Transcript
Lyndsey Farmer (00:00) hey, there. Hello. How are you?
Kelly Martinelli (00:02) I’m good. How are you doing? Doing well. Your hair looks so pretty. Thank you. I love that.
Lyndsey Farmer (00:09) Thank you. Doesn’t happen that often, but.
Kelly Martinelli (00:12) I hear you. I’d be so dressed up the last two days because of calls with our board and stuff. And so I was like, I can’t wait to just throw it back in a ponytail. Yep. Oh, wow. Yeah, the stress is real. It.
Lyndsey Farmer (00:28) Is, yeah, it is. And I have so much hair. So, it like takes so long to blow dry and, yeah.
Kelly Martinelli (00:34) Yeah, mine takes forever anymore, and if I, it depends on what blow dryer I actually use, like if I use a regular hair dryer, it gets like this.
Lyndsey Farmer (00:41) Yeah, mine too.
Kelly Martinelli (00:46) Are you going? Two different ones? I?
Lyndsey Farmer (00:48) Think Kat is here?
Katherine Rivera (00:51) Kat, yeah… one, one, one, one, one.
Kelly Martinelli (00:57) Yeah, you’re on two different.
Katherine Rivera (00:58) Ones.
Katherine Rivera (01:05) You hear me now? Yes. Perfect. Okay. I apologize. I can’t hear.
Kelly Martinelli (01:09) Her. She got her hair all long too.
Katherine Rivera (01:11) I had to, these whites are just getting to me. Hold on. All right. She’s coming in. Give me one second. Lindsay. We have Sonia that we’re adding on.
Lyndsey Farmer (01:23) Oh, sure.
Katherine Rivera (01:24) Having issues. Let me just make sure that, she can join. Okay?
Katherine Rivera (02:02) My apologies, guys. She’s right? Issues with zoom.
Lyndsey Farmer (02:07) No worries.
Katherine Rivera (02:10) I’m going to forward this to her.
Katherine Rivera (02:27) We’re so used to teams.
Katherine Rivera (02:32) No,
Kelly Martinelli (02:33) we’re on that. I zoom I.
Katherine Rivera (02:35) resent it again. I sent it to her before, but I resent it again.
Kelly Martinelli (02:38) Sometimes it’s hard. It’s hard to click on the top one.
Katherine Rivera (02:42) Can we, yeah. Okay. I just sent it again. So, bear with me. Great.
Katherine Rivera (03:06) Hopefully she’ll get on. We’ll see, I called her again.
Lyndsey Farmer (03:27) There she is.
Katherine Rivera (03:29) Perfect.
Kelly Martinelli (03:50) Hey, Sonia.
Lyndsey Farmer (03:52) Hello?
Kelly Martinelli (03:54) You’re familiar with Lindsay, right? I.
Katherine Rivera (03:57) wasn’t I wasn’t sure that, it was.
Kelly Martinelli (03:59) Through zoom, I thought it was like, oh, okay.
Katherine Rivera (04:03) That’s all right?
Kelly Martinelli (04:06) Okay. I’m here. All right. No worries. Before we get started, I just have a question, sure because I just got off the phone with one of the asc administrators and they had… a triple ahc inspection and they failed on a few parts and it was credentialing that they failed on.
Kelly Martinelli (04:26) Okay. So in medallion… I want to make sure that they can see all like the national provider database stuff like if I click on one of these guys, if I just click on one of them, let me share my screen here. If I just click on this, if I go down here to documents, is this where they’re going to see everything? Because I see ceqh in here, but are they going to see the, I don’t see the national NP, whatever they call that npdb? Yeah. Is this where it would be housed? I need to make sure that all the credentialing documents can be.
Lyndsey Farmer (05:08) Housed. Is this going to be for a provider or for a?
Katherine Rivera (05:12) Group? Yes, for?
Kelly Martinelli (05:12) A provider? Okay.
Lyndsey Farmer (05:15) Yes, it should be.
Kelly Martinelli (05:18) Let me.
Lyndsey Farmer (05:19) pull one up on my end. I’m having a hard time seeing.
Katherine Rivera (05:23) We’re going to need to discuss this because I just need to remind you everything that’s inputted in the system here and profiles of the provider is just what’s captured in caqh is not npdbs. We have our internal provider folders that house anything for npdb for a provider between 22 to 25?
Kelly Martinelli (05:49) Okay. Can we get them sorted in one place? That’s what I need to make sure of? Yes, I can’t have the violations with asc triple HC.
Katherine Rivera (05:59) Okay. I understand. But also when… we created the medallion, it wasn’t housing old information from the provider. It was only based on caqh. So that’s something that, yes, we can transfer over? Okay? Because it was internal and.
Kelly Martinelli (06:20) Lindsey, there’s places for that. I just want to make sure it.
