Transcript
Connor Morley (00:00) hey, everyone. All right. Looks like we got everyone coming in, Adele. We’ll talk about the delegated rosters. Rheta. Did we ever get an answer on medicare part a and part B?
Rheta Larson (00:15) I think so. Let me pull up. I have like eight or so agenda items for them, but I have, I can deliver this via email, but I do have some info on that.
Connor Morley (00:27) That’s fine. Let’s start with Adele, and then we can jump into some of your agenda items. And then I just have a credentialing anc, QH management item for them.
Adalee Arreola (00:42) Do we?
Rheta Larson (00:43) Send them mpdb info like merit… had asked me about that comes from implementation? I’m trying to pull the exact verbiage but I wasn’t sure.
Connor Morley (00:56) We have their mpdb set up if that’s what you mean? We’re set up as a registered agent?
Rheta Larson (01:04) Yeah, because they were asking about specific inquiries for the mpdb because I know they had been charged those 25, but is there mpdb instructions that they get?
Connor Morley (01:16) Yeah, but I can send you that, okay?
Rheta Larson (01:19) Yeah, that would be cool. I’m going to put that in the response that I sent back to them.
Connor Morley (01:24) Thank you. Yeah. All right. I’m going to let them all in.
Connor Morley (01:43) Hey, good morning, everyone. Morning, morning. Morning. Good morning. We have a pretty packed agenda. It’s going a little bit out of order, but I wanted to start with the delegated rosters. I know we have like an outstanding question on, you know, how do we identify terms, ads, updates? So I’m going to pass it off to Adalee… to kind of talk through that because I think we just need a way to identify how to tell the payers… that information hi.
Adalee Arreola (02:28) Team. Good morning. I’m going to share my screen just so that we’re all looking at the same thing. So, Marcia, thank you for sending over those data points. I was able to split them up into, you know, an actual excel sheet and we kind of have these two tabs. It looked like basically the same fields for both of the rosters. So we can just kind of take a look at one after putting it into these, you know, two separate tabs. It looks like here on the facility data, it’s you know, all, your tins. So that’s pretty straightforward. And then here on the provider data is where I had the questions rosters, the ones that we typically do there’s like roster designations of like full add update terms… and so that’s where I was still not understanding how you all do that designation just to show on here. I think since you, I’m… hoping that there’s some liberties that we can take and to get this in a good spot, for the payer, what I’m thinking is we just add some columns here to the left hand side, you know, we say like roster designation. And so we’ll add like if this is a term like this line is a term, we’ll say if they’re an ad, and then we also put an effective date and so that’ll let them know like when that term was effective or when the ad was effective or when like an update was effective. Does that make sense? Marsha, and do you think that might be useful?
Mcoffman (04:19) Yeah, the current roster we have, we had, we put, we had like our temporary privilege dates and our effective… dates. And we had a separate list… for our term dates. So yeah, just having one row for effective date, term date adding. I think that would be good.
Adalee Arreola (04:48) Okay. Awesome. So we can get started on like building this out and actually filling this out with data. And then, you know, we can work with you on the payor just to get it to a spot where it works for everyone. So usually we have like we can do, a tab of ads updates and terms all in one. But then do you all usually send the full list or is it just usually those ads updates and terms since the last roster?
Mcoffman (05:21) You know, cause, we didn’t really have the capacity to… do these all separate and everything. So, we just maintained alphabetical list for everybody, all payors, everything. So we just sent them the full list every time. So, the only one that I would send separately was deancare… only wants to know the terms and the current people that have terms. And alliance has said that they, want the most current people, like at the top, or, you know, called out, everybody else that we’ve sent. I don’t know they haven’t really, you know, stated anything differently. So, yeah, I guess we could reach out to them and state, you know, what would you prefer? I don’t know. Yeah.
Adalee Arreola (06:35) I think what we could do is kind of like lay it out for them, like what works? So, I think what we would do is probably add another sheet here for just the fulls. So we would have one tab here for ads, updates and terms, and then we would have another tab separated a full list of, you know, the full terms. And since there are, it sounds like there are like super hard requirements, I think like this is kind of standard for how we do it for other payers, you know, they’re all kind of different what they ask for in like, required fields, but this is kind of like the standard template, that they do use. So, hopefully, since there aren’t hard requirements, we can, you know, send them this as an example and then, you know, they can give feedback, yeah.
Mcoffman (07:26) Okie. Dokie, so I was, I’m sending out lists for other insurances because of, the no surprises act? Is… that something you guys would be able? Or is that a different, I mean, is that an additional cost? Or is this part of just you guys just maintain rosters… at, you know, for everybody as we’re needed or is it, are you guys just maintaining this for just the delegated, plans or?
Adalee Arreola (08:06) Yeah. So, the rosters that you and I are going to work with, you know, with me, they’re going to be the delegated rosters. There’ll be just limited to that, but I think, you know, Rheta and Connor, you all might be able to work with them, for those other rosters?
Mcoffman (08:26) Okay. Because I was able to find, like two or three of them that have, and they have their own templates already laid out. We just, we’ve never worked with them because we just don’t have that, the ability to do that, but they have their own templates there. So I didn’t know if that was something that so.
Connor Morley (08:53) I think last time we talked about this, the only delegated rosters that you have are with alliance and group health of.
Mcoffman (09:03) South.
Connor Morley (09:04) Central Wisconsin, and augsian, but augsian, is your internal?
Mcoffman (09:08) It’s just an internal?
Connor Morley (09:10) Yeah, right.
Adalee Arreola (09:11) Is.
Connor Morley (09:12) is that correct? Yeah. And are you asking, like, would you like to pursue delegated rosters with other?
