Transcript
Vanessa Persha (00:00) hey, Deanna. Good afternoon. How are you? I’m doing well. Thanks. How are you? Good. Awesome. All right. Is anybody else joining us today? Or should we go ahead and hop in?
Deanna Purchiaroni (00:16) I just met with Sarah this morning and I think she said she was going to join, she might be joining just a little late. Okay?
Vanessa Persha (00:24) I’ll try to keep my eye out to see if she joins here. All right. So, let’s jump down to this newest one that you added today, Brenda? Rodriguez?
Deanna Purchiaroni (00:39) Yeah. So, billing… is saying that she’s not like enrolled as a bcba. I’m… I checked the application that medallion submitted. Okay, let’s take a look.
Vanessa Persha (01:06) Oh, rodriguez, I don’t know why I was typing Hernandez.
Deanna Purchiaroni (01:22) Yeah. So at the very top, they attach the application and it does show that her degree is bcba on that top right corner, but I’m wondering if, because medical specialties instead of that being like behavioral analyst, because that technically is their like title. I wonder if it was like entered like that’s. Why she’s not showing in their system as a behavioral analyst. Interesting. And I don’t know what’s like typically written on those applications. Yeah, but just like, right when I saw it, I was like, oh, I feel like if I saw that I would have typed in probably behavioral analyst, not autism spectrum disorders.
Vanessa Persha (02:07) Yeah. Let me go look and… see.
Deanna Purchiaroni (02:19) Health, yes.
Vanessa Persha (02:31) Let me just see if there’s any special enrollment rules for bcbas?
Vanessa Persha (02:41) That’s considered behavioral, right? Okay.
Vanessa Persha (03:09) Now, let me just check one other place. I want to check your project plan because I feel like I remember this being called out for health net that bcbas have to be listed a specific way on these forms.
Vanessa Persha (03:43) Interesting. Okay. Let me take this one back.
Vanessa Persha (04:10) Just making a note for myself. So I remember where to look, but I will take that back.
Deanna Purchiaroni (04:16) Thank you. Sarah. Also just messaged me that she’s in the meeting room.
Vanessa Persha (04:21) There she is. I see her. Thank you.
Vanessa Persha (04:30) Hi, Sarah. Good afternoon.
Deanna Purchiaroni (04:39) Hi, sorry, I sort of got on mute?
Vanessa Persha (04:42) Nope. You’re okay. All right. Have you had any success recently Deanna, in submitting? Your emails to support or you’re not getting any kind of response?
Deanna Purchiaroni (04:58) No.
Vanessa Persha (04:59) Okay. I did flag it for the lead from support. She was going to take a look at it. Let me see if we can get you an alternate solution. In the meantime. I don’t know why these are not being picked up by our internal support team, but I think it’s something on the back end. So I’ll follow up with her today.
Deanna Purchiaroni (05:19) Okay. It seems like I get responses when I chat support in the medallion system, but I’m not able to upload attachments in those chats. And a lot of times we’re like forwarding them approvals or like letters from payers. So it would be easier to like forward the email. But then I’m not getting responses. Yeah. So, yeah, okay.
Vanessa Persha (05:40) We may have a different email account we can use for you to send them, and then they’ll go directly to just a handful of our leads onshore with the support team. Okay. Medicaid North Carolina training tasks. So I did flag this for our PE ops team to review the emails… the medallion emails and forward all of those out to the providers that were pending completion of their North Carolina training. Let’s take a look and see where we’re at with those.
Vanessa Persha (06:36) Looks like there’s still 28 that are pending the provider’s response to mark that the training was completed.
Deanna Purchiaroni (06:47) Are we certain that all of them received the request for training? Because a lot of them, I heard that they did not.
Vanessa Persha (06:56) Yeah. So the ops team did go through all of the emails that we received from North Carolina medicaid and had forwarded them to the providers. Let me see if they updated the task as well.
Vanessa Persha (07:16) Because I did ask them to look at the.
Vanessa Persha (07:24) Looks like they also attached it in the task itself. This is the body of the email from North Carolina medicaid with the unique hyperlink for the providers to complete their training, and the access codes.
Deanna Purchiaroni (07:43) I’ll have to go in because I have had quite a few providers tell me that they’ve completed the training. So I feel like there might be a few that they’ve already completed the training before they were tasked this in medallion. So they haven’t like gone back in and marked those as complete since they did it prior to being assigned. Okay? So I’ll go in and like double check those and I can just close out the tasks myself and write like a note that the provider completed it.
Vanessa Persha (08:10) Okay, perfect. Yep. That is perfect.
Deanna Purchiaroni (08:14) Does medallion need like the certificate, like anything showing… that it’s completed? Or me just marking the task complete?
