Aug 28, 2019 For Immediate Release
VITAL CARE INC. CONTINUES EXPANSION – TONJA GILSON JOINS FRANCHISE DEVELOPMENT TEAM
Meridian, MS, August 28, 2019 -- Vital Care (vitalcareinc.com) is excited to announce the continued expansion of the Franchise Development department, with the appointment of Tonja Gilson to the new position of Payer Coordinator. Tonja brings more than 20 years of experience in provider relations and contracting to this critical role, knowing how important it is to submit accurate and timely documents to ensure there are neither lapses in plan participation nor delays in credentialing and re-credentialing. Moreover, her understanding of Vital Care’s Financial Services workflows, from initial patient referral support to billing and collections on behalf of our 60 franchise locations, uniquely qualifies her for this new role.
"I worked in the health insurance field for over 20 years and was able to bring that knowledge to the Financial Services department when I joined Vital Care because of my understanding of researching payer related issues, knowing what was expected from the provider when submitting claims research projects, and understanding the thought patterns behind how claims are processed," said Tonja.
Additional responsibilities Tonja has for new franchise sales and support include: Researching state laws, processes, and criteria for Vital Care to enter new markets; researching payers in these new states and assisting with enrolling franchises in new plans to eliminate claims problems or patient care issues; and assisting with Vital Care’s Code Blue process for accelerating new patient referrals.
"It’s great that Tonja has this knowledge and has enthusiastically brought it over to our department to help us all," said Logan Davis, Director of Franchise Development. "Her ability to understand complex contracts helps us track claims to see if they are processed according to the contract, or for example whether there could be a different payer-policy issue based on UM department criteria or CMS rule changes."
"In her new role, Tonja is helping us bridge any gaps between payers and Vital Care by being the liaison for provider-relations representatives so we can better understand their expectations in processing and paying claims," said Ed Eiland, CEO. "This helps us continue adding value for our franchise owners across our complex network where insurance rules can vary from state to state and among different health insurance companies."
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About Vital Care, Inc.
Vital Care is the premier pharmacy franchise business for home infusion services. Our passion since 1986 is improving the lives of patients and healthcare professionals through locally owned franchise locations across the United States. We have over 60 franchised pharmacies across two dozen states.