Mcoffman (09:19) Groups? Well, it’s not really a delegated roster. It’s a roster for keeping up with that no surprises act where you have to tell the insurance companies require every three months, you have to update their update, the, your, providers for them.
Alicia Iannece (09:39) I don’t know if you’re familiar and that’s regarding delegated status. So it’s yeah.
Mcoffman (09:44) It does.
Alicia Iannece (09:44) It’s just the roster requirement in general. So you.
Mcoffman (09:47) either have to go out on a portal and update those or you have to provide them with a roster, whichever you can do. Yeah.
Connor Morley (09:57) And Rheta, maybe you can jump in here a little bit because that sounds like it’s not just the ads or the updates, which sometimes we use like roster templates for new providers. It sounds like it’s full rosters to update for some of these payers.
Rheta Larson (10:17) Yeah, I can definitely take that back to the team to inquire further just because I’m not familiar with that off the top of my head, but I’m happy to take that as an action item as well.
Rheta Larson (10:30) Do you have, do you have specific examples you can share?
Mcoffman (10:36) I can send? Do you want me to send them? So like Molina… anthem… there’s like two or three of them that I was able to go out and get their templates that they would accept rather than, you know… otherwise, I have to go out into like a well, Molina, they have been just taking our, the one that we have, but they do have the designated template. They would prefer anthem. I have to go out into a portal and try to work on that every quarter, but they do have a template they would prefer us using. So, yeah, yeah.
Rheta Larson (11:27) Feel free to share me those two that you just mentioned from Molina and anthem and I can look into it. Okay?
Rheta Larson (11:57) Are there any other questions there? I guess Adalee, Connor from your end?
Adalee Arreola (12:03) So, I don’t have any other questions regarding your delegated rosters, but I did have one question… on the data import template. If we can move on.
Mcoffman (12:15) Are we good. Okay. So.
Adalee Arreola (12:17) One last question. So here we have, so we’ll need the provider practice groups for the.
Mcoffman (12:27) You know, for some of the,
Adalee Arreola (12:29) logic on the delegated rosters. So it looks like you all have filled this out. I just wanted to confirm that this is complete and this is the full list before I go ahead and do the import.
Alicia Iannece (12:47) Did I put it in there or did I send it to you separately? Connor? I can’t remember.
Connor Morley (12:56) Sorry, could you repeat the question? I was multitasking that’s my bad.
Alicia Iannece (12:59) I can go take a look at the link too, and see, yeah.
Adalee Arreola (13:01) I can also share it in the I,
Alicia Iannece (13:05) ended up saving it because I had such a hard time finding it the one time.
Adalee Arreola (13:09) Just shared it in the meeting chat. If you need that link.
Alicia Iannece (13:17) That doesn’t look complete. The one in the template in.
Mcoffman (13:23) Google.
Alicia Iannece (13:25) But I thought I had sent it separately to Connor you?
Connor Morley (13:28) Did.
Alicia Iannece (13:31) is that not the right? Take a look at my original?
Mcoffman (13:35) One.
Alicia Iannece (13:41) Let me double check here.
Alicia Iannece (13:48) I also have been putting in practice locations based on some requests coming through. So, I don’t know if that’s going to impact this… upload?
Alicia Iannece (14:18) Okay. Yeah, that is correct. Actually, it’s about 190. Yeah, 195 lines all together? Yep, that’s correct at first. I was like, no, that’s too small because we have more providers, but that’s the providers that are in payr enrollment.
Adalee Arreola (14:34) Okay, awesome. Then I will go ahead and do that. What about the providers that are in that… we’re going to be doing like… the appointments for?
Alicia Iannece (14:54) That was sent over a long time ago.
Mcoffman (14:58) Yeah, Adalee.
Connor Morley (14:59) That’s the one that, are you talking about the existing appointments? Yeah. So.
Adalee Arreola (15:04) We do have that data, but I’m talking about like their associations?
Alicia Iannece (15:11) Can you clarify it’s.
Connor Morley (15:14) just one entity? Yeah.
Alicia Iannece (15:18) So, every location once they have an approval date that applies to all locations?
Adalee Arreola (15:34) Okay. Connor, just get with you on this one really quickly just to clarify, but yeah, I think we’re good here.
Alicia Iannece (15:42) And the only, sorry, the only caveat to what I just said would be the Laval clinic location, because that one is brand new from December.
Mcoffman (15:54) But let’s see.
Alicia Iannece (15:56) Did I update that date… on that document? I can’t recall, let me take a peek here. So.
Connor Morley (16:04) Adalee… for all of the existing appointments, there’s only one entity there’s. Only the reedsburg entity.
Mcoffman (16:15) So, it’s just,
Connor Morley (16:16) reedsburg area medical center.
Mcoffman (16:20) Okay. And,
Adalee Arreola (16:22) what locations would we associate them with?
Connor Morley (16:29) Well, with Adalee, maybe you and I can take… this offline because we do have the providers practice groups tab filled out separately and that.
Alicia Iannece (16:41) Is unique to who needs payer enrollment that’s how I did that one. Yeah. So for the ones that aren’t done, I could go in and do those or I could do them in addition, but, yeah, because there are going to be some that aren’t listed on the providers practice groups, but they are listed on the appointments… on the providers practice groups tab, though there’s the provider practice start date. So, I do have those updated correctly based on either when the place was activated. So like the new one that I just talked about, there is a December 20 25 date for that one for Lavalle clinic, but it’s only on a couple of providers.
Adalee Arreola (17:37) Okay. So, is there like a blanket, you… said, and let me just see. So these are the praxis, oh, they’re not on here. But so we’re saying that for the providers that have appointments, we can do associations of that one group that you all have, and it’s that reedsburg area medical center. And then it’ll be all practice locations on your.
