Transcript
Shannon Costine (00:00) how are you?
Cody Smolka (00:06) I am doing all right. How are you doing? I’m.
Shannon Costine (00:10) on the struggle bus today, man? Yeah, I got a terrible headache.
Cody Smolka (00:16) Yeah, I ain’t feeling so great this morning. Either. Sorry… I’m definitely with you on the struggle bus. That’s for sure.
Shannon Costine (00:25) Yeah, I’ve had kind of a flu bug that’s going around. So, I don’t know if that made it worse, but half of our office is sick. It’s crazy. Yeah.
Cody Smolka (00:35) Yeah, I believe it. Well, then we definitely don’t need to keep each other long, but I do have a couple of questions for you and then see if there’s anything you have for me when a nurse practitioner who we are actively, you know, doing the ongoing monitoring for, but also is a part of in home connect and is involved in pay or enrollment tasks and stuff when they resign and leave Emily, Nika, lock for in home connect of Michigan. I went into medallion and I put a termination date in her profile and then I went to the notes tab and I just put, Emily no longer works for this organization as of, you know, this date just so that way it’s like prominent and available. I’m not really sure if you guys have like a notification process or if I need to go comment on that pending or if there are any pending enrollment lines that are, you know, in progress still that never completed if I need to put a comment on there. So they don’t continue those efforts or they can withdraw those efforts.
Shannon Costine (01:38) Yeah, we need to withdraw them. What’s the provider’s name again?
Cody Smolka (01:42) Emily. And then last name is Nico Locke N, IK o L a UK, Nico Locke?
Shannon Costine (01:50) Do you know if she has anything pending? I’m pulling her up now? Yeah, I.
Cody Smolka (01:55) don’t remember.
Shannon Costine (01:56) She’s got one and it is align senior care.
Cody Smolka (02:02) Oh, and that’s the one they were supposed to close the line on because… looks.
Shannon Costine (02:09) Like it’s adopted. So it was one that you were already working on. Oh, maybe there?
Cody Smolka (02:16) Was another provider that they said, align senior care network has to go through xyz network review. And so, therefore, can we close this line if you want them to go through that review? They need to. So I was like, yeah, go ahead and close all those lines for align senior care.
Shannon Costine (02:32) Yeah, the notes literally say, resolve, yeah, let me, okay. Do you want everything closed for align?
Cody Smolka (02:40) Yeah, that’s fine.
Shannon Costine (02:42) Okay.
Cody Smolka (02:43) Align actually reached out to me via email and said, can you send me a quarterly roster? And so I just sent them a roster?
Shannon Costine (02:50) Oh, that makes it easy. Let me find the cancel. They don’t make it easy request, stopped. Client request here we go. Provider is… no longer with.
Shannon Costine (03:20) Okay. No attachment available save. Okay. That one is stopped. Let me make sure she doesn’t have any, what?
Cody Smolka (03:29) About all the current enrollments? Do they need to report an end date for her term of employment or?
Shannon Costine (03:34) That would be up to you if you, oh, Kim’s here… that would be up to you. If you want us to term them out. I would suggest it if you want us to.
Cody Smolka (03:49) Yeah. Okay. I just don’t want them to come back and ask for revalidations or re credentialings, and it’s not needed. You know what I mean? Hey, Kim, we’re talking about the process of Emily.
Kim Neathery (04:03) Now, I can hear you. Hello? Okay.
Cody Smolka (04:05) Good. I was like, Kim, we’re talking about the process of what it takes to report someone leaving like Emily nikolak, like what do I need to do to make sure her pay enrollments are stopped? And, you know, that we report the ending and all that stuff. And so we were kind of going through that.
Kim Neathery (04:19) Okay. Great. That’s a good question.
Cody Smolka (04:22) I hadn’t thought about it. Yeah. And.
Shannon Costine (04:24) Then Cody, if you have this happen again, you should be able to submit it to support and ask them to stop the line. But if they don’t get back to you, just send it to me and I can stop it for you.
Shannon Costine (04:36) Okay? Just like we just did now, it just takes two seconds. Okay? Stop all enrollments and then terminate enrollments. Okay? Let me find out. What if you need to put anything in specific for the terminations? Yeah, I will let you know as long.
Cody Smolka (04:57) As I know what your process and expectation is, I’ll do it that way.
Shannon Costine (05:00) Appreciate it. I will find out for you and let you know… are you up for hire to train the rest of the clients?
