn@peds.ufl.edu

Ø        Provider Contracting Assistant

Ø        Provider Credentialing Assistant

Gina Cone, CPC, CPC-H

Claims & Systems Manager

352-334-1684

kendallrl@peds.ufl.edu

Ø        Claims Problems/Education/Billing Issues

Ø        Claims Appeals/Questions

Donna Acker, CPC

Claims Processor

352-334-0200

ackerd@peds.ufl.edu

Ø        Claims Problems/Billing Issues

Ø        Claims Appeals/Questions

Jennifer Barry, BSN, RN

Quality Improvement Manager

352-334-1701

barryjs@peds.ufl.edu

Ø        Provider Site Visits

Ø        Quality Issues

Ø        Medical Item(s) Pricing & Supply Issues

Sheila Anderson, LPN

Quality Improvement Nurse

352-334-1572

skanders@peds.ufl.edu

Ø        Provider Site Visits

Ø        Quality Issues

Glenda Cole, LPN

Quality Improvement Nurse

352-334-1564

glcole@peds.ufl.edu

Ø        Provider Site Visits

Ø        Quality Issues

Pati Colvin

Quality Improvement Assistant

352-334-1583

pcolvin@peds.ufl.edu

Ø        Assistant to QI Nurses

Ø        Site Visit Scheduling

 

 

 

 

 

 

MED 3000

Department

Hrs. of Operation

Phone #

Fax #

Responsibilities

Customer Service

7:30A-4:30P CST

800-664-0146

866-246-2094

Ø        Verify Eligibility or Check Claims Status

Medical Department / Utilization Management

8:00A-5:00P CST

800-492-9634

866-256-2015

Ø        Referral & Authorization Requests

Ø        Pre-cert for Inpatient Admissions or Specified Outpatient Diagnostic Procedures

Ø        UM Policies and Procedures

Provider Help Desk

7:00A-4:30P CST

866-703-1444

 

Ø        Technical Assistance with eINFOsource

 

 

General Information

Ped∙I∙Care T21 Claims Address

Ped-I-Care Claims Appeals Address

Ped-I-Care Office Address

CMS Locations

Ped∙I∙Care

University of Florida, ICS

P.O. Box 10887

Pensacola, FL  32524

Ped∙I∙Care Appeals

University of Florida, ICS

P.O. Box 10786

Pensacola, FL  32524

Ped-I-Care

1701 S.W. 16th Ave., Building A

Gainesville, FL  32608

Children’s Medical Services - Daytona Beach                     Phone : 386-238-4980

Children’s Medical Services - Gainesville                            Phone : 352-334-1400

Children’s Medical Services - Jacksonville                          Phone : 904-360-7070

Children’s Medical Services - Ocala                                    Phone : 352-369-2300

 

 

 

 

CMS/Ped∙I∙Care T19 Claims Address

 

 

ACS - Choice Counseling (Medicaid Reform)

CMS/Ped-I-Care

University of Florida ICS

P.O. Box 10885

Pensacola, FL 32524

 

 

Choice Counseling for Sib Referrals/Questions                              1-866-454-3959