Alicia Iannece (18:08) Plat?
Adalee Arreola (18:11) On the platform minus, no.
Alicia Iannece (18:14) I think it would be just the remc location, the reedsburg area medical center, the hospital location, you could put that as the main one.
Adalee Arreola (18:24) Okay. And is this the, is this it?
Alicia Iannece (18:26) Yeah. Yep. Okay.
Adalee Arreola (18:28) So, it’ll be one association, essentially, correct?
Connor Morley (18:32) And I can.
Alicia Iannece (18:33) And I can go back and review those ones that are a single one, like there’s some in here that are the single location, but for the ones that aren’t that we’re not doing payer enrollment for, I didn’t put any locations on them yet. Okay?
Adalee Arreola (18:45) So, if you want, I can go ahead and do that. So, any providers that are here, you know, that have an existing appointment or, you know, we’re going to do appointment stuff for I’ll.
Rheta Larson (18:56) add.
Adalee Arreola (18:56) Them to the provider practice groups tab with that one tin, and that one practice.
Alicia Iannece (19:03) Okay. Sure. Thank you. Sorry about that. And.
Adalee Arreola (19:06) Then I’m sorry if I missed it, but is there anything that you needed to add here?
Alicia Iannece (19:12) I don’t think so. Okay. Awesome.
Adalee Arreola (19:14) So, I’ll work on that today and get these associations imported great. Thank you.
Alicia Iannece (19:23) And then the only thing to go in line with that because I know it’s kind of been my fail safe right now that they don’t have a location listed because that’s kind of prompting us with the caqh management as far as who’s being managed correctly? And not, so, is there any update on that as far as working with that team? Yep.
Connor Morley (19:42) We are removing those providers that were added… for caqh management that should not be added. So hopefully, we can finish that within the next couple of days, but it won’t have an impact on cost or anything they won’t show up on the usage. Okay?
Alicia Iannece (20:06) Have we been able to confirm how they got added? Is it from entering information into the external accounts tab or? Yeah, it?
Connor Morley (20:16) Was someone on our side using a wrong spreadsheet to enable… caqh management? So we’re correcting that, okay?
Alicia Iannece (20:30) Sounds good. Yep. But.
Connor Morley (20:32) we did confirm that if you add caqh user id and password, it’s not going to automatically enable them for caqh management. Okay?
Alicia Iannece (20:40) Sounds good. And hold on just one second, please. Okay?
Alicia Iannece (21:31) Have a question while we’re waiting.
Alicia Iannece (21:36) Shoot. Well, first of all, I don’t see the appointments tab, is it?
Rheta Larson (21:41) Gone?
Connor Morley (21:44) Should not be, let me… check your user profile because you should still have credit.
Rheta Larson (21:53) Access.
Alicia Iannece (22:10) I’m back. So sorry about that.
Rheta Larson (22:12) No worries.
Connor Morley (22:14) Jenny, while I check that out, I’m actually going to pass it to Rheta because she has some follow ups for.
Rheta Larson (22:24) You.
Connor Morley (22:24) all to view and to go through around npdb and some of those reports we talked about. Yeah. And I.
Rheta Larson (22:34) can get all this back to you via email as well just because I know there’s a lot about sending items, but at least I’ll start with the payer side. We had gone through a few questions there. The first one being the medicare part a and part B. That is still an outstanding question on my agenda item. The team is actively looking into this. But just so we’re clear here, I know y’all are inquiring if I know the change January first came where both parts a and B are required for providers. So we’re just trying to understand and ensure that is the correct workflow and then how y’all request that in platform. So that is one thing that’s still on the agenda. The second discussion item we talked about was a security health plan. Was the example here for the email that was going to remc underscore hosp at remc health. Org. I think we had asked to change that to the medical staff office or Jay schultz at remc health. Org, but I did pee the team and alert them that email address should not be used moving forward. They did dig into that one specifically for security health plan. And it looks like the email was used because that was the app specialist had provided that on the enrollment request when they submitted the enrollment. Technically. I think we also discussed this that this should have been our medallions payer enrollment, email address. So we have communicated that to the team. We made sure that they’re aware to receive the credentialing app, sending it to that particular email. And then, yeah, we’ll make sure that we get the medicare questions answered for you. But I just wanted to revisit at least from that standpoint, the email address discrepancy. Do you have any questions on the email address change?
Alicia Iannece (24:39) I don’t think so. Okay, great. And I’m so sorry, can I jump in with Nick’s message you’re hopping off? I think I had sent it to you, Nick, the questions we had for merit and you were forwarding that to her and I haven’t gotten anything back. I.
Nic Schisler (24:56) Thought I sent a note back with the updated agreement last week. I tried to send it through the… secure site and to go through. So I think Jennifer said I could send it back via?
Rheta Larson (25:09) Email directly?
Nic Schisler (25:10) Did I not? I could have sworn, I did.
Alicia Iannece (25:14) After our call on Wednesday, I… don’t think I had anything after that.
Nic Schisler (25:29) that’s weird. Okay. Let me go back to make sure that,
Nic Schisler (25:41) yes, you are right. I have not heard back from merit on those two. So, let me go back to merit and bump her there. And then I’ll be in touch. Okay? Sorry, I know we were kind of going back and forth with the secure environment and that, but yeah, let me bump her and then I’ll be back in touch there with you sounds.
Alicia Iannece (25:58) Good. Thank you so much.
Nic Schisler (25:58) You’re welcome.
Rheta Larson (26:04) Okay. Any other questions before I hop into some of the general credentialing or, mpdp caqh, board cert, questions you’ll had?