Cody Smolka (05:10) Yeah… you guys would wish, right? I had another vendor, bamboo health. They tried to ask me the same question. Can you train our, you know, the people like you were such an advocate? Will you publish a success story with us? Will you come on stage? I was like, no, I will not do all that. They’re like we’ll give you a 75 dollar gift card. I was like, no.
Kim Neathery (05:33) That’s not enough.
Cody Smolka (05:35) Amen.
Shannon Costine (05:36) I agree with that.
Kim Neathery (05:39) Like I could be a consultant but not for 75 dollars.
Cody Smolka (05:42) Exactly a 75 dollar gift card, and, you know, thank you. And, I.
Shannon Costine (05:48) Appreciate that.
Cody Smolka (05:51) The other question I had was, as I’m receiving communications from payers, like, the other day, I received a communication that Judy Bailey in Indiana was approved by humana. Okay. And so, I went ahead and I loaded a copy of that approval letter to the notes of that payer enrollment, which is still processing or in progress status. Okay? What’s the best method? What is the best process for me to take on my end? Do I just send that support email as well? Because I’ll notice, like if I put them there in the notes or whatever, the status doesn’t get pushed from, in progress to completed for sometimes days or weeks until someone goes in and sees it, you know, like this one, they actually just did an update three days ago, and it says, next follow up is in two weeks from now. And so, I’m like it’ll be two weeks from three days ago that they go back in and follow up on that task because when I put a note in, I know, that doesn’t generate a task for you guys. It doesn’t generate a notification. They’re not truly monitored. So, what’s the best way to make sure that I get when I get approval letters that are coming directly to me and I don’t know if you guys have copies. I don’t see you guys ceasing on that email?
Shannon Costine (07:09) Exactly what you did, except I would give me the name of the provider again. Sorry.
Cody Smolka (07:16) Judy Bailey, Judy? Yeah.
Shannon Costine (07:23) I believe there should be a place where you can check.
Shannon Costine (07:30) Which one was complete?
Cody Smolka (07:33) Humana?
Shannon Costine (07:35) Oh, man, which?
Cody Smolka (07:37) Is perfect. Because I mean, she… she’s been getting… humana patients and her claims are not being paid right now because she’s out of network… or well, she was out of network.
Shannon Costine (07:54) Was, yeah… I thought there was a place where you could request support right on the line item. Let me… find that out for now. I will send it over to the team and let them know that this needs to be closed out… okay with approval, but I would say, definitely send it over to support.
Cody Smolka (08:19) Have you done that before on?
Shannon Costine (08:21) The line item where you can request support, right on that provider’s line?
Cody Smolka (08:26) You want to see what it looks like on my screen?
Shannon Costine (08:28) Yeah, if you don’t mind.
Cody Smolka (08:33) All right. So, when I go to Judy Bailey?
Shannon Costine (08:38) Are you sharing your screen? Oh,
Cody Smolka (08:41) I guess I have to press accept. Yes. I chose the screen to share. I didn’t press share. Okay. I’m on her. I’m going to click on humana. And then this is where I went to the three circles. I pressed view details. And what I did was I just put add note and then I put my note in here with the attachments of the approval letter. For one approval letter is for the choicecare, and the other approval letter is for the medicaid. Have you?
Shannon Costine (09:10) Done that’s? Perfect. But excuse me close that out for a second. I want to look at the, yeah, go back to that line where you just were, have you done that need help? Contact us?
Cody Smolka (09:21) I have not, I can click it and see what it does.
Shannon Costine (09:25) I believe that’s where support will get. Yeah. And then that’s where you can say providers approved, please see notes. Now, this is a robot. I would suggest if you need something more in depth, put, I need a live agent in that chat.
Shannon Costine (09:54) I’m still going to send it over though to make sure that they close it out. Humana is approved.
Cody Smolka (10:11) I’m just going to chat in there and see what it does. I’d like this pair of Roma has been approved. I’d like to update it and complete it. And then it just said a ticket was created have.
Shannon Costine (10:20) You? Okay. Have you created or sent anything to support on this one?
Cody Smolka (10:25) I did forward them an email yesterday. Okay. I wasn’t sure if that was what I was supposed to do but I did it.
Shannon Costine (10:33) Oh, that’s perfect. Yes. It was, I’ll circle back with them again today just to make sure that they get that closed out.