Lyndsey Farmer (06:23) Would be in the documents? Yeah, you’d be able to upload stuff? Yeah, you can input stuff that you have on your own that were, you know, that we didn’t that didn’t come over that we didn’t do in a mass bulk upload. Okay. Yes, you are able to bring in your own documents and welcome letters or approvals or, yes. Anything that you have for a provider or for a group you are able to store in here as well? Because.
Kelly Martinelli (06:51) The auditor for triple HC said that we needed to get rid of modio because it doesn’t house everything. Okay. So I just, you guys, I’m really transparent, sure because I want to make sure everybody knows the ground, you know. So that was my question. So.
Lyndsey Farmer (07:11) Okay. Yes, you can, you are able to bring your own things in here as needed? Okay? So if you have a document for one provider that another provider doesn’t have or whatever, yes, you can upload anything that you have for a provider into that. Okay?
Katherine Rivera (07:28) Will it accept a zip folder? Lindsay? I’m.
Lyndsey Farmer (07:32) sorry, will it, will the?
Katherine Rivera (07:33) System accept zip folders?
Lyndsey Farmer (07:36) That I’m not sure of, we’d have to, yeah, we can either test it or I can take that back to the tech team and see.
Katherine Rivera (07:46) No, that’s fine. Yeah, I’ll test it first and see. Okay.
Lyndsey Farmer (07:54) What else did you have? Kelly? Anything?
Kelly Martinelli (07:55) And I sent you the list that operations. Yes. And I’m just going to be, I’m glad we had our call and I met with Kat and Sonia as well because guess who I got my phone call right after from Doug. Yep. So, and I told him that we did not need to have a meeting with all of us, that we would take care of it and we would work out the wrinkles so he was fine with that. So he took a breath. Okay, took a breath, but he wants to make sure that, you know, we have our, we have what we need in the medallion website and that we’re getting the correct reports and stuff like that. That means as a company. Sure. Yeah.
Lyndsey Farmer (08:36) I just saw your email right before the call. So I did respond to you and CC Jack on that as well. So we’ll get working to see what we can figure out on that.
Kelly Martinelli (08:47) The other thing that I want to be able to see in medallion, it’s probably on your analytics board is like the date that it was submitted, like it was submitted for a particular provider, like the payer was provided, the date it was submitted, was our follow up? When was that follow up? When was the effective date? That kind of thing? Sure. Do we have that on the analytics tab?
Lyndsey Farmer (09:13) Let’s take a look.
Kelly Martinelli (09:15) Let me share my screen real quick.
Lyndsey Farmer (09:20) For analytics? I.
Kelly Martinelli (09:22) just want to make sure that there’s a good tracking system in here? Yeah, for Kat and Sonia. So, Kat and Sonia, you need to speak up, remember, I’m brand new.
Katherine Rivera (09:35) You’re not going?
Kelly Martinelli (09:36) To offend me if you can say, Kelly, you’re on?
Katherine Rivera (09:38) If we’re going to be transparent, I just want all the tasks that you’re requesting currently are not tasks that were assigned from the beginning. So basically, right now, modio is only housing caqh imports in there and active enrollments that either medallion has entered or Sonia and I have entered on the level of group and facility. So, anything outside of that box that is currently being axed just to bring to the table, it has not been imported in here because the first import that was done was just the bone of the provider and facility and group level, just to make sure you know what I mean? It’s not something that we, you know, that it hasn’t been applied to as of yet. So if anything does need to transpire, Sonia and I are more than willing to go ahead and do so just to put it out there. Okay.
Kelly Martinelli (10:43) So, does the tracking mechanism have everything in there that we need?
Lyndsey Farmer (10:51) I am looking at that right now.
Lyndsey Farmer (11:06) So I think if you go over to payr reporting in the analytics tab.
Lyndsey Farmer (11:16) And then if you go to that, the drop down in payr status, well, you can filter it by payr name. So if you’re just looking at one individual payr, then you can filter it by that. But if you go to the payr status that’s going to give you all the statuses that this application could be in. So we could look at existing enrollments, we can look at application completed, QC required. So any like status that an application could be in, would this is where it would be housed in the payr status tab?
Kelly Martinelli (11:52) Okay.
Lyndsey Farmer (11:54) So, like we’re going to look at existing enrollments for example… so that’s going to bring up anything existing and requested. And then you’ll have to select a payr name… so we can just look at Aetna.
Kelly Martinelli (12:20) No results.
Lyndsey Farmer (12:21) No results. Ax love to see it. Okay. Let me take this back. Okay, let me look at one more thing here.
Lyndsey Farmer (12:38) Okay. Yeah. Let me play around with this. And then I will,
Kelly Martinelli (12:48) There was one other thing I was going to ask you about. Sure. There’s a lot of things that, I just don’t understand it was, I… wrote it down payers, the payr list. Why doesn’t anything? What’s what’s supposed to be? Because he has no submitted enrollment request. Is that what it is?
Lyndsey Farmer (13:08) Yes. So anything that he is approved for, would show up there in the payr list?
Kelly Martinelli (13:15) Okay.
Lyndsey Farmer (13:16) So if you look at.