Rheta Larson (26:20) Okay. So, for mpdp, I know there was, we were going back and forth cause you had flagged that the mpdp wasn’t yet communicating with reedsburg, and there was, I think the 25 providers which y’all were charged for. It sounds like y’all, had an action plan in place where you contacted the mppd, they were processing your refund. I think all that is working on y’all, side if I’m correct? We were.
Alicia Iannece (26:47) Kind of waiting for a call back from them. I think we’ll have to touch base with them again here cause we didn’t get a call back.
Rheta Larson (26:53) Okay. You had also questioned very specific selections. It was the select the functions on the inquiry, where is the agent authorized to use the account? Who should receive the responses? Where should we send your requests? So, I did double check with the team just to make sure that wouldn’t impact our workflow?
Rheta Larson (27:14) And, they don’t see it being an issue with mpdb, at least from our end. The only thing that we wanted to call out, it’s possible that.
Alicia Iannece (27:27) You might.
Rheta Larson (27:27) End up paying the renewal fee on top of that annually for both of us. So, I just want to be sure like if you do change that and you hear back from mpdb, maybe flag that to them and ask like if I change those, will that cause a payment on our end as well, but I don’t see that being an issue on medallions and if you decide to update those two sections that you highlighted?
Alicia Iannece (27:49) Okay. Do you have any?
Rheta Larson (27:50) Questions there on those two? I don’t know if you need me to go further on the specific questions like who should receive the responses, both of us is fine. Is the agent authorized, et cetera. Do you need any clarification there?
Alicia Iannece (28:04) I think the only one was that, oh, what was it, the type of response that would be sent if it would be done through an mpdb platform or through the separate… the iq? Yeah, yes, that one.
Rheta Larson (28:23) Yeah, I think that’s where… I don’t think that should be an issue. If you do it through. Did you want to change it to them? Did you, were you requesting to change it to the mpdb platform?
Alicia Iannece (28:40) Possibly cause that’s where we would view it. Okay? I’ll.
Rheta Larson (28:43) double check. Cause it looks like that one’s actually, they didn’t confirm an answer there, but, okay, from what I gather from the conversation, they stated if you change any of those, it shouldn’t impact our workflows at all, but I’ll double check on that iq, QRS, the mpdb or qrx are our internal platform, perfect.
Alicia Iannece (29:03) Okay.
Rheta Larson (29:04) Any other questions on mpdb? I think the only other thing I would highlight there at least from our end is, yeah like, that can happen where you, if you don’t cancel the continuous query you previously had set up, you can run into that issue of paying for it again. So just be sure whenever you hear back from mpdb that, that’s set up with them. Okay. Any other questions there? Okay? The last one or I think there’s two more, one was going to be the board certification expirables. I know we had gone through some examples because you had several of the board certs that were expired in the expirables tab. We noticed you all didn’t have the verify button, but I confirmed that the board certifications are verified during the process of a credentialing application. So, if the provider has reported it in their profile or their application, then that, that’s where it gets like updated, but they’re not verified in between credentialing events. So that would be the feedback there. If you’re seeing those in the expirables. My suggestion there would be to update the platform with the relevant info because you all do not have that ability to run the verification.
Alicia Iannece (30:33) That might be an issue with, a surveyor with joint commission because they would challenge us and question us verse regarding if it’s a provider’s board certification who expired on December 30 first, and they’re not up for reappointment until the following October.
Alicia Iannece (30:51) Then that’s 10 months that goes by that we didn’t verify whether their board certification remained current. So we would get cited on that.
Rheta Larson (31:04) So that’s, joint commission, which surveyor, sorry, do you have? Like a particular?
Alicia Iannece (31:12) Well, that would just be, that would be something that wouldn’t, pass in a survey, like they would be, we would be expected to maintain the board certification to confirm that it’s current on an ongoing basis. Okay, gotcha.
Rheta Larson (31:26) Let me see. I know there’s nothing actually like processed yet, files wise. So, I think this will naturally fall into the cadence of when those files come through. But the one offs were like, I just mentioned, it’s in between, that might be some issues. So, let me explore,
Jennifer (31:47) Workflow.
Rheta Larson (31:47) And just make sure that they’re running appropriately first, and then see if there’s anything on medallions and that we can do to avoid that audit issue. Like I want to make sure that’s working appropriately for your.
Alicia Iannece (31:58) Organization.
Jennifer (31:59) yeah. So, Alicia, basically, it would be, ran just like the licenses, correct? We need those ideally, yeah.
Alicia Iannece (32:07) Cause it, or if there’s an opportunity for us to request it, if it can’t be automated for some reason, then, to even request it in between credentialing… cycles.
Jennifer (32:19) Or.
Alicia Iannece (32:20) reappointment cycles.
Rheta Larson (32:24) Yeah, I imagine there’s going to be maybe… the exception to the rule, cause I don’t foresee these expiring during that time, if we’re checking it, right? Am I thinking about that correctly? Some?
Alicia Iannece (32:36) Of them only are annual?
Jennifer (32:38) Some of them are.
Alicia Iannece (32:39) Renewed annually. So, even when it’s the ongoing maintenance of certification, technically, it doesn’t expire, it just has a verified date that it’s active. But technically, those verifications are only good for like a year, okay?
Rheta Larson (32:55) Yeah. Let me, let me put something.
Alicia Iannece (32:56) In place and I think.
Jennifer (32:57) Obgyn.
Alicia Iannece (32:58) Would be a good example. There’s this December 30 first every year. I think, and there’s a couple others.
Jennifer (33:06) Yeah, maybe.
Alicia Iannece (33:07) Emergency physicians would be another good one emergency medicine.
Jennifer (33:13) I think worst.
