Transcript
Connor Morley (00:00) hey, Nicole. Hey.
Niccole Russell (00:01) Connor. How are you?
Connor Morley (00:03) Good. How are you doing?
Rasencio (00:04) Doing well.
Connor Morley (00:07) All right. I see Renee, I’m going to let her in. Hello? Hey.
Rasencio (00:18) There? How’s it going?
Connor Morley (00:20) Good. How are you doing?
Rasencio (00:22) All right… Liz and Kenzie will not be on today. It’ll just be me.
Connor Morley (00:29) Okay. No problem. I was… looking… through… the email chain where you sent us the group enrollments, and… I just want to confirm we only got the group enrollments right now. We don’t have the provider enrollments yet. That is correct. Okay?
Rasencio (00:55) That’s one of the reasons Kenzie’s not on today.
Rasencio (00:57) She’s finishing up the ones for our Texas providers, so she can get them over to me so I can finally get this off to you. Okay? Perfect. Only imagine how many light items, I think at this point for our provider enrollments. We’re at about 15,000, 239 light items not including Texas and Texas is massive. Oh, my goodness.
Connor Morley (01:22) Yeah, that’s crazy.
Rasencio (01:23) Yeah. So thankfully, our enrollment requests are under a 1,000. So that’s good. And they’re all vivo owned. We’re not going to have you guys own any of that because those are ones we’ve previously submitted and are just following up on. But yeah, we’re over 15,000 line items. I imagine Texas is probably going to add another two or 3,000.
Connor Morley (01:47) Okay. And just to confirm you want the, is medallion owned to be false for all of it, correct? Okay. And you guys have a system already where you have the like tracking… numbers or like the application ids to follow up. Okay. All right. Perfect. So that’s good. So I have not seen any questions come in yet on your group enrollment data. So I don’t have any… questions for you right now on those?
Rasencio (02:34) No news is good news.
Connor Morley (02:36) Yep. The team’s been working on it and everything looks good. The only other kind of piece I want to talk to you about is we discussed the ipa enrollments… correct? Right? Like last week and I had sent back some information on how we could go about running through those ipa enrollments.
Connor Morley (03:09) Did you have any questions on that? It’s essentially, we would, you… would request an enrollment with the ipa and you would not include the other customers in the requests, correct? But we would know that they would result in all those other essentially enrollments.
Rasencio (03:32) Yes, correct. And then I am assuming at some point during training, we’ll be able to go through and see how like if we get different effective dates from those individual payers, how we can kind of enter it in for our own tracking purposes… because it wouldn’t necessarily be a separate payer enrollment even if there’s like somewhere on that ipa listing, like if there’s a notes section where we can just kind of document those individual effective dates.
Connor Morley (04:05) Yeah. Let me double check. I’m pretty sure there is a notes field, maybe Niccole, if, you know, off the top of their head in the existing payer enrollments, but let me just double check that because I know we have included notes on specific plans for enrollments in the past… but I just want to double check on that. Okay?
Niccole Russell (04:32) Yeah. And Renee really what I need for my piece is just to know exactly outside of this, if you can update the spreadsheet, just let me know exactly which ones are payers. So I can start working on the mapping for that.
Rasencio (04:50) I don’t think, I understand. So.
Niccole Russell (04:53) There are a lot that say no enrollment needed. Ah, yes. So as far as that goes, am I able? Yeah, right there, so.
Rasencio (05:03) Beautiful.
Niccole Russell (05:04) Yeah. So all of those that say no enrollment necessary. Am I good to skip those? Because really, we only track when they, when the insurance company pays claims?
Rasencio (05:19) So, with those, they are payers and we are submitting to them and getting claims reimbursement for them. It’s just how we’re contracted. It doesn’t require individual provider enrollment whether it’s because it’s billed as the group only without any individual provider information on that claim or like our individual providers are listed as the rendering provider, but it’s only for documentation purposes. Only they’re still just taking the group information. So it just doesn’t require individual provider credentialing with that payer. But we do submit claims to those payers.
Niccole Russell (05:56) Yeah. So that’s fine. So they pretty much enroll based on claim submission.
Connor Morley (06:02) And these are all group enrollments, right? Renee?