Kelly Martinelli (13:17) So, if I go to Misty, schroll, let’s look at hers because she’s kind of new, but she’s.
Lyndsey Farmer (13:22) got some, she,
Kelly Martinelli (13:23) should have something. No, she,
Katherine Rivera (13:26) doesn’t Misty schroll, is a re, a resubmitted provider? A, re, she used to work for psa before. So, she, her information is in medallion. How about, I mean, excuse me, her information is in modion?
Kelly Martinelli (13:43) Who would be in medallion? Sabrina, littles?
Katherine Rivera (13:47) Sabrina littles is a crna, and she’s a locums. So she wouldn’t need, any, enrollment, her stuff.
Kelly Martinelli (13:54) Comes up, yes.
Katherine Rivera (13:56) Because we submitted her stuff through medallion. She was after the fact. Okay. And Misty, Misty’s in here. What I’m trying to, what I’m trying to say is the things that you’re looking for the providers that you’re looking for are not complete completely in here as of yet. Okay? Because because, they don’t have any active enrollments. So, if, what we can, what we can show is active enrollments, if you go to, if you go to enrollments for her, you’ll see that it was submitted, but it was on hold because she was one of the profiles that came back saying she was at 77 percent.
Kelly Martinelli (14:33) Yeah, it doesn’t say anything here under.
Katherine Rivera (14:35) Enrollments. So then that’s something that, yeah, then that’s something that we will because, enrollments were requested for her. Is there any way Lindsey, you can see if enrollments were requested for her so that we can show?
Lyndsey Farmer (14:48) Is this for it?
Kelly Martinelli (14:49) Says right here, it says right here.
Katherine Rivera (14:52) But nothing has been completed as of yet for her, correct? So you can see the process. Yeah, yeah.
Lyndsey Farmer (14:59) If you look over here on the right side with request status, it’ll show you. So something’s on hold there’s some processing, some needs client attention.
Katherine Rivera (15:12) Okay. So this is where we come back to the questions that haven’t been answered yet. Lindsey, one is, how do, how are we, how are we going to track the follow ups because currently, right now, for any old provider that we did, internal, enrollment for, medallion is supposed to go and follow up on it, but myself and Sonia cannot enter a follow up because we haven’t been shown how to do that. And it’s been two meetings that we asked that. Okay. Yeah. And then the next thing would be, well, if you can do that one first. Sure.
Lyndsey Farmer (15:52) Let me.
Lyndsey Farmer (15:58) I think I have some information on how to enter a follow up,
Katherine Rivera (16:10) And then the next part of that is, how are we tracking what was submitted to medallion to Naomi, for the staff to, you know, to come back with the follow up information? Because those are the two things because right now, the only, component that you guys are working on are cna requests… and we have, you know, new providers like the ones that Kelly’s saying, Misty schroes, dr. Hackey, we have dr arias, we have a few more providers, that we need to put in those follow ups so you guys can work them. Okay? So.
Lyndsey Farmer (16:48) For the first part of the question, how do you do that? So you would under… the tags? So, when you, put in a new request, for that provider, under tags, you would be able to submit the follow up date. So I can send you the screenshot as well?
Kelly Martinelli (17:12) Do you want to show your screen? Yeah.
Katherine Rivera (17:14) Yep, I can do that.
Kelly Martinelli (17:18) I don’t know what you’re talking about with tags.
Lyndsey Farmer (17:20) Sure. Yeah. Okay. Give me one second.
Katherine Rivera (17:25) Let me share.
Lyndsey Farmer (17:27) My screen.
Lyndsey Farmer (17:36) Okay. Are you able to see now? Yep. All right. So.
Lyndsey Farmer (17:49) Let me see if I can.
Lyndsey Farmer (18:11) I’m trying to find a good provider that I can show.
Katherine Rivera (18:14) This on. Maybe you can try dr arias or dr hackey. Okay? Because those are the ones that we’re concerned about that we have, that we need. Okay, we need the follow up.
Lyndsey Farmer (18:26) Now, dr. Hackey, did not come over on the import template?
Katherine Rivera (18:31) No, he did not. Okay. He did not come over on the import because, we kept those in house. Okay? And we informed medallion that they were not going over on that report.
Lyndsey Farmer (18:41) Perfect. Okay. That is fine. All right. So.
Lyndsey Farmer (19:05) that’s for a new task. It would be under here. Let me go back to the screenshot that was sent over.
Lyndsey Farmer (20:05) Not… I will go back and let me make a note and figure this out because it is not, can.
Katherine Rivera (20:16) I can I ask, if we’re doing this, it’s been two meetings. Can we at least get maybe something a workaround by hopefully today or tomorrow? Yeah. Yes. Absolutely. They’re adding up? Okay? Yep. Okay. Perfect.
Lyndsey Farmer (20:41) And this is for existing enrollments, right? Yeah.
