Thank You For The Work You Do On Behalf Of The People We Serve

Provider Information, Policies, and Procedures

HealthWest Providers

At HealthWest, we value the relationships we hold with our contracted providers in Muskegon County and surrounding communities. With your help, we offer integrated quality care, pathways to a bright future, and expanded access to behavioral health and prevention services.

Interested In Becoming A Provider?

If you are interested in becoming a contracted provider of HealthWest, please contact the HealthWest Contracts Department at contracts@healthwest.net

Provider Network Overview Finance & Claims HR & Credentialing Electronic Health Record Substance Use (SUD) Resources Recipient Rights Training & Customer Service Corporate Compliance Quality Assurance Best Practice Guidelines

Provider Network Overview

Important Documents:

Important Links:

Provider Policies

Downloadable Provider Policies

Provider Contract Attachments

Downloadable Provider Contract Attachments

Contacts:

Gina Kim: Gina.Kim@healthwest.net
Anissa Goodno: Anissa.Goodno@healthwest.net
Jackie Farrar: Jackie.Farrar@healthwest.net
Contracts email: Contracts@HealthWest.net

Finance & Claims

Important Documents:

Important Links:

Important Medicaid Bulletins:

Contacts:

All claim questions/issues should be emailed to Claims@healthwest.net.
Amanda Florez, Claims Supervisor: Amanda.Florez@healthwest.net
MaryAnn Trach, Accounting Technician (Claims A-H): MaryAnn.Trach@healthwest.net
Sophie Rogers, Accounting Technician (Claims I-Z): Sophie.Rogers@healthwest.net

HR & Credentialing

Delegation of Credentialing

HealthWest delegates responsibility for credentialing and re-credentialing of employed and subcontracted direct service providers to contracted provider organizations. Credentialing and Re-Credentialing carried out by provider organizations must uphold all contractual requirements and be done in accordance with HealthWest policies and MDHHS Credentialing and Re-Credentialing Processes.

Monitoring and Oversight

Beginning in FY24, HealthWest will perform quarterly audits on a random sample of provider staff to ensure they are appropriately credentialed and fully trained according to contract requirements.

Tools and Resources

Provider organizations are encouraged to refer to HealthWest policies 02-026, 10-004, and 10-016, as well as MDHHS Credentialing and Re-Credentialing Processes for more information. Tools used by HealthWest and the LRE during credentialing audits are also available below for reference and to assist in preparing for audits. These tools, identified by provider type, can be found by clicking here.

Important Documents:

Electronic Health Record

After the clinician has completed their training, a Latitude 43 New User Request Form must be submitted requesting clinical access in the system. Staff who have not yet completed the credentialing process for the provision of clinical services, will also need to submit the New Hire Employee Verification Form.

Important Links:

Important Documents:

*Staff working with Substance Use consumers must have BOTH of the forms filled out for access

Important Contacts

For troubleshooting or assistance, please contact the help desk at Latitude43Support@healthwest.net.

Substance Use (SUD) Resources

Important Documents:

ASAM Continuum

The ASAM Continuum biopsychosocial assessment is required by MDHHS for adult clients (18+) whose services are funded through Medicaid, Health Michigan and/or Block Grant.

Recipient Rights

Individuals served by HealthWest and it's provider network who receive public services for mental illnesses and developmental disabilities have rights guaranteed by both State and Federal Laws.

You can learn more about recipient rights by reading the Your Rights booklet

Submit a Complaint

If you believe that someone's rights have been violated, you may submit a written complaint using the Complaint Form.

If the person you are filing a complaint on behalf of receives SUD services, please use the SUD Complaint form and note that the Recipient must sign it.

What to Expect After Submitting a Complaint

A letter to let you know that we received your complaint will be mailed or emailed to you within five (5) business days from the date that we received your complaint. This letter will let you know what will happen with your complaint.

When the Rights Office completes an investigation about a possible rights violation, the Rights Office will talk with the people involved and also review the clinical records.

Within 90 days the investigation will be completed and the person who filed the complaint (the complainant) and the person who the complaint was filed on behalf of (the Recipient) will receive a letter with information on the outcome of the investigation.

Contact Us

Recipient Rights Staff are available to answer questions and assist with filing a complaint.

Call us at 231-724-1107 or email Rights@healthwest.net

Important Documents:

Complaint Forms:

Rights Books:

Substance Use Service Rights Brochures:

Posters:

Training & Customer Service

At HealthWest, we use the Lakeshore Learning Management System (Lakeshore LMS) as our platform for classroom and online training courses. This learning platform uses a self-registration system in which each student registers for both the online and classroom courses they wish to complete. Sign-up here: https://lakeshoretraining.org/

Important Links:

Important Documents:

Contacts:

Customer Service: 231-720-3201, customer.services@healthwest.net
Training: 231-724-6057, training@healthwest.net

Corporate Compliance

The primary roles of the Corporate Compliance Department are:

To ensure HealthWest has a functional Compliance Program that meets all federally mandated essential elements, and that regulatory and statutory compliance is adhered to across the provider network.
To ensure HealthWest maintains a comprehensive risk management system that monitors key functions across the provider network, identifies potential risk areas, provides recommendations and solutions for remediation, and monitors the system for systemic compliance and risk management concerns.

The department is also available to assist anyone wanting to report alleged Fraud, Waste and Abuse in the Medicare/Medicaid system. Reporting can be made in various ways. Employees have a duty to report concerns, compliance is everyone’s responsibility.

Support:

Contacts:

Linda Anthony, Corporate Compliance Officer - 231-670-7831, linda.anthony@healthwest.net
Helen Dobb, Compliance Manager - 616-566-6946, helen.dobb@healthwest.net

Quality Assurance

Important Documents:

Contacts:

Pam Kimble, Director of Quality Assurance - 231-788-8863, pam.kimble@healthwest.net
Bennie Chambers, Accreditation and Performance Improvement Manager - 231-760-9495, bennie.chambers@healthwest.net

Best Practice Guidelines