Rasencio (06:05) Correct. Yeah. I think there’s a select few that Alex notated on the group enrollments that are through the individual providers. I think she let me pull up. I have the spreadsheet open on my other screen. Let me just take a peek.
Rasencio (06:25) Let’s see there are, very few that are through the individual providers and it’s pretty much through those ipas because they don’t do it at a group level. It’s an individual provider level. Yeah. So, she did document them here on the group enrollments tab. They’re in red. So it’ll say individual providers through the independent physician network that’s in Texas… or in Wisconsin, individual providers through the Peterson pho that’s in Texas.
Connor Morley (07:06) Sorry, are you looking at the group enrollments?
Rasencio (07:10) I am looking at group enrollments, yes.
Rasencio (07:20) Yeah. Anything that’s done at the individual provider level? And like I said, they’re, very few and far between, and most of them are through those ipa phos. So.
Niccole Russell (07:32) Can I ask that on the scoping sheet? Do you have a line there, Connor that says client notes at the end?
Niccole Russell (07:46) By chance?
Connor Morley (07:47) Yeah. Okay. Under.
Niccole Russell (07:50) The client notes, can you mark the ones that are provider only? So I know which ones to kind of scope out there in our medallion platform to see exactly which payers we’re going to add? And then I know we’re kind of looking into the apa process as far as documenting that stuff. But this is just for the ones that we would enroll providers with.
Niccole Russell (08:18) Like individually, of course, linking to the group. Does that make sense?
Connor Morley (08:27) Niccole? Is that an ask for Renee?
Niccole Russell (08:30) Yeah, that’s an ask for Renee. I’m.
Rasencio (08:31) sorry, repeat, I was, I got look, I was looking through the group enrollments to see if I could just pull individual names for those?
Niccole Russell (08:38) No, that’s okay. So, on this scoping sheet right here, the payers scoping sheet all the way to the far right there’s a client column, client notes column. Will you just list the payers that you actually send enrollments for the providers on? Not that you’re billing, you know, sending claims and things like that, but things that we actually need to submit for a provider for enrollment. Yeah, absolutely. Awesome. Because that’ll help me do my piece as far as this specific spreadsheet goes?
Rasencio (09:08) Yeah, absolutely. How would you like me to document just, you know, I mean.
Niccole Russell (09:16) You can just do as simple as provider enrollment.
Rasencio (09:19) Yeah. Anything that has it. So in that column, K, anything that has something other than no enrollment necessary, those are going to be the ones that we have to submit processes for?
Niccole Russell (09:30) Oh, okay. Then I don’t need that. If it says.
Rasencio (09:33) No enrollment necessary. You have nothing to do for provider enrollment there?
Niccole Russell (09:38) Okay. Because I did notice the others and I thought that’s what it was. I just wanted to make sure that no… other ones were included in there so that’s perfect. You don’t have to go any further.
Rasencio (09:50) And Connor.
Niccole Russell (09:52) I don’t need her to go any further on that. I can just look at K and anything that has like steps I can work with that.
Connor Morley (10:00) Let me know if you want me to just do some excel magic and highlight if there’s something that it does not equal, no enrollment necessary in here. Niccole, would that be helpful or are you all set?
Niccole Russell (10:16) Yeah, I’m all set. She just clarified it for me. So I’m good. Okay, all.
Rasencio (10:21) Right. Thank you. Okay. So going.
Connor Morley (10:28) Back to my notes. We… talked about the ipas for the payer enrollment. I know last week, we talked about provider announcement and inviting the providers into the system. Did you send out a provider announcement? Because I think I had written here?
Rasencio (10:52) Yeah. I just followed up with my team today on our call and all provider announcements have been sent out. We did notify them. This is something that they will need to respond to, it’s not phishing. Especially, we got a notice from our it last week. There was a lot of phishing attempts coming through from DocuSign unfortunately, which is something we utilize a lot. So we did make sure to specify to our providers and our clinic managers. When you receive outreach from medallion, do not report it as phishing. We do need you to log in and complete this information.
Connor Morley (11:25) Is it helpful if I like give you the email address that these invites are coming to, so that we can whitelist.