Rheta Larson (33:13) Case scenario, we can jot these down on our operational sinks and I can ensure that I pull them, and run them. But, I just want to make sure like this specific question that you all had asked is that particular level of detail? Cause I think there was quite a few that were expired and I know Connor did one as an example and it went through when he, we reran it. So great. Possibly can do that on our end. If y’all, don’t have the verify button? Okay?
Jennifer (33:40) Great.
Rheta Larson (33:43) Okay. How?
Jennifer (33:44) Do you, it’s just one question. If you guys are doing that on your end, how are you going to know that it needs to be ran like that? So, for us, it looked expired you went and you did, you know, renewed it or what have you, how do you know to do that from now on?
Rheta Larson (34:04) I’m not sure. So we’ll set up the workflow in place for the actual files when they come through, when the requests come through, as far as the expirables tab is concerned, Connor, I don’t know if you were going to jump in and say something here?
Connor Morley (34:17) Yeah. So we can discuss with our ongoing monitoring team to also verify that. I don’t know if it, if there’s a certain cadence that we need to do to check on these board certs. I don’t know, I’m trying to think what, like what, can you help me understand what a, what cadence would be appropriate to make sure that your survey were still?
Jennifer (34:41) In line?
Connor Morley (34:42) With your surveyors? Is it like once every month or is?
Jennifer (34:45) It, like… what?
Alicia Iannece (34:48) Would that be? I think it’s just as expiration is coming up?
Jennifer (34:51) You know, if an expiration?
Alicia Iannece (34:53) Date is coming due, then validating whether it’s been renewed at that point? Yeah, it doesn’t need to be done every month, two weeks?
Connor Morley (35:01) One week before the expiration?
Alicia Iannece (35:02) Date? Yeah, yeah.
Connor Morley (35:04) Okay. That’s fine. We can, we can confirm.
Jennifer (35:07) That with our ongoing?
Connor Morley (35:10) Monitoring team?
Jennifer (35:12) Okay.
Rheta Larson (35:17) Cool. And I think the only other outstanding item I had was the caqh, the old cvo email that was attached to some of your providers. I think we had to use Katie porter as an example, but you all were questioning if this is something medallion automatically updates for the group. Currently, this is not something that medallion updates on the contact side. So, any updates and changes to the data itself, like the email that would need to be done by the provider or by the admins on your end. And I think it was because Katie was receiving those?
Jennifer (35:53) There was a few providers.
Rheta Larson (35:55) That got those emails. So that does happen, feel free to forward them to us and then we can explore it further, but I would encourage you all to definitely get those updated to avoid that in the first place.
Alicia Iannece (36:05) Okay. So, I know those.
Rheta Larson (36:10) Are six things at least on my agenda item that I had? Like I mentioned, I’ll be sure to get some of those other questions we had outstanding, the mpdb one for that one system for mpdb or the qrxs system. And then clarity on the board certification expirables, just to make sure that cadence is working for reedsburg.
Jennifer (36:37) Are.
Rheta Larson (36:37) we missing anything? Is there any other questions there that we have not yet discussed thoroughly with you all?
Jennifer (36:49) In general rather? Or just on regarding boards just on the past?
Rheta Larson (36:52) Conversations we’ve had, I can open the floor for any net new questions that y’all, have going forward today, we can add that to the agenda Connor.
Jennifer (37:02) Did you check on that appointments tab? Yeah, I.
Connor Morley (37:05) did, so, can you check on it again? It’s changed the name changed from appointments to privileging. Oh, yeah.
Jennifer (37:17) I thought happened, but I didn’t know like if I just lost that in general, so, yeah, no, it’s.
Connor Morley (37:24) the name changed from appointments to privileging, but we’re still going to use privileging and where that appointments was?
Connor Morley (37:36) I’m following up with product on why it was changed?
Jennifer (37:39) Okay.
Alicia Iannece (37:42) And if there was an email about that, I didn’t get it. I didn’t either.
Jennifer (37:47) I.
Connor Morley (37:48) did not get that.
Rheta Larson (37:48) Email either.
Alicia Iannece (37:52) And there’s two providers in there, I don’t know. Are they test?
Jennifer (37:56) Providers?
Alicia Iannece (37:57) Maybe or because they’re not on our list for the upcoming ones but.
Jennifer (38:09) Rheta, while we’re talking about that, and I know you probably are going to give us an update on it, but we were talking about those ones that we had in there previously, they were going to get re, entered… yep.
Connor Morley (38:21) That’s what Adalee is working on Jenny.
Jennifer (38:22) Oh, gotcha. Okay.
Connor Morley (38:28) But for those two that are entered in there, let me double check if those were just re creds, I think those were just re creds that automatically pulled in.
Jennifer (38:39) And they are coming.
Alicia Iannece (38:40) Up somewhat soon, but we do have ones that need to get done before them. So, okay.
Jennifer (38:51) I have a couple.
Alicia Iannece (38:53) Enrollment questions, some follow up from yesterday, and then a couple new things that kind of popped through yesterday, but are there any other older things that we still need to follow up on?
Jennifer (39:09) Yep. So there?
Connor Morley (39:09) Is also that caqh management… workflow document that I talked about yesterday with the termed providers and what happens with the termed providers and with medicare medicaid and pcos with surgery for those termed providers still working on getting that document to put together for you?
Jennifer (39:30) Okay.
Jennifer (39:34) You were going to send me a copy of that application?
Alicia Iannece (39:38) And you sent me the?
Jennifer (39:40) References but not the application yet?
Connor Morley (39:45) For the entire packet? Yeah.
Jennifer (39:48) Yeah, for like the joint commission. You said you could send me a sample or something?