Katherine Rivera (20:45) So, it’s internal enrollments that we have submitted that we need follow up on. And then, also on the first implementation sheet that we gave to Naomi on open enrollments now, me and Sonia call on those, but they may be already approved, but we need to confirm what happened to that listing as well because we still have a numerous amount out there. Okay? And,
Lyndsey Farmer (21:13) have you asked Naomi about that being that it was an implementation?
Katherine Rivera (21:19) We, we asked in our meeting and we were already transferred over to you. So we were waiting for an answer from you? Okay? Because you said you were going to go back to Naomi, sure?
Lyndsey Farmer (21:28) Yeah. And I tell me I did go back to her. Let me see if she.
Lyndsey Farmer (21:42) This will be for.
Lyndsey Farmer (21:56) This is for the tracking report, correct? Yes.
Katherine Rivera (21:59) Coming from?
Lyndsey Farmer (22:00) Modio, yes. Okay. So, I did ask her about this. Let me see what came?
Kelly Martinelli (22:07) Of.
Katherine Rivera (22:07) that.
Lyndsey Farmer (22:09) there is a lot of discussion around it. So I’m not sure if we ever got, we discussed integration.
Lyndsey Farmer (22:30) Okay. So if you, we have a, let… me show you this and I’m not sure.
Lyndsey Farmer (23:04) Okay. Are you able to see my screen again?
Kelly Martinelli (23:08) Okay. So we,
Lyndsey Farmer (23:10) are able to filter this by your adopted lines which are pretty much lines that we took over. And then here is everything that was sent over to us from modio that you all were working on, correct?
Katherine Rivera (23:32) That’s the import, right?
Lyndsey Farmer (23:34) So, this is where all of the follow up would be done. So, this, like for instance, Rewa brown is still processing.
Katherine Rivera (23:45) Okay. So, this is from the tracking sheet that we submitted, not from our template… that was submitted on the implementation side. This is separate, correct?
Lyndsey Farmer (23:58) Yeah. So, according to Naomi, we did not integrate anything into medallion. We took, the template that you sent over and we uploaded all of that information.
Katherine Rivera (24:15) That’s fine. That’s the template, and that’s what Greg uploaded into the system based what we got out of modio?
Kelly Martinelli (24:22) I have a question because your screen looks different than my screen. Like I can’t see those fields that you have when it said follow up with the amount of time?
Lyndsey Farmer (24:32) You can’t see follow ups,
Katherine Rivera (24:36) Okay. Does it say admin on the top? Really look on the top? Does it say admin? And really? Okay. Oh.
Kelly Martinelli (24:43) It says admin, it says admin, but I can’t see certain fields and maybe that’s my problem.
Katherine Rivera (24:48) Maybe, let me look at mine too, just in case. Remember that’s? What happened to me in the beginning? Yeah, I was given admin. Huh? You had, you had admin, but you didn’t have super admin. Oh, oh, I didn’t know that was, and that had to be changed because, it was specific fields that Naomi didn’t turn on that they turned on me. That was your issue and that.
Kelly Martinelli (25:11) Could be why I’m not seeing what I need to see.
Katherine Rivera (25:13) Yeah. Maybe that’s it too. Hold on.
Lyndsey Farmer (25:19) So, just real quick to go back to the template versus the tracking. According to Naomi. We never, there was not a discussion to build an integration into like a tracker… there?
Katherine Rivera (25:37) Was not an integration but they were working on it and there’s a recording on, that they were working on the tracking system. So they should have been giving us updates on that. So maybe you can go back and ask her on that.
Lyndsey Farmer (25:48) You.
Katherine Rivera (25:48) told me the staff, I have the email too. I can look for it, but the staff was supposed to work on it and then give us updates and that’s why we were switching so much from, you know, which screens we were going to be working on specific weeks. Yeah. Okay. And okay. So yeah, maybe we’re not using the right terminology but it was just an excel spreadsheet submitted and they were supposed to be working on that for us.
Lyndsey Farmer (26:15) And this was discussed during implementation.
Katherine Rivera (26:18) Yes, it was, yes. Okay. It was discussed into implementation and Angela had asked her if she could pick up the follow ups because since we did the internal providers, there were no more internal, excuse me since we did the two providers internally, there were no more providers for them to work on as far as a new onboarding provider. Then they took the follow ups that we had outstanding and they were going to work on that for us. Okay?
Katherine Rivera (26:55) I’ll look, I’ll send you that email. Thank you. Great. No problem.
Kelly Martinelli (27:02) Sorry that you’re getting all the fallout, Lindsay that’s.
Lyndsey Farmer (27:05) okay. I just, I was not part of the implementation. So I don’t know a whole lot about what was talked about and what was supposed to be. I came in at the very end. So I apologize… but we will get this worked out. I’m so sorry.
Kelly Martinelli (27:36) Yeah, because as soon as I can get some stuff off of their plate because they’ve got other stuff that they deal with. We went through their whole list yesterday. I don’t know how they keep up.
Lyndsey Farmer (28:01) Okay. I’ve got that.