Vanessa Persha (08:24) If you have anything that would be helpful to attach only, and I only say that because if the payer comes back to say, hey, they didn’t complete it or something like that, we have some kind of proof we can show so they don’t close out the application.
Deanna Purchiaroni (08:42) Okay. And then we’ll talk about Emma.
Sarah Aloisi (08:47) Berry, that says accreditation information authorization code required.
Vanessa Persha (08:57) Are you looking at needs client attention lines here?
Sarah Aloisi (09:05) I’m looking at Emma berry.
Vanessa Persha (09:18) Okay. So this one… this is a provider who is technically already enrolled with medicaid, North Carolina medicaid, and what I had asked the ops team was, you know, if they’re already enrolled with medicaid, do we actually need to update their billing information with North Carolina medicaid, considering that you guys are not billing medicaid directly? You guys are only doing this enrollment for the managed care plans. And so they did, she did send me an update this morning, give me one second. Let me go look at that.
Vanessa Persha (10:08) Yeah. So essentially, they said this oa information is only needed if we need to update their billing information. But if you’re not going to be billing medicaid directly, then we don’t need to update it. So, do you guys want us to mark the lines for the providers that we confirmed are par and have an active medicaid id, just mark those as completed. And then you guys can begin submitting your requests for the managed medicaid plans?
Sarah Aloisi (10:45) So, the managed medicaid plans do not need the providers to be attached to cortica?
Vanessa Persha (10:59) That I don’t believe they do. There was the ops team was going to confirm just on a handful of payers. But it’s my understanding that with the managed medicaid plans, they just have to have a medicaid id established in that state to be billable. Okay. Yeah, if you were, if any payer were to require them to be linked to cortica, then cortica would have to obtain a group contract with medicaid that’s the only way to link the provider to cortica with medicaid.
Sarah Aloisi (11:37) Okay. So, for people who are already contracted with medicaid, you’re not doing anything?
Vanessa Persha (11:43) Correct. Okay. Yep. So, I just wanted some guidance from you all on those that we confirmed have an active id. Do you want us to just go ahead and mark them as complete? And then you guys can begin submitting your managed medicaid requests?
Sarah Aloisi (12:03) Yeah. Can you give me a day to ask mercycare just to make sure?
Vanessa Persha (12:08) Yeah, absolutely.
Vanessa Persha (12:14) I’ll just make a note for myself here.
Vanessa Persha (12:57) And then evernorth, Arizona, we had three lines that were on hold. I had flagged that for our ops team. So, let’s just make sure these are moving.
Vanessa Persha (13:35) It’s just a minute here for this. Okay. Looks like those are off of hold. Now. Who are those three profiles? Rios? Montanez?
Vanessa Persha (14:00) Looks like Montanez is in and needs client attention. Let’s take a look here, see what they need. Bye bye.
Vanessa Persha (14:41) are you guys having any issues billing under this group for your Arizona location?
Sarah Aloisi (14:51) You don’t know I can look it up though, okay?
Vanessa Persha (14:56) Because this is like on… multiple occasions now, I’ve seen for… some of these that the notes are saying the payer is advising the Arizona location is not par, but we’ve… successfully completed other enrollments. So I don’t understand why the payer would be saying… the location is not par… and it’s just one practice location you have in Arizona under this group?
Sarah Aloisi (15:33) Yes. Yeah. Okay. Yeah. The claims are paying. Okay?
Vanessa Persha (16:13) Quick… that’s provider Rios.
Sarah Aloisi (17:04) Right now?
Vanessa Persha (18:33) Okay. These ones were just notes for myself. I will get that out of there… Arizona medicaid domain transfers. So, I did follow up with our ops team this morning because I noticed that one of your provider lines still has not, it appears as though it’s not made movement. They’ve shared with me that it has, but again, the notes continue not to be updated. So I flagged that for the leader this morning and she said she’ll connect with the agent and get her to update it ASAP.
Sarah Aloisi (19:16) Okay. Wasn’t that the same message we got like two weeks ago yep.
Vanessa Persha (19:20) And I did, I flagged that. I said look like we’ve talked about this for the last couple of weeks now at this point, like we, something needs to be done because we’ve we can’t just be told anymore that lines will be updated. Notes will be made like I need action on this ASAP. So she talked to her this morning about this and I’ll follow up again here in, about as soon as we wrap up our call just to make sure that we haven’t lost sight of it. But I did see that. Let me see.
Vanessa Persha (20:03) Oh, no. Sorry. I was thinking it was another provider that moved to par. I forgot it was Taylor Phillips we were looking at.
Vanessa Persha (20:33) Looks like she’s making her follow ups.
Vanessa Persha (21:02) So those three providers, it looks like the apps are still in process. And then mark violetti. This was a newer request… and looks like it’s pending the domain transfer still.