Cody Smolka (10:41) So, for me, it’s weird, like when I create a new email, it ties a name to it, which I guess is the last time someone did it. So like I’m like,
Cody Smolka (10:54) so there’s the medallion team support at medallion co, but then there’s this other email that I see that gets used a lot, and it’s called payerenrollments at medallion. Com. Is it best to go through the support… yep?
Shannon Costine (11:09) Go through support. You’re going to get quicker action. You should get quicker action.
Cody Smolka (11:14) And then that’s the payerenrollment one that’s the one I sent it to. So I did not send it to support. I sent it to this one. Don’t worry about sending.
Shannon Costine (11:21) it because what you just did is sending it to support. Okay? But for future, yeah, send it to support. All right, cool. And then when.
Cody Smolka (11:33) I send… an email to payerenrollment at medallion. It sends it to this person’s, name. It puts this person’s name in there. And I’m not sure if it works. When it does that. That’s what it looks like. Let.
Shannon Costine (11:51) Me ask about that one. Yeah, I always get an Asia a lot when I send to support. I don’t know if you’ve ever gotten that one.
Cody Smolka (12:00) I haven’t yeah, it looks like this. It looks like it says, I sent it to badru… ram, but when you hover over, it was the payerenrollment email. So it kind of assigns it to a name, I guess the last person because sometimes when they reply, when emails come from this inbox, whoever it’s coming from, they actually put their name in the email body like from Asia from badru, from Danette or whatever their name will be under the thank you or whatever.
Shannon Costine (12:36) That’s good. At least, you know, who you’re talking to?
Cody Smolka (12:39) Right. It just looks like I’m like, who did I send this email to? Did it go to that person or did it go to the site? I will.
Shannon Costine (12:49) Find out for you… to see what, just to see out of curiosity what that pay enrollments for, but I’ve always been told to use the support but I would do it truthfully, I would do it through where I just showed you through that link because then you can track it and please, if you are not getting action, send it to me and, I will give them the elbow in that job.
Kim Neathery (13:15) What?
Shannon Costine (13:16) Else you got? I?
Cody Smolka (13:17) Think that was it for now, excuse?
Shannon Costine (13:24) Me with your only six tasks. I.
Cody Smolka (13:27) know this.
Shannon Costine (13:28) One.
Cody Smolka (13:31) She’s still pending oig review. So there’s nothing I can do about it. He’s still pending oig, review. The priority health portal is a nightmare. I have, they want access to it and I’m like honey, so do, I have tried and tried like I cannot get it to work. Okay, Torres. I actually have a conference call with him this morning to go over his paycos. I’ll ask him about his team, HP. It’s up for revalidation and I can’t add him to ours until his is done here’s. Another one that’s like the astrana health… that the line can be closed. So, okay.
Shannon Costine (14:13) Wait, which one is that? We’ll just do it, right?
Cody Smolka (14:15) Now, dr Torres.
Shannon Costine (14:22) What’s the pair astrana that’s right?
Shannon Costine (14:30) You’ve got quite a few processing for him. Why do you want that one closed? Just so I can put a note?
Cody Smolka (14:37) In, outside of service area? Okay?
Shannon Costine (14:43) I see needs client attention, okay? Client input.
Shannon Costine (14:54) Why won’t, it? Let me close this one out.
Shannon Costine (15:03) Provider input, follow up?
Shannon Costine (15:10) All right. I’ll ask them on this one because for some reason that’s not letting me close this out, dr, Torres for astrana… and you said outside of service area? Okay? Yeah.
Cody Smolka (15:28) That pair is outside the service area for him. So he can’t it’s not a, he won’t they can’t credential him, okay? Perfect.
Shannon Costine (15:41) Anything else you got, Kim? Were you gonna say something? I saw you come off mute. I didn’t know if you needed to ask something. I.
Kim Neathery (15:48) Don’t I don’t think so. I was just gonna say one thing I guess is that Shan, this has been so much smoother with you here. So, thank you. I mean, I am not kidding. I just was talking to Amy this morning. I’m like it’s night and day from what we were doing before since you’ve come on. So we very much appreciate your help. And, I mean, I’m sure Cody can speak to it better than me, but I’m like doesn’t feel like we’re beating our head against the wall, you know? So we very much appreciate it. So, thank.
Shannon Costine (16:18) You so much because I’ve had a few rough ones. So thank you that.
Kim Neathery (16:23) Helps me.
Shannon Costine (16:24) That means a lot, yeah.
Kim Neathery (16:25) I think Cody, you would agree, right? It’s been so much better. So, I think I.
Cody Smolka (16:31) agree. Yeah, I agree. Yeah.
