VNSNY Heroes of 2020: Physicians Database Coordinators: Keeping the Care Moving

“I have come to heal the brokenhearted/And to give your heart a song.” So goes the gospel song, “More Abundantly,” that Maude Tolbert is listening to at her home office these days in her work as a VNSNY Physicians Database Coordinator.

The tight-knit Physicians Database team is responsible for credentialing physicians, tracking down their contact and enrollment information to make sure that patient treatment continues uninterrupted and that VNSNY receives proper compensation for the care it delivers. This includes checking physicians’ current standing with PECOS (Provider Enrollment and Chain/Ownership System) and OPRA (providers who Order, Prescribe, Refer or Attend Medicaid patients). All this helps VNSNY provide seamless patient care and reimbursement for services in the constantly changing environment of the COVID-19 emergency.

“When we do our job efficiently, there should be no lapses in patient service,” says Maude, who has been with the team for 15 years. “The doctor’s made the referral and is enrolled in the proper programs for the patient’s insurance, and our clinicians can just go out and see the patient.” She notes that she typically has seven windows open on her computer screen to access the information she needs. “I’m trying my best to keep it all moving.”

Managed by Business Operations Manager Kathleen Lillis, the team’s job has become more fast-paced and demanding with the onset of the coronavirus, yet they haven’t missed a beat in rising to meet the challenge. New regulations have added nurse practitioners and physician assistants to the list of providers who must be credentialed, and whose information must therefore be rigorously tracked by our Physicians Database team. In addition, with doctors traveling from out of state to assist New York with its surge of COVID-19 patients, the team had to track down where these physicians after they’ve referred a patient in order to properly process paperwork on behalf of patients. Plus, there were new locations—such as the Javits Center and tents in Central Park—where COVID-19 patients could receive treatment, further complicating the tracking.

“We play the role of private investigator,” says team supervisor Mirian Quilachamin. “It can be hard for nurses in the field to get all the provider information. We do the necessary searches, so the nurses can proceed with the start of care.”

Like so many VNSNY teams, the Physicians Database team is powered by collaboration. Even though they are teleworking, the team members speak frequently for support and companionship. “We’re a small group with a lot of work, but we’re always hands-on, helping each other out,” says Mirian. “I wouldn’t change this team for anything.”

Left to right, Miran Quilachamin, Christina Garibaldi and Maude Tolbert.

To read more VNSNY Heroes of 2020 stories, please click here.