Connor Morley (39:53) Yeah, I can send that to you right now?
Jennifer (39:55) Okay. Thank you.
Connor Morley (39:58) I’ll send it to both you and Alicia.
Jennifer (40:01) Okay. It is.
Connor Morley (40:03) Redacted just a heads up.
Jennifer (40:06) It’s okay?
Connor Morley (40:13) Go ahead Alicia.
Jennifer (40:16) I.
Alicia Iannece (40:16) just wanted to ask for the ceqh management issues. Do we have a tentative, like estimated when to expect that to be fixed by just so I can keep an eye on it should?
Connor Morley (40:29) Be done by Friday?
Alicia Iannece (40:30) By Friday? Okay?
Connor Morley (40:31) Yep.
Jennifer (40:44) You’re doing that because I know you can multitask.
Alicia Iannece (40:48) He’s shaking his head, Jenny.
Jennifer (40:51) You’re going to miss me so much when you don’t get to talk to me the reference forms. Do you know if those are electronic or is that like a paper copy that they have to fill out and send back in the reference forms?
Jennifer (41:10) I think.
Connor Morley (41:11) I’m pretty sure they’re electronic, but I can double check, okay?
Jennifer (41:18) I mean, so we.
Connor Morley (41:19) get so like those reference forms, like it’s more for our team to follow up on the references that they put into the system? So I.
Jennifer (41:30) just have to double check.
Connor Morley (41:31) With our team to see if they’re actually filling that out on paper or if they can just yeah enter it in and I’m pretty sure they can enter it in electronically.
Jennifer (41:38) Okay. Thank you.
Alicia Iannece (41:40) And I think just knowing the process and what things can get delayed or at least from our past experience, I think we’ll be.
Jennifer (41:47) Following up on those.
Alicia Iannece (41:49) First few providers closely just with the time crunch. So, and I think a number like any of the ones who are here with us like primarily with us, you know, their references will also be here. So we’ll work on, you know, following up with the references closely too. So we just wanted to kind of understand what that will look like for them.
Connor Morley (42:14) I mean, so you’ll see them within the system and we can follow up on them next.
Jennifer (42:22) Week.
Connor Morley (42:24) To see how they’re progressing.
Jennifer (42:26) Okay, great.
Alicia Iannece (42:34) For the like.
Jennifer (42:35) For the work history?
Alicia Iannece (42:36) For the like primary source verifications, for the work history, do those, are those going to be expedited for this first group too? Or are they going to kind of go through a standard process? Do you guys?
Connor Morley (42:49) Have a plan, we can, we are planning on expediting those providers that need to get?
Jennifer (42:56) Done?
Connor Morley (42:56) By April?
Alicia Iannece (42:57) Okay. Perfect. A couple of new questions. So, when the reappointment application goes out?
Jennifer (43:05) The provider who’s.
Alicia Iannece (43:07) being reappointed? Are they like reattesting to their information in any way? Or are they like, are.
Jennifer (43:16) they seeing the?
Alicia Iannece (43:17) Final application that gets submitted on their behalf, as I see Rheta nodding her head. We’re just curious like how does, where does that flow in? Like, you know, that a provider has submitted their information within X, number of days that’s like that ncqa requirement? I think, yeah, for any.
Rheta Larson (43:33) Applications that medallion completes, we will upload the application back to the provider for review with details, just explaining like please make sure the information is correct, and we will get their confirmation and sign off before submission.
Alicia Iannece (43:46) Okay. So we’ll point them.
Rheta Larson (43:48) To the provider tasks, make sure that they’re actioning that typically there’s a due date associated with it depending on the urgency. But in some cases, it will just be an open task. So, if we don’t hear back after those three attempts, we’ll task the admin and ask you all to push them to review.
Alicia Iannece (44:04) Okay. So, Rheta?
Jennifer (44:06) One thing we have to log is the date the provider signs off went for reappointment? Will we be able to see the date that they signed that reattestation?
Rheta Larson (44:19) I believe we record that in the platform via one, the application. You’ll be able to see that and you can see the history of anything that we’ve attached prior.
Jennifer (44:28) Okay. So.
Rheta Larson (44:29) You should have access to pull that from the applications as.
Jennifer (44:32) Well, thank you.
Alicia Iannece (44:42) And then a couple payr issues, we received a call from aspyrus health plan from their contact and he had concerns, well, minor concerns that he was receiving emails from several different people from medallion and they were basically submitting kind of wrong information. And then he was advising them on how to submit stuff back. So he wanted to touch base with us and like confirm that, yes, we’re working through with medallion even though we already sent him a notification to aspyrus that we had a new cvo. It probably just didn’t go directly to him. So, Julie made that call yesterday and was able to kind of confirm with him like what is needed and what is you?
Jennifer (45:26) Know different steps.
Alicia Iannece (45:27) I guess for their commerce and we’ve known this, but their commercial… line of business and their medicare advantage line of business have two very separate application processes. And so he was kind of just spelling out what those are. So Julie was able to kind of put those together and put his contact information down because he was offering to be a resource as well. So I didn’t know if you guys wanted to before sending it off. I just wanted to touch base about it here first and see Rheta, do you want to get that information and kind of work on that as far as like the overall process structure for submitting those applications to aspyrus, yes, if you can.
Rheta Larson (46:08) Please send that over because we will take the relevant information and make sure our internal payer guides are appropriate for the relevant workflow. So it’s like the first piece.
Alicia Iannece (46:21) And then the second.
Rheta Larson (46:23) Piece is the individual that you’re getting the contact info for? Are they required requesting that we send the application? Like submit the applications to them? And then they’ll work them moving forward or is it just like for general questions and outreach?