Kim Neathery (16:33) We were, we were, repeat what is going on, you know? So it was, it’s, very much appreciate you, so.
Shannon Costine (16:42) Thank you. That really makes.
Cody Smolka (16:44) my like what you’ve done like just now with you taking care of in.
Kim Neathery (16:47) The history?
Cody Smolka (16:51) Of before, it would take three or four calls to get that same task done, and I would tell the people on the call like we talked about this last time and you said you were going to help me and you said you were going to put a support to get in and I escalated it to you, but it’s still not done. So, thank you. I mean, just the fact that we finished these things and we can come to the next call with new things, not the same things is great for.
Kim Neathery (17:14) Real. So, I just want to say that this morning, so.
Shannon Costine (17:18) Thank you. That really makes my day. I really appreciate it. And thank you, Cody. I appreciate.
Cody Smolka (17:23) you. Now, if I can just get the MDS loaded into the, I have some ideas. I was going to talk to Kim and John about it this week. We’ve got all the nurse practitioners for hospice loaded into the.
Kim Neathery (17:34) Monitoring section. It.
Cody Smolka (17:38) Didn’t take the first time I loaded it Shannon.
Cody Smolka (17:41) And so I waited about a week and then I tried again because it said give it 24 hours and I was like, I was like, and then 24 hours came and went and I was like, let me give it two days, let me give it three days. And then the weekend came and I was like, let me try next week. And the second time I did it, they were there by that afternoon. I think when I loaded it the first time I, there were 115 people on the roster and so I filled it in, put everything in there. When I loaded it. I did get a little error banner on my screen that said, unable to load line 116. And I’m like, well, duh because it’s blank. I was like there’s nobody on 116. It stops at 115, you silly system. And I was like, well, let me just wait a little while and see if it loads the first 115 and it didn’t and but when I, so, what I did before I loaded it again was I went into this, the roster and I clicked on line 116 and I deleted it.
Cody Smolka (18:31) Like, right? Clicked it and deleted it and made a new one. 16. And then when I reloaded it, I didn’t get that message and then it was, and then it worked. So I was,
Kim Neathery (18:40) like, yeah, just a little glitch. Yeah.
Cody Smolka (18:42) I guess it was just a glitch. Let me get rid of line 116. If it thinks that there was a character in there before and I don’t know, so.
Shannon Costine (18:49) Good. I’m glad, it worked. If that doesn’t happen though, we can have our tech team load it for you. Obviously, it’s quicker for you just to upload it but, if it stops like that, just let me know and I’ll have them take care of it, but I’m glad it worked. They.
Kim Neathery (19:04) Were in there this morning, Cody, when Amy and I were looking, so the ongoing monitoring is happening. So that’s exciting it.
Cody Smolka (19:09) Is yay.
Shannon Costine (19:10) I will get you guys that report too. I did, we were on a team meeting this morning and somebody was saying that you really have to look at some of those monitors. And some remember you were looking at the report. You were like, what do I do with this? So somebody was saying that sometimes the provider will come back with an issue and it’s not that provider. And I’ve seen that happen on a few. So just make sure it’ll give you additional data in the row to show like address or something to try to match it up. So if you see that a provider comes back with an issue, just make sure that you fully look at the data before you throw up the flags or the bells. You know what I mean? Yeah.
Cody Smolka (19:48) Yeah. You know, speaking of… Shonda in Texas?
Kim Neathery (19:55) Yeah. I.
Cody Smolka (19:56) went in and updated her caqh profile, and I updated the disclosure questions in medallion because we had one payer that came back and found out that her Dea registration was surrendered and they did a credentialing review. And I mean, she still has her nurse practitioner license. It was a voluntary surrender. Suggested if you didn’t voluntary do it, we were going to take it anyways, whatever. So they terminated her. But since then, I’ve had two other payers come back and she’s actually under review right now with two other payers, well met and superior. And but when they pulled her caqh, her disclosure questions were like no, no problems and they’re like you need to change question?
Kim Neathery (20:36) Number. You do have a problem? Yeah, you.
Cody Smolka (20:39) Need to change 13 to yes. So I did those things. I did that in medallion, she wrote a statement that we’re providing to the payers. And so when you guys are doing enrollment for her, do I need to load that statement into the system? Or is that something that we just wait until the pair requests it? And I’ll handle it or what’s our process for situations like that? I?