Lyndsey Farmer (28:07) I’ve got that out to her. Okay?
Katherine Rivera (28:15) I’m sorry, Kelly, I could wait for my other stuff that we have you go for.
Kelly Martinelli (28:19) It.
Katherine Rivera (28:19) okay. So, sorry. Okay. The next one is going to be in our manager training, the biggest… issue that we have, and I know that this is going to be a big issue… is going to be that, our managers and all our staff are accustomed to seeing product lines with the names. So, hmo, ppo, let’s say it’s a blue cross choice in your system. It identifies as commercial managed care, traditional medicare, those type of things and that’s going to throw them off because when they see patient, even it’s going to throw authorization off and it’s going to throw our in house staff. At the offices. Is there any way that we can change… that? I know that I spoke about it in implementation and they said no, but is there a way that we can?
Lyndsey Farmer (29:23) Unfortunately, not, we can’t that’s how the system was built.
Kelly Martinelli (29:29) So, I got a question for you. What do your other larger clients do? Because this is the lifeline of our business and Doug that’s one of the things that’s why I asked you for the report. We need to see the products. Yeah. So.
Lyndsey Farmer (29:41) The products will come out on the report the same way that they do listed in medallion. So it will be commercial medicare advantage.
Kelly Martinelli (29:50) That’s not going to work. I can tell you Doug will have it. He will have a fit.
Katherine Rivera (29:55) Yeah, unfortunately there.
Lyndsey Farmer (29:57) Is not a way.
Kelly Martinelli (29:58) Yeah. How do your other clients do that? I guess I need to know where is that information in our system in the system?
Lyndsey Farmer (30:05) So, if you’re looking in the system, you would look under. So you’d take a provider, let’s see who?
Kelly Martinelli (30:13) Take meta. And.
Lyndsey Farmer (30:16) then you would go under payers?
Lyndsey Farmer (30:23) As soon as my computer… cooperates,
Katherine Rivera (30:33) yeah. My system was slow yesterday, so.
Lyndsey Farmer (30:35) Yeah. Okay. There we go. So payers and then you would go under enrollments for this particular provider.
Katherine Rivera (30:44) Wait, Lindsay, you’re not sharing, I’m sorry, would help.
Lyndsey Farmer (30:49) Wouldn’t it.
Kelly Martinelli (30:51) And this is one of the things that Doug wanted to know in the sales meeting and we were told you could do that.
Lyndsey Farmer (30:58) Yeah, I’m really sorry, so.
Kelly Martinelli (31:02) How do you know what payers when we ask you to become participating with a particular provider? I mean, you gotta have that somewhere.
Katherine Rivera (31:10) So, I’m can you see my screen? Yes. Okay. So.
Lyndsey Farmer (31:14) For example, for Aetna. So, for this particular payer… this provider is enrolled with these lines of business. So, medicare advantage, commercial exchange and traditional medicare.
Katherine Rivera (31:31) But, but that, but again, Aetna commercial fine, let’s talk about the bigger, the big ones like blue cross of Texas. They have like eight different product lines and, you know, they go into, from managed care goes to silver, bronze and gold. If I’m right, Sonia, correct? They’re not.
SoniaFigueroa (31:50) Enrolled in the same product?
Katherine Rivera (31:52) Yes. So, there’s some available, so, correct. And the tax ids that come out, let’s say our tax ids that we currently have, and I’m only going to talk about ctpc and ctpi, they have different product lines underneath it. And sometimes our providers show in the directory. When we go back and look at them, they’ll say, par, blue. And then it says two lines of business that says hmo and managed care. We can’t identify that because our team needs to identify each product that we have within the contract and within the scope of it. So that’s where this.
Kelly Martinelli (32:34) Will affect our sunshine laws. This will affect the sunshine law as far as giving good faith estimates. It’ll affect our reimbursement.
Katherine Rivera (32:41) It’ll.
Kelly Martinelli (32:42) show out a network. It’ll cause it’s going to create havoc.
SoniaFigueroa (32:48) Is there like a note or something that you can put within that enrollment? You?
Lyndsey Farmer (32:53) Can add notes. Yes. When you do an enrollment request, you can put notes… but.
Katherine Rivera (33:02) here’s the issue. If you put a note, I’m sorry, I don’t need a.
Kelly Martinelli (33:05) Field. I need a field. I don’t need a note.
Katherine Rivera (33:09) That’s what I was thinking. Yeah, we’re going to need a field and also for the ipas for like spin, right? Or ascension, let’s just say because that’s the ascension family, it has payers underneath it as products. So they have the Aetna cygnus united underneath it. And then within that, they have their ppo, hmo, whatever it is. And it’s going to be so hard to identify it this way. Sure. Yeah, this is something that’s it’s bigger on three scopes.
Kelly Martinelli (33:41) Maybe you don’t have large clients. I don’t know.
Lyndsey Farmer (33:44) Yeah, no, I understand completely. Where you’re coming from and how.
