Who to Ask, Where to Send

Corporate Office

“Who to Ask, Where to Send”

Accounts Receivable

Pre-Admission Medicare Screening: Call Hilary Wilkey309-689-5870 or go to the Petersen website, log in, and click on My Forms. Select Medicare Screening Form and complete and submit the form. The screening will be e-mailed back to you.

Private or Medicaid Resident Balances: Questions regarding monthly statements, private resident accounts, Medicaid questions and issues, etc. should be addressed at statement time with the AR specialist doing your statements. Otherwise they can be e-mailed to Mary Hughes at

Hospice Billing: Questions regarding Hospice and Hospice billing can be e-mailed to Mary Hughes at

Medicare: Questions regarding Medicare can be e-mailed to Diana Keime at or Noonie Melvin at

Medicare, MDS, etc. Questions regarding MDS or other Medicare issues can be e-mailed to Nancy Moraski at or call at 309-253-2832

Insurance: Questions regarding resident insurance, Verification of Benefits, resident EOB’s, etc. can be addressed to Justine Rogers at nd fax number is 309-691-8622.

Veteran’s Administration Billing: Questions regarding VA billing can be addressed to Justine Rogers at nd fax to 309-691-8622.

Census: Questions regarding the web census program can be addressed to Mary Hughes or Sheri Lawsat

Training: If you feel you need more training, please e-mail Jennifer Howdyshell at

Refund Requests: Requests for resident refunds should be e-mailed to Nicky Pollitt at . Please also e-mail her with any and all correspondence and updates related to the refund.

Month End: All AR month end invoices, logs, RUGS, etc. are to be e-mailed to . If you cannot scan and e-mail, please fax with a cover sheet to month end at 309-689-5894.

Verification of Insurance: Email or fax all Verification of Insurance forms and copies of insurance and Medicare cards (front and back) to or faxed to 309-689-5861.

Zero Insurance EOB’s: Email or fax all correspondence from residents’ insurance companies (such as denials or requests – any EOB that comes without a check) to Mary Hughes at or fax to 309.691-8622.

Deposits and EOB’s: Deposit information and explanations of benefits that come with payment should be sent to Sarah Gresham (Strauch) at or faxed to 309-689-5838.

1156s: 1156s must be sent to corporate within 5 business days. Please send to . It is helpful if you put in the subject line of the e-mail if it is for a discharge or to report a death.

Medicaid Rate Sheets, LTC Report, Prepayment Reports that are received in the facility should be e-mailed to Mary Hughes at or faxed to 309-689-5832.

Medicaid Remittance or Alien Recipient Forms: All Medicaid remits or Alien Recipients that the facility receives in the mail need to be sent to Sarah Strauch at or fax to 309-689-5838.

Prepayment Report Discrepancy Logs: these forms are all to be sent to Jennifer Howdyshell at and Becky Stokes These should all be e-mailed.

Monthly Focus Plans: Send updated Monthly Focus Plan to Gail McGinnis, Vicki Villa, and your Regional Director at by the 10th of each month.

Medicaid Denials: Please send information regarding all Medicaid denials to Vicki Villa at

Medicare Appeals Notices: Any correspondence from Medicare, CMS, NGS, Maximus, WPS, etc. regarding Additional Development Requests (ADRs) or other Medicare claim appeals should be sent to Jennifer Howdyshell at or faxed to 309-619-8622.

Transportation Billing: Medicaid Transportation billing logs should be sent monthly to Becky Stokes at by the 10th of each month. For questions about the billing process, e-mail Jason Crowder at

Gas Credit Card Reconciliation with Receipts: Please mail these to Becky Stokes each month by the 10th of the month to the home office with original receipts and copy of Van Log.

Resident Trust: Questions about the resident trust program or assistance with balancing and closing should be addressed to Jennifer Howdyshell at or 309-689-5824, or fax to 309-689-5834 or to Barbara Hart at r 309-689-5851 or fax to 309-689-5833.

Resident Trust Month End Close Documents: Send to Barbara Hart, a copy of your completed and balanced Bank Reconciliation sheet, a copy of the trust Bank Statement, the Balance Report from AOD, and a Cash Box Reconciliation Sheet with your final cash box balance at month end. Barb will review and close the trust.

Payroll & Human Resources

Payroll: Questions regarding payroll procedures and deadlines should be addressed to Debbie Orman at

Human Resources, 401K, Employee Insurance: all questions should be directed to Debbie Orman at

Insurance Coverage Issues: If you are participating in one of the insurance plans and you have a question about a claim or coverage, contact Sharon Halstead at or at 309-266-7300.

Wage Assignments or Garnishments should be sent to Debbie Orman at or faxed to 309-689-5898

If you receive Payroll Tax materials in the facility, please send to Debbie Orman at or fax to 309-689-5898

Request for Employment Verification should be directed to Debbie Orman at

Accounts Payable

Vendor Collection Calls: Please refer any vendors calling about payments to AP at 309-689-5867.

Marketing Check Requests: Go to and click on the Employee Login at the bottom of the page. Click on Employee Request Forms. You will need to login with your regular Username and Password. Click on the Employee Forms link at the top of the page. Scroll to Marketing Check Request and fill in form and submit request.

All Other Check Requests: Go to and click on the Employee Login at the bottom of the page. Click on Employee Request Forms. You will need to login with your regular Username and Password. Click on the Employee Forms link at the top of the page. Scroll to General Check Request and fill in form and submit request.

Report of Receipts: All receipts from either Marketing Check Requests or General Check Requests together with the Report of Receipts should be sent to Becky Stokes at . Receipts should be taped neatly on an 8 ½ by 11 sheet of paper. Please tape only one side, not both.

Gas Credit Card Reconciliation with Receipts: Please send these to Becky Stokes each month by the 10th of the month.

Administrative

Workman’s Comp: questions or matters related to Workman’s Compensation claims should be addressed to Greg

CMS Medicare Cost Reports: If you receive correspondences from CMS or any other source regarding the facility’s cost reports, these should be sent to Dannelle Berry at or faxed to 309-691-8622.

Records Requests: All requests for records or questions regarding records requests should be addressed to Marikay Snyder at or

faxed to 309-689-5840.

Bed Taxes: Please send all bed tax information or correspondence with your AP packet marked to the attention of Marikay Snyder.

License Renewals: All license renewals should be completed and mailed to Marikay Snyder.

CLIA Certification is to be sent to MaryAnn Carroll at or faxed with a cover sheet to 309-691-8622.

Telephone Service: Questions or problems with telephone service should be addressed to Mark Scott at or 309-208-5152.

Equipment

IT - For problems or questions regarding computer hardware (router, computer, monitors), password problems, AOD, Citrix or other “technological” issues, contact Nate Gray.

You shouldsend an e-mail to describing the problem or question (be sure to include your name and the name of your facility).

You may also go to forms.petersenhealthcare.net and go to support, then Technology Support to do the same.

For questions regarding maintenance supplies, please contact Carl White at 309-369-3861

Check Scanners: Questions or issues regarding the bank check scanners can be addressed to Sarah Strauch at or 309-689-5893.

Vehicles

Vehicle Maintenance: contact Nate Gray at

Vehicle Accidents: contact BOTH Marikay Snyder at and Nate Gray at

Facility Web Site

Facility Web – For issues or questions regarding your Facility Web Site (editing your facility’s web page, uploading photos, etc) please email Tony Klein at