Rasencio (11:33) That would be great. Yeah. And I can even send that to Greg gross, our… it specialist and just let him know if there’s any way we can have it pull in our email so that it doesn’t go to junk or anything else like that, if they’re able to put it in, but I will let I’ll reach out to our providers and just let them know this is the email address you’re going to get the request from?
Connor Morley (12:00) Okay, perfect. Okay. All right. And then I did send over the credentialing file. Any questions on that?
Rasencio (12:17) No, not that I was able to come up with. I’m really happy with the way, that looks again, I think that will suffice rather than our internal verification form. I think that kind of shows what our process is to joint commission and, you know, all of the information that’s pulled. So I don’t see why we would need an internal verification form anymore.
Connor Morley (12:36) Okay, perfect. So I can just cross that out. How do I strike through again?
Connor Morley (12:50) Okay. That sounds good. Then… we have caqh import complete. I can’t read what this says right under here. Oh, this is about temporary privileges we talked about that. Okay? And then we talked about the cred committee and how that would work. So it’ll be you Renee. And then Kenzie is the backup.
Rasencio (13:15) Yep. That’s perfect.
Connor Morley (13:17) Okay. All right. Then, I think.
Rasencio (13:25) The only question I have is I wanted to see how soon. I mean, obviously, we’ve got to get this spreadsheet over to you. And I know we discussed possibly like by end of April, we might be able to go live with it. How soon do you think we’d be able to start training with our credentialing specialists on how to use the platform? I?
Connor Morley (13:48) Was going to actually say that I’d like to start doing that training next week now that we are inviting the providers.
Rasencio (13:56) And.
Connor Morley (13:57) I’d like to kind of walk you through all of medallion.
Rasencio (14:01) That would be great. Okay?
Connor Morley (14:06) So I can,
Connor Morley (14:15) oh, one second… I don’t know, oh.
Connor Morley (14:24) Added something training… and can we use this regular touchpoint? Yeah.
Connor Morley (14:43) Okay… perfect. And you all have access to medallion, correct?
Rasencio (14:51) I know that I do, let me check with the specialists and see if everyone’s been sent access. I know we have one person who’s out on maternity leave. She won’t actually be back until April. So I anticipate Kenzie and I will probably have to tag team training on her. And if you know, if there’s any training videos that you guys have, if anything’s able to be recorded that we can share with her when she returns, that would be helpful. But let me check with our other specialists. Let me just send them. Yeah.
Connor Morley (15:24) This is the list of admins I have for you all right now.
Rasencio (15:31) Let’s see Kenzie. Okay? So I will email over to you the list of our credentialing specialists with their email addresses because they will also be, they will also need admin access. So.
Connor Morley (15:46) You can actually invite them so you can invite them into the platform as admins. But my question to you is for these credentialing specialists… what do you see like their role within medallion as being? Will they enter in provider profile information? Are they going to be making requests for payers and credentialing requests and things like that?
Rasencio (16:17) Yep. Our credentialing specialists essentially own the entire process for our providers from the time they get notification that we have a new provider starting. They are the ones doing the outreach, gathering all the credentialing documentation, doing the verifications. Once we have that complete, then they send that information over to me, I approve their privileges and their work while they’re working on their enrollment applications with the payers, they’re doing the follow ups, all of it. So they own that process, start to finish. Okay?
Connor Morley (16:47) So, yeah, they will be responsible for entering in the provider data and making the requests and following up on the requests and answering like admin tasks and provider tasks, and keep an eye on that. But just as a call out, medallion’s going to be doing a lot of that follow up directly with the payer. And then also the verifications.
Rasencio (17:14) Okay. So, then if we gave them a role other than admin, what would that look like?
Connor Morley (17:21) To be honest with you, it will just be an admin role. From what, based on what I’m saying, what, what you said, because the admin, can they have access to edit the provider profiles and make requests? And it sounds like that’s what you want them to do?
Rasencio (17:37) Yep. That way, if anything, they’re going to be the ones following up and just keeping in contact with our providers and our clinic managers notifying them of where that provider is in the process. So yeah, I’ll go ahead and I have my login up on my screen for medallion. I’ll go ahead and hop in and invite our credentialing specialists.
Connor Morley (17:57) Yeah. And I would say as well, if there’s anyone who needs read only access to the system to view some of the progress. They can be given what’s called an auditor access or auditor role.