Katherine Rivera (33:49) I get.
Lyndsey Farmer (33:51) It… I’ve invited Naomi to a call. So as soon as I hear back from her, I will get a call, set up a one off call with us set up and I will also have Jack on that as well. Like I said, to my knowledge. And I think to Naomi and Greg’s knowledge as well. Greg being part of kind of the technical solutions part of it. I don’t believe that this is something that can be changed.
Katherine Rivera (34:29) But,
Lyndsey Farmer (34:29) again, I’m going to invite you, I’ll.
Kelly Martinelli (34:31) need to include Doug. So I’ll have to come up with some times, okay? Because he will, I will tell you Lindsay, it will be an ugly meeting. It will be a really ugly meeting. Okay? I’m just going to prepare you for me.
Katherine Rivera (34:43) Really, there’s two other things. And Sony, I’m going to ask you if you can give more information because you could explain this better than me to be honest with you. The document, the issue that we’re having when we’re uploading documentation from diplomas, it’s not connecting there’s. Desert. There’s a default in there that either we’re not understanding how to grasp it or the systematic issue. So, Sony, if you can just give a little bit of insight when you’re uploading the document for the nursing because it’s happening when the provider is uploading information and it’s happening when we’re trying to upload. Yeah.
SoniaFigueroa (35:21) So, we put in like they have, the tab, the drop down tab that they, you guys have, it’s asking us to put the… nurse practitioners or like allied ones under a professional education, but there is no tab to put that on there. So we put it under either their masters or a graduated thing. But it doesn’t accept it in. Medallion, it literally throws back the task saying it needs to be put into a professional education. But when you drop down, the box, there’s nothing there to put in the professional education for that ally.
Katherine Rivera (36:03) And then it comes back as a task, we close it out and explain it as.
Lyndsey Farmer (36:07) A.
Katherine Rivera (36:07) task again, two or three days later, can?
Lyndsey Farmer (36:11) You send me an example of one of those?
Katherine Rivera (36:14) Yeah. And.
Lyndsey Farmer (36:16) then I can take that to our tech team perfect.
Katherine Rivera (36:22) It.
SoniaFigueroa (36:24) like it accepts on some of them and then on some of them, it doesn’t it’s just and I tried to put it in every kind of way to see if it’ll accept it and it just doesn’t okay?
Katherine Rivera (36:35) Then… the last thing, I have two other things. So then when we are, when we’re entering an addition, an additional task again for, let’s say the asc we, you know, how we’re going to be adding on the address? Yeah, and we have spoke about where will be we be doing that. So if we can see that now, where will we go to enter the location ad with the payer? Is it just like the regular way of signing a task? So?
Lyndsey Farmer (37:10) Yes, you would, are you adding, is it just an address ad or is it a whole new group? It’s.
Katherine Rivera (37:17) an address ad? Okay?
Lyndsey Farmer (37:19) Into what group into?
Katherine Rivera (37:22) Into go into facilities, it will.
SoniaFigueroa (37:25) Go into psa, anesthesia? Or no? No facilities?
Katherine Rivera (37:28) And then it will go on to, you see where it says, it would say Austin, psa, the address that shows, I’m sorry, I can’t see the screen over here. I think it’s the first one, the new address, yes, that’s the new one. Yes. Okay.
Lyndsey Farmer (37:45) So… you would come in here and then you would, nope.
Lyndsey Farmer (37:57) You should be able to task it out and it might not work on mine because I’m in as myself, not as one of you.
Katherine Rivera (38:11) So it should be able to, I’m gonna try it on my end. Yes, you should be able to, yeah.
Lyndsey Farmer (38:16) Let me know since I’m not able to. Yeah, it’s not gonna let me do it on my end because it’s me, it’s not you. Okay?
Katherine Rivera (38:31) So that’s something that I’m gonna try. And then if it’s an issue, I’ll bring that up in the email. But the next thing is our crnas, and I’m not specifically talking about the ones that are going to be assigned because Sonia, that’s a different setup, but I’ll tell you about that setup after, but our original crnas that are employed with us, they… go under medstar. So if you go into clinics into groups and you hit the medstar… you see where it says psa, anesthesia, pllc, medstar, anesthesia? Yeah. So we have our three ascs that operate under this specific entity. And what happens is when we try to add a provider and I try to assign out, let’s say, I want the crna to go to all three clinics. It’s picking it’s picking up the asc and not picking up the location. If that makes sense. It’s only targeting.
SoniaFigueroa (39:36) Up the location and not the actual.
Katherine Rivera (39:41) No, it picks up medstar. But when it says medstar, it only shows Duval’s address and not the other two locations address is under it. Okay. Yes. So if I send a task, it’s going to credential only for one. So, I’m not sure. And that’s another thing we keep taking out for here. All these locations, it shouldn’t be 10. It should be three. Okay? And when we fix, it comes back with 10 locations.
Lyndsey Farmer (40:08) So, you keep removing them and they keep coming back yes.