Alicia Iannece (46:36) General questions. Yeah. And it sounds like, you know, if something is submitted incorrectly, he sends the information back that it was wrong and like sends them to the right direction. We did look at one of them that it looks like it did get then submitted the correct way. So, you know, if they’re giving that feedback that something was wrong, then there’s additional steps. They won’t do anything with the information they received the first time. Does that make sense? Yeah?
Rheta Larson (47:09) And are they just asking for a resubmission after that? Yeah?
Alicia Iannece (47:14) Maybe on a different form or at a different link or different, or to a different email address that’s what it kind of sounded like. So that.
Rheta Larson (47:22) Makes sense. Yeah, please pass over any of the information you can email out to me and then I can digest it and then review with the team and then get our internal resources updated if anything differs. But if you do have examples of any of the ones that he’s called out, I don’t know if that’s included in this, that would be super helpful. So I can ensure we’re correcting whatever the workflow error was, whether that’s a medallion error or like a payr issue or.
Alicia Iannece (47:49) Error. Okay. Sure. Yeah. The one I peeked at was Tenzin, first name, Tenzin, last name, atruxing a TR, he, it looked like his stuff did get resubmitted. And then for trushil, shah… it looks like there were a number of attempts on his request and I didn’t I couldn’t quite verify on his, whether his got done correctly. So, maybe you want to start with that one, and see if you think that one got corrected. And then there’s a, we have a number of requests in because it also, it sounds, it seems like this is not unique to us or medallion because rwhc, our previous cvl, they, things weren’t directly submitted on their part either. And so some of these are follow up ones because we’ve done the par analysis with them and we’ve identified that they need to be resubmitted. So, so we put those requests in into medallion, gotcha. Okay?
Rheta Larson (48:49) Yeah, I have Tenzin, and then trueschel, I’ll explore further for trueschel, just to make sure the corrections were made and that we’ve gotten that.
Alicia Iannece (48:56) Relevant. Okay, put.
Rheta Larson (48:57) It to the payer and then I’ll use Tenzin as an example just to make sure the first time we submitted what, where the error occurred or what was corrected?
Alicia Iannece (49:06) Okay. Sounds good.
Alicia Iannece (49:14) Then.
Alicia Iannece (49:21) With one of our other payers… for dr shah with WPS, it looks like something had come through for them. And I actually copied you Rheta, on the email I sent back just before this meeting. There was like an additional request between medallion and WPS. And WPS ended up reaching out to one of our contacts here saying this is confusing please, you know, please verify what should be done. So, I have seen this form come to us before where they’re just looking for an admitting physician on behalf of the provider. So it’s usually additional information that comes back directly to us kind of asking us to verify. So in the future, I would anticipate that could be a task that medallion would assign to us to complete because it’s regarding the provider’s privileges at the hospital. And that might not be something well, maybe as we get more built out and developed, you know, maybe that would be visible in medallion, but right now, it’s not for dr shah. So I would anticipate that would be something that would be assigned to us as a task because they ended up putting down like his Texas hospital. And that got very confusing for the payer because they were asking for a Wisconsin based admitting process for our hospital and they were putting down the provider’s primary location based on his profile, what’s in his profile. And it was that Texas based hospital. So, but he’s a telemedicine provider for us here and so completely separate things. So, yeah, I think we’d prefer to just take those requests and complete those on behalf of the provider and medallion can assign that task to us if that comes up when it asks about like admitting privileges. Yeah, I will.
Rheta Larson (51:15) Take a look at the email that you sent and I’m looking at chushil shah, and this is for WPS health plan, provider network, right? Yes.
Alicia Iannece (51:25) And I can also send you, it looks like they had previously sent this… like medallion had completed that on his behalf on our behalf first. And, it was like just kind of the wrong information on the document. So I’ll send you that one too. So just so you can see it for reference.
Rheta Larson (51:47) Yeah, that would be helpful. And then I can also include that in my ticket to the team. So when I meet with them, we can discuss that further.
Alicia Iannece (51:54) Okay. Sounds good. Let.
Rheta Larson (51:57) Me just jot that one down for WPS health.
Jennifer (52:02) I’ll show.
Jennifer (52:07) Okay. Got that.
Rheta Larson (52:08) As an action item as well.
Rheta Larson (52:14) Anything else for WPS or dr Shaw?
Jennifer (52:20) Just.
Alicia Iannece (52:20) kind of a general like because they listed his Texas hospital, I didn’t know if it would be helpful just to say, you know, we’re a Wisconsin based organization. So there should only ever be our hospital listed for something versus, because we’re independent and we’re you know, unless we’re specifically calling out that it’s something in addition, I think it would be just important.
Jennifer (52:49) To say.
Alicia Iannece (52:49) If they’re considering putting something that’s out of state, they should be touching base with us first to ask.
Jennifer (52:54) And that’s going to apply.
Rheta Larson (52:56) To your full organization, correct? Like for.
Alicia Iannece (52:58) all payers, all providers, you know, I think if they’re considering putting information in about a different state, they need to touch base with us first because we only function in Wisconsin and.
Jennifer (53:11) our are.
Alicia Iannece (53:11) two on our behalf, like they might work in other states, but on our behalf, they’re working in Wisconsin.
Rheta Larson (53:18) That is super helpful. I can also get a note over to our like quality assurance and quality control teams just to be sure if they see that like that’s. Definitely being flagged.
Alicia Iannece (53:28) Okay. But I will.
Rheta Larson (53:30) Relay that to the team so they can hold the necessary coaching and kind of just like announcement with them for your organization.
Alicia Iannece (53:40) Okay, great.
Jennifer (53:42) And then I do have one other.