Rasencio (18:10) Okay.
Connor Morley (18:12) And they would just be able to view all of the in flight requests and the provider profiles, but they wouldn’t be able to edit or make any new requests.
Rasencio (18:21) Okay. That’s really good to know. I’ll see if I’ll reach out to our compliance officer and see if that’s something they want access to.
Connor Morley (18:30) Okay. Sounds good. Okay. Then… so you do have the ability to add them as users, right?
Connor Morley (18:45) So you’ll add them as users?
Rasencio (18:50) Yes, I’ll go ahead and add them. Okay, perfect. Yeah, I’ll go ahead and get those sent out to them today. And then when we go through the training and everything like that, we’ll be able to see how to set the teams up. That way they have their dashboards tailored specifically to their states and providers.
Connor Morley (19:17) Okay. So they, I apologize you want the, so then we, you can add them as admins right now and I can show you how to, we can always change. I can change their user profile to team managers to limit their view to just be what those teams would be. And those teams, we can base off of the group profiles or the practice locations that the providers are associated with. Okay?
Rasencio (19:46) And if we have a provider that’s associated at multiple locations, like not even just within the same state. Like we have a provider that’s in Connecticut, Pennsylvania, Texas, and Florida, and those are all managed by different credentialing specialists. We’ll be able to have that individual provider at those specific locations, be on their teams or is it just only one provider can go on one team assignment regardless of what state?
Connor Morley (20:14) No, the provider can be on multiple teams based on what they are looking… at, but, they… would be able to see everything on the provider’s profile. Okay? And.
Rasencio (20:31) that’s okay. I’m totally fine with that because a lot of the times if they’re in doing something for that provider, and once they like npdb which I know you guys would manage moving forward, but they’ll sometimes, you know, shoot over the credentialing specialist. Hey, I’m doing so. And so’s verification, do you want me to do it for this state? So it’s fine. If they see all the information for that provider, I’m okay with that. I just wanted to make sure it wasn’t going to limit that they only get access to this one provider in this, okay?
Connor Morley (21:01) Nope. I mean, the team assignments are not like, you can only be on one team. Okay? You could be on multiple teams. Okay? So in the instance of that provider, if you base it off like a group or a practice location or state and they’re working in three different states with three different groups in three different locations. Like they could be on three different teams and three different team managers could be able to view that provider’s profile on all the requests.
Rasencio (21:34) For that provider… that works before I do this, I think I’m going to reach out before I give our credentialing specialist access. I think I’m going to reach out to Greg gross because I know he set up that single sign on for our company. So I don’t know if he has to do anything to link our specialist to that single or that, yeah, that single sign on. Yep. So I’ll reach out to him and see what he needs in order to get that. I may have to submit an it ticket to do that.
Connor Morley (22:03) Okay. No problem.
Rasencio (22:05) So, but I’ll get that set up. All right.
Connor Morley (22:07) That sounds good. All right. I’m just looking through my notes. Those are the wrong notes I pulled up.
Connor Morley (22:26) Oh boy. That is all that I had right now. Do you have any questions for me? No?
Rasencio (22:38) Not that I can think of right now. Honestly, Connor, I’m just, I’m sorry, we haven’t been able to get this spreadsheet back to you. No, Kenzie, is, I told her if she could get it back to me today or tomorrow, that way I can get it out to you. It’s literally just Texas that we’re waiting on. Okay? Because like I said, everything else is in here. So definitively by this week, you’re getting this spreadsheet. Yeah, trust me, we’re all happy to see the back end of that spreadsheet… if anything comes up. Like if there’s any questions I’ve gone through and tried to scrub it as best I can, but my eyes are crossing and I could have missed something. So if there’s ever anything on there that you’re not sure of you guys can always reach out to me. I’m happy to, you know, fix it or update it or whatever you need me to do. Perfect. Thank.
Connor Morley (23:29) You, Renee, we’ll definitely reach out if we have any questions.
Rasencio (23:33) Okay. Awesome. Thank you guys. So much. I appreciate you yep.
Connor Morley (23:37) Thank you too. Have a great rest of the day.
Rasencio (23:39) You too. Bye everyone. Bye bye.