SoniaFigueroa (40:12) Correct. Goodness.
Katherine Rivera (40:14) Gracious. Yes, we did a test, me and Sonia. Okay?
Lyndsey Farmer (40:25) Okay. I can put tickets in for all of this stuff.
Katherine Rivera (40:31) Well, there’s one more ticket that we haven’t answered yet.
Kelly Martinelli (40:34) Can I just ask a really stupid question? Sure. Okay. I got to ask a stupid question back to the insurances when we ask you to get a payer enrolled. Okay? We do an enrollment request. How do you get that enrollment request with like let’s say blue cross blue shield of Texas. How do you get them enrolled with each one of those other payers? Like we’re not on with some, but we are with some other ones and it just comes up with blue.
SoniaFigueroa (41:07) Cross blue shield.
Lyndsey Farmer (41:08) I.
Kelly Martinelli (41:08) don’t understand. I’m having a hard time understanding why your system doesn’t do it and then how, you know, which ones to become on plan with participating with. So.
Lyndsey Farmer (41:18) What were you looking for?
Kelly Martinelli (41:20) So, let’s look at blue cross blue shield of Texas. Okay?
Lyndsey Farmer (41:23) So, I’m just going to use this as an example and I’m not going to save it. So nothing will be saved but just for time’s sake, I’m just going to just pick anything and… all right. Oh, Texas, I’m sorry?
Lyndsey Farmer (41:44) And we want… blue cross of Texas, right? So here are all the, so do you do?
Kelly Martinelli (41:55) They become a network with all of these plans or? Yes. So then why are we saying? We don’t have silver and gold and all that other stuff… that’s what I’m having a hard time understanding.
Katherine Rivera (42:10) It’s not.
SoniaFigueroa (42:11) Trying to understand too.
Kelly Martinelli (42:12) But the product, we’re not enrolled with the products, we’re not in network with certain products… educate me like.
SoniaFigueroa (42:20) Yeah, we’re not enrolled with the full commercial that’s right there’s, different types of commercials that you’re approved for, right? So.
Lyndsey Farmer (42:29) When we go in and do so, for instance, we select this provider, this state and blue cross blue shield, and it’s going to put her application in for all of these lines of business. That is not what you’re looking for. If I’m hearing that correctly. Okay?
Katherine Rivera (42:47) We’re looking for exact, our contracts have specific products underneath it that we have and we may, and that’s the biggest issue that we have for… ipas, have products that are actual payers and those payers at times we opt out of specific payers, and we need to identify those because we are contracted through locality and we’re contracted through, yes, you know, location and it affects our contracts because we’re based on a region is what I’m trying to say.
SoniaFigueroa (43:27) Right. Like for example, we have the Austin region area, and then we have the Waco, which, and then there’s certain states, I mean, cities that are located to that Waco, and then there’s at the Austin and not, like for example, blue cross blue shield will not approve certain regionals where they’re set like in Waco, they’re not, they won’t be part in certain commercials.
Lyndsey Farmer (43:55) Okay.
Katherine Rivera (43:58) And that was something this.
Kelly Martinelli (43:59) Will affect our business. Lindsay. Yeah. Sure. That’s why I’m telling you when we.
Katherine Rivera (44:04) first had the initial calls coming in, we all sat on a call and we identified that we had ascs that we had, because in our first call, no one knew that we had ascs, no one knew how we ran, and we specifically said we have eight different tin numbers, you know, may we use all tin numbers, but all our contracts are contractually separated by tin number. Okay? It’s not all o, two or seven four. You know what I mean? Right? So that’s a problem because we’ll have a specific provider that we have a region of seven four and we have a four six, and we can’t add all providers to each one because of the locality of where it’s at. Okay?
Lyndsey Farmer (44:48) I understand a little bit more now. Okay. And that, yeah, that helps me to better explain this when I take it back too. Okay? Awesome. So I will try to escalate that and get that out.
Katherine Rivera (45:09) Thank you. You’re.
Lyndsey Farmer (45:10) welcome.
Katherine Rivera (45:14) All right. You don’t like me right now, but I have one more, no.
Lyndsey Farmer (45:17) No, you’re fine. You’re fine.
Katherine Rivera (45:20) We never got a response on when I provide, I’m happy that a provider, we could do a request with 85 percent. Yeah. But when my provider hits the 100 percent and I submit it and then it comes back at me with 79 percent or even 73 percent, whatever I need to know why it’s doing that and it doesn’t specify and I never got an answer on that. So, I don’t know, no, that’s something I.
Lyndsey Farmer (45:51) Know that the profiles fluctuate all the time depending. So you could be 100 percent like right this minute. And then if something expires or we need something from the provider or anything could take it back down to 80 percent depending on what that particular item is, could go back to 92 percent, 95 percent. It’s going to fluctuate.
Katherine Rivera (46:14) So, you’re saying basically that if it’s at 100 percent, we submit the task. And then if it’s missing a Coi, let’s just say it’s going to task it out saying missing Coi and come back at whatever percentage, correct? Okay, that makes sense. Okay?