Shannon Costine (21:01) Would 100 percent load that in there when you go to put the request in so that they can make sure that they send it with the initial application. Okay? When, when you have something like that now, it should still be in the caqh, but I would still, I would still load it for her because I do not want them to miss that and.
Cody Smolka (21:22) As payers are finding it themselves because they’re doing their own npdb queries and they’re finding it. And that’s what they’re coming back as we did a query in national practitioner databank and found this, can you give us more information? Is I know a lot of pairs are like if you’ve had changes or if you had this or if you had that, you need to report it, does medallion recommend reporting this to the other payers ahead of them doing their own queries and finding out or just, let it rest?
Shannon Costine (21:51) I would, from what I’ve heard, I would just let it rest and then when they request it, send it over, that would be my recommendation for.
Cody Smolka (21:59) You.
Shannon Costine (21:59) I.
Cody Smolka (22:00) agree that’s what we were.
Kim Neathery (22:00) That’s what we thought too. But yeah, yeah, I.
Cody Smolka (22:04) Just wanted to make sure I didn’t load it in there and it was start flying out to payers without us knowing because I wasn’t sure what this process was. Yeah, I was like, I want to put this in there yet, right? I don’t want to change that question to, yes, I.
Shannon Costine (22:15) don’t want to do that. Don’t make me… that. Yeah, that’s what I would recommend. And if they ever come back to you and say, hey, why didn’t you report this? Just put admin error. That’s what I would just say it was an error on our part. Here you go and they won’t dig you or the provider because I have that happen with the anesthesia group that I was at. We had a few that came back and even medicare was fine with us saying it was an admin error which they’re like the, they’re the bullies, you know? Yeah.
Kim Neathery (22:45) Exactly.
Shannon Costine (22:48) All.
Cody Smolka (22:49) right. Shannon, I hope your headache gets to feeling better.
Shannon Costine (22:51) Thank you. And.
Cody Smolka (22:53) I’m over here just not feeling great. Either we’re both in the same, we feel like shikaka, we’re both like I’m like she’s like I’m a struggle boss. I was like girl me too well, me.
Kim Neathery (23:04) Too, but not because of that. I’m like I’m you know, 52 years old and moving my daughter and I mean between, so my daughter is, she’s her and her husband live at in fort hood, but he’s in Poland and they bought a house because he’s not coming back and been gone since last August, but he’ll be back in June Ish, but they bought a house in the meantime. So my husband and I, who pay for people to move us, moved to them. It’s like between that and then my mom, you know, godi, with my mom packing up all her stuff, I’m like my whole body is like you’re hurting, so.
Shannon Costine (23:43) My, my stepson is in Colorado at fort Carson and they’re getting ready to move the entire squad, everybody over to coming?
Kim Neathery (23:54) Yep. They are, he’s are they the infantry? It’s the infantry? Yep. He’s so he’s.
Shannon Costine (24:01) in tanks, but they’re moving everybody. He’s been to Poland twice. They’re talking about putting him a third time, which is crazy. Yeah, I.
Kim Neathery (24:09) know. And it’s not like, I mean they’re doing anything. They’re just over there training, you know, I mean, it’s just kind of nuts, but whatever. But, and now they’re so Sean just left from Poland or they’re packing up to go to Germany for some big, you know, training like a big, like everybody, you know, kind of coming together and training there. But here’s what’s so great. You guys, I just, I love it. We didn’t know settlers is jumping on. I’ll have, to do that. You’ll have to jump on that Cody because I may not be able to, but is their neighbor literally? So my daughter just graduated nursing school, their neighbors next door, her husband’s in the military. He’s in Germany. Right now. He’s combat medic. She’s graduates in may with her nursing degree and they’re the exact same age I’m like this is such a great little like it’s perfect for them. So I was excited how?
Shannon Costine (24:58) Long has your son been in?
Kim Neathery (25:00) It’s my son in law, but he’s been in, I think this is his fifth year now, so I think he’s rolled into maybe he’s at the end of his fourth. I can’t remember. Yeah, it must be at the end of his fourth because no, it might be his fifth. I don’t know. I have to look four or five years. Yeah. Those two have been together since they were 13, 14 years old. So, yeah, so.
Shannon Costine (25:20) They got.
Kim Neathery (25:21) married young, but they’ve been together since they were, you know, babies, I mean, call it together. You know what I mean? So.
Shannon Costine (25:27) Well, you rest this weekend. It sounds like you need it.
Kim Neathery (25:30) I’m telling you it’s terrible. So, all right.