Vanessa Persha (21:22) Completed on the thirteenth. Let me flag this one for her. I want to make sure this is not another situation where she’s… making activity and not updating the line.
Vanessa Persha (21:58) Mariah Baldwin. I’m still waiting for a response from them. I asked them to call the payer and confirm the correct licenses on file. We looked through that one last week, Deanna, with her temp license being submitted on the app. So I’m just still waiting for a response from ops on confirmation there. Okay. Masterson, let’s see what movement has been made on this one. It.
Deanna Purchiaroni (22:27) Does look like since I made that note on the fourth, they submitted the application two days ago. Okay?
Vanessa Persha (22:35) Perfect.
Deanna Purchiaroni (22:39) I also made an additional tab on our notes spreadsheet. Where is that? Yeah, just like the denials that we’ve been receiving, some of them are for like the hospital privileging, some of them are for the specialty that we had issues with like yadava and vathakulam, okay. So I’m just like kind of making note on them here since it seems like we are having like quite a few issues with our doctors.
Vanessa Persha (23:13) Yep. Okay. This is helpful. Thank you for adding that. I’ll use this to… escalate anything else that hasn’t been already escalated.
Deanna Purchiaroni (23:26) Okay. There are two here for dr barrows and dr call for uhc, that both of the applications I believe… were closed out because they said that they needed a response within three days or else the application would be closed. So I do think that both of those need to be resubmitted.
Vanessa Persha (23:48) Okay.
Deanna Purchiaroni (23:51) And then the two below, I’m waiting for the little snippet from Neil internally to respond to the payer, but I think since again, it’s been over those like three days we’re going to have to resubmit. And then the last one for dr yadava for carillon. I just forwarded you an email today. Okay? A denial because he doesn’t have that psychiatry specialty. I’m thinking that’s the same issue that we were on the phone with dr vathakulam, yep, that she needs to update, but I think he was maybe giving a little bit of pushback that he didn’t think that it should be updated.
Vanessa Persha (24:28) Okay. All right. I’ll take a look at your email for those, and then I’ll manage those internally. So, Haley masterson, she’s on here for uhc, and it’s.
Deanna Purchiaroni (24:43) okay. I do have that. She’s resubmitted. And then I have another column of just like if we’ve received an additional request because I have a feeling that we’re going to get that same email again requesting the hospital affiliation. So hopefully now we’ll just like be able to respond quick before those three days yep.
Vanessa Persha (25:00) Okay, perfect. And then the North Carolina medicaid portal, Deanna, I haven’t had a chance to confirm with you, but did you end up getting the email and have you tried to log in to make sure you have access to the cortica group account we created?
Deanna Purchiaroni (25:24) I didn’t get an email about that. Would it have been an email from medallion?
Vanessa Persha (25:30) No, it was, would have been from medicaid, North Carolina, medicaid, directly. It was essentially like giving you access to the account we created to do provider enrollments… I?
Deanna Purchiaroni (25:46) Don’t recall, I don’t think I thought that. Okay?
Vanessa Persha (25:51) Let me see if they can resend it.
Vanessa Persha (26:10) And then provider email preferences, Deanna, I have to, I’ve talked to Molly about this. Just, I remember we talked last week and I was saying some type of bulk updates may require payment to do them or there’s a fee that we charge for those. So Molly’s working that out with the TSM team, to confirm if there would be any charge. And if there is a charge, she’ll connect with Sarah to see if it’s something you guys want to move forward with. And if not, she’ll, let me know and they’ll give me the template that we can do that bulk update. Okay? I’ll just want to touch base again before, as we’re updating the template to confirm the correct settings, cause I know we originally talked about this at the beginning of the year, yeah.
Deanna Purchiaroni (26:58) And just like a follow up with this, I know that we’re wanting to update the email preferences that are currently in medallion? Is there a way that like moving forward when we add providers, that only certain ones are toggled on? So like we can prevent this from happening from future for future providers that we add in the platform?
Vanessa Persha (27:19) That’s a good call out. Let me add that note here.
Vanessa Persha (27:50) Okay. Yeah, that’s a great call out because we can probably lump it all together in one custom configuration at the same time. And I apologize, I do have a hard stop today at 12 30. Was there anything else you wanted me to look at urgently that I can follow up with you on via email?
Deanna Purchiaroni (28:14) Sarah, did you have anything? No?
Vanessa Persha (28:18) Okay. All right. I will go ahead and, I’ll send out some meeting minutes, before the end of this week, but if anything comes up, you guys know where to find me and I’ll keep you posted on some of the items we called out today.
Deanna Purchiaroni (28:32) Okay. One quick thing, could you actually update the North Carolina medicaid tab? I believe you had like separate notes but if you could copy them into there yep?
Vanessa Persha (28:42) I will absolutely do that. Okay. All right. Awesome. Thanks, ladies. Bye, bye bye.