Lyndsey Farmer (46:27) Yes. Yep.
Katherine Rivera (46:29) So, if that’s committed on the task side, will it bring back that profile to a specific percentage or do we have to, re, import the caqh? No?
Lyndsey Farmer (46:42) You don’t have to re, import the caqh. If you send the Coi, they will update the caqh, and then the profile will go back to whatever it.
Katherine Rivera (46:51) Was, and the profile goes back to green being 100 or whatever it is. Okay. Perfect. Yep. That brings me one more question. I’m sorry, but I need to ask because we’re it’s going to come down. So, if a provider, we have older providers that have enrollments, that are not, you know, obviously that are already secured and they already enrolled in our products… they’re not going to be their profile. If it’s red at 93 percent. Does it make? Does it make any difference? Like does it, does everyone need to be at 100 at that 100 percent limit? Okay? All right. No more for me. Okay. That’s all I had?
Lyndsey Farmer (47:30) All right. Anything else?
Kelly Martinelli (47:36) Well, I’m I have other things, but I know we are like, so short on time, but I want to know Lindsay from you because I went through their list and I’m like holy cow.
Kelly Martinelli (47:49) I don’t know how they’re actually surviving, honestly, I mean, to me, it’s a lot of stuff that a lot of moving parts and it’s really hard to be organized. Okay, just be honest. So, I know that you’re going to take all the enrollments and I know they’re going to push all of that stuff over to you. But let’s talk about what other stuff like that you can handle, if they got to focus on something else like revalidation or whatever else you guys do. Yeah.
Lyndsey Farmer (48:20) So that’s more of a question for Jack when it comes to like what other products we have and how they can be used, that comes really down to Jack giving you those things. Okay?
Kelly Martinelli (48:36) Yep.
Kelly Martinelli (48:41) So, really, right now, all medallion does is really enrollments, well?
Lyndsey Farmer (48:46) We do enrollments, we do revals, we do follow ups. We do credentialing, we do licensing.
Kelly Martinelli (48:53) Primary source verification, that kind.
Lyndsey Farmer (48:55) of stuff. We do primary source, huh, the caqh management, let’s… see what else… I think, privileging, if you, I don’t know if you guys do any privileging?
Kelly Martinelli (49:11) So, so they do asc privileging, like, they get all those documents together and stuff, but they also do primary source verification for that. And that, I mean, primary source verification takes a long time. Yeah.
Lyndsey Farmer (49:25) That’s part of, the primary source verification, I believe and don’t quote me on this, I believe that is part of the ongoing monitoring, piece of medallion. So, if you have ongoing monitoring once it sees that is needed, it will automatically start the primary source verification. Again. Don’t quote me on that. These are bits and pieces that I hear throughout the day in reading different people’s chats, and kind of what clients are asking and things like that. But Jack would be your Guy, for all things medallion and kind of okay.
Kelly Martinelli (50:01) So, can he come to our next meeting that you can ask him those questions? Because Jack and Sony need to understand, what can be done and what can help them out. As far as, yep.
Lyndsey Farmer (50:14) I can invite him and like I said, I’m going to try to get a one off meeting together with Naomi and, Jack as well to kind of go through some of these implementation, taking it all the way back to implementation with the tracking and kind of where, what the communication was surrounding that.
Lyndsey Farmer (50:32) I apologize. I wasn’t there for that particular piece. So I’m kind of in the dark with it. But, at least we can get that answered and then, to kind of, pick again at these product lines, and see if there’s kind of what we can do about that and.
Kelly Martinelli (50:53) Doug’s going to say we pay you guys a lot of money.
Lyndsey Farmer (50:55) Yeah, I totally get it. And.
Kelly Martinelli (50:58) We’re not getting, what we need out of it. So, totally understand that’s going to be his first comment. Okay. Yeah.
Lyndsey Farmer (51:06) I totally understand that. And, yeah, I would unfortunately… at the, there’s nothing I can do about that, that’s way above me in anything that needs to be changed or if we can change anything.
Lyndsey Farmer (51:24) Just like I said from my knowledge, and it sounds like from Naomi and Greg’s knowledge that’s kind of just how it’s set up. But again, we can talk about it and see what we can figure out.
Kelly Martinelli (51:35) Okay. Sounds good. Thank.
Lyndsey Farmer (51:36) You. All right, you’re welcome. Let me know if you need anything, I will follow up with you on some of these outstanding items as I get updates. So I’ll try not to wait until our next meeting. If I get updates before then I will send them out and then I’ll try to get that one off with you guys, too.
Katherine Rivera (51:53) Okay. And we’ll send you the diploma example.
Lyndsey Farmer (51:55) Yes, thank you so much. Thank.
Kelly Martinelli (51:58) You all.
Lyndsey Farmer (51:59) Right. Have a good.
Kelly Martinelli (51:59) Day, guys. Bye.