Alicia Iannece (53:43) Question, but it’s regarding payments. So I’m gonna email Nick separately or, and I’ll copy you guys on it.
Jennifer (53:52) If there’s anything?
Rheta Larson (53:53) You think we can dive into definitely let me know, but if you can CC us, that would be helpful because going forward as once we are out of implementation, Nick will join, not every single sync, but he’ll join when he can, because he typically will meet on like a monthly cadence with you all. So some of those might be filtered to me, but I can get the appropriate responses back to you if necessary or loop Nick in to have him join.
Alicia Iannece (54:17) Okay. Sounds good. We have a couple minutes. I’ll just explain my, I spoke with our accounting team and they’re asking if we can maybe have a longer turnaround time for the payments because they don’t process ach, payments every day. They process them every one to two weeks depending on the volume and what comes in. So just seeing if it’s possible to, you know, versus having payments that are looking late, it’s definitely something we’re going to manage and do timely. But because of their workflows, like they can’t do them as frequently and they can’t sometimes get them done within five to seven business days, which is what I’m seeing is the turnaround currently.
Jennifer (54:57) Got it. That is a great.
Rheta Larson (54:59) Question which we will actually point towards accounting. So I would definitely make sure accounting is included on that email thread because they will be the ones who most likely will set that up for you if it’s.
Alicia Iannece (55:11) possible. Okay. Sounds good. Thank you. We’ll.
Rheta Larson (55:15) get back to you there now that I understand the scenario here and I’ll give them a heads up as well.
Alicia Iannece (55:19) Perfect.
Rheta Larson (55:26) Is there anything else you all want to chat through?
Alicia Iannece (55:31) There is one thing.
Jennifer (55:33) And Alicia, you can jump in to help too. But just saying it out loud, is there anything we need to finish up to take any credential? By proxies?
Jennifer (55:47) Alicia, you and I talked about me piece, you know, piecemealing it together for this coming month? Is there anything they need to do on their end to help with the credential by proxy? I don’t think so.
Alicia Iannece (55:59) Because I think we have identified… that we’re not putting through them, putting them through the privileging tab, correct? So because of that, because they can’t attest and they can’t sign off on a file and all of that is supported through our contract with uw to do it that way. So I think we have to just kind of keep it manual. And but then you have your as long as the audit meeting, as long as the monitoring is set up, the npdb reports the licenses, the deas, as long as we have those set up, then I think we’re okay.
Jennifer (56:34) Okay. And so Connor, or Rheta. I noticed that, you know, we talked about before about the 65 percent and then the files can go on. It looks like once I did that, I put in some like dummy information to get that file up to 65 percent. And then I kind of saw the verification start running. Does that sound right?
Alicia Iannece (56:57) To you for the credential by proxy?
Jennifer (57:03) Verifications.
Connor Morley (57:03) Don’t necessarily need to be at 65 percent. They need. There are only a handful of required fields that we need for, to run the verifications. It just depends by verification. So, like I was,
Jennifer (57:16) noticing the npdb wouldn’t run until I had it at 65 percent because I tested a whole bunch.
Alicia Iannece (57:22) Yeah. We, we had a few where because we were getting reports early via our email that would say, hey, you’re missing the birth date, you’re missing the npi number of the provider, you know, in order to do ongoing monitoring. And so we had gotten all that information in. But then these ones were looking like they still hadn’t had the npdb run. And that was when Jenny did a couple, and she was like once I got it to 65, it flipped right away to run an npdb?
Jennifer (57:47) Report. Yeah, I did several just to test it out. I’m like my God, it worked.
Alicia Iannece (57:51) So, just so you guys interesting?
Connor Morley (57:54) Let me, let me confirm with our.
Jennifer (57:58) Ongoing monitoring team.
Connor Morley (57:59) But in terms of like what is required to do npdb? Like we’ve I’ve been told we need first name, last name, date of birth, profession, either an npi or a social security number, gender and address like that’s. Those are the only requirements I’ve been told that we need for npdb. But I can double check with our ongoing monitoring team.
Jennifer (58:24) Okay. Yeah. And it was kind of fun to watch it flip though. I was like, I figured something out.
Alicia Iannece (58:29) Jenny broke the system though. Yeah, she cracked it. Can I also ask too? Because our previous cvo also required maiden names or alternate names and out of state licenses? Can you guys check and see if those are required for npdb, or needed? Because I think they had explained to us that they need to run npdb report on any license that a provider holds not just a Wisconsin license. And so, we were collecting out of state licenses for that reason. But we don’t need them for any other reason. So, if you guys can help us verify that that’d be great. Yeah.
Connor Morley (59:05) Let me take that question back to the team. I.
Jennifer (59:09) think maiden name is.
Connor Morley (59:10) Something that we would need but for the out of state licenses, let me double check that as.
Alicia Iannece (59:16) Well, okay. Yeah, the uw or if you have one license, does it link all licenses based on their npi number or something? I would.
Jennifer (59:24) Hope that it does. But, yeah, the uw was saying when they run their npdbs they do not have to put a maiden name in that’s where we were double checking on that.
Alicia Iannece (59:37) You probably don’t have to, but, if it, if it’s available.
Jennifer (59:42) Yeah, I think.
Alicia Iannece (59:44) If it’s available, it’s.
Connor Morley (59:46) helpful. I don’t, let me confirm with the ongoing monitoring, but, I apologize. I do have another call.
Alicia Iannece (59:56) Oh, no problem.
Connor Morley (59:58) But we’ll talk with you all like this week and we’ve got a lot of follow ups to get through. So we will send out as those as well.
Alicia Iannece (60:09) Awesome. Okay. Thanks guys.
Connor Morley (60:11) Thank you bye.