Transcript
Jason Zednick (00:00) hi, good morning.
Jason Zednick (00:23) How is everyone today?
Mwinship (00:26) Good. How are you?
Jason Zednick (00:28) Doing okay, doing? Okay. Yeah, if I can get through today, I can get through tomorrow. That’s something.
Mwinship (00:46) There we go. All right. So, did you, Jason, did you get my list of questions? I?
Jason Zednick (00:54) Did I did KP’s on his way too? So, okay, I know we have some questions for him, but yeah, I did. Can you tell me more about what you mean about responsibility for board certifications?
Mwinship (01:11) Tina, that was Tina’s question. Unfortunately, she had a doctor’s appointment this morning. So what I can do is have her elaborate and then send you an email unless Alyssa, you know, what she was, her question was, I don’t unfortunately.
Jason Zednick (01:32) Okay… great. That’s all right. We can come back to that.
Jason Zednick (01:43) Another one of your questions was Jaclyn hill of tricare, and your question made a bunch of sense. So, let me just sort of show you what’s happening with that. And I think that’ll answer your question. But if not, we can always dig in a little deeper. So, how… do I share?
Mwinship (02:09) Yeah, that was also another Tina question too.
Jason Zednick (02:19) so, so her question was, if I understood it correctly, is like we have Jaclyn and we have the enrollments. We have the tricare east, and it’s like here, it’s like recorded as an enrollment and you can see here, copc hospitalists, location… you know, whatever tenure effective date. Okay? But in the requests, there is still a, these… are not alphabetical. Tricare is still an open request. And so, okay, like why is there an enrollment? And why is it also open? It’s because we have the ability to do what we call partial completions. So when they’re hey, KP, welcome. When we do… when we get like, yeah, you know, like they’re good. And we have all these follow up questions to like capture for the enrollment, like what’s the effective date? Can you confirm they’re good for? Location? One, location, two, location three, location four, what’s, the pay your id? All that stuff. We also want to capture that. So sometimes when we have some information but not others, we have the ability to be like, okay, like this part’s done. But these aren’t and one thing you can do is, so we have that one location on the enrollment, but there’s nine practices that were included. So what you can see when you hover is you can see like that green icon. So that is the one that’s done. We’re still trying to confirm the other eight. And so as we confirm them, we’ll add those to the enrollment until everything is wrapped up. That’s all that is that’s what’s happening there?
Mwinship (04:09) Okay. Now, is there a reason why it doesn’t all get done at the same time? Is there, just to make sure in my head, I’m understanding, is there separate there’s not separate enrollments being done for each?
Jason Zednick (04:21) Location? No, it just depends on how the payr confirms for us. Okay? You know, like sometimes we’ll talk to somebody and they’ll be like, yep, they’re par and we’ll be like, okay, great. Can you confirm these locations? And they’ll be like, well, I don’t know, check back. It’ll show up in the directory. Okay? And so we try to keep it open until we confirm everything. And that’s all that is if there’s an enrollment request where you’re like particularly curious, you like specifically need to know. For some reason, I would just like come into the notes and see what’s happening. We typically capture like, yeah. So like this one verified on the portal, they’re in network linked to the 10, but only affiliated with the primary location. So we submitted a request to add the rest to the group. So that’s probably going to take a little bit of time. So that’s all that’s why sometimes payers give us everything we need. Sometimes they don’t okay. Yeah.
Mwinship (05:23) Makes sense.
Jason Zednick (05:24) Yeah. Okay. All right. So that’s that… you had a question about?
Jason Zednick (05:37) Credentialing and recredentialing and credentialing files. So.
Mwinship (05:41) One of the things that I found out yesterday and I do not have the new ncqa handbook, but we are being told by one of our delegated… audits that we have to keep a file that of so like say, you know, we have a provider, they were initially credentialed three years ago through medallion. So just say we’ve been on medallion for three years. It comes time for a recredential, and it gets approved. Does that initial documentation? Is that housed somewhere?
Jason Zednick (06:21) Yes.
Mwinship (06:22) Okay, perfect. Because we’re being told that they and I don’t know if this is correct, but they are telling us that it could possibly be up to 10 years retention for those files. I wouldn’t think so. That’s.
Jason Zednick (06:37) a big look back.
Mwinship (06:38) Because I thought, you know, especially with our delegated audit audits, they could only pull stuff from the year pro before.
Jason Zednick (06:46) That’s what I would expect. Yeah. So.
Mwinship (06:49) But they told us yesterday with one of our, and it was one of our big payers that it was a potential of 10 years, but she couldn’t provide that document. And like I said, I don’t have that new book. So I don’t know what the retention policy is.
Jason Zednick (07:07) I’ve never heard of it. So.
Mwinship (07:10) I mean to me months would be, you know, but so I didn’t know where that information was retained at in medallion and how long medallion retained. Yeah. So.
Jason Zednick (07:21) So, let me show you like we’re just going to pick a provider we’re going to sit here and use because… we only have like one file. It’s like a little like, but what you’ll be able to do is either their name or npi. If you search them in the credentialing section, you’re going to see all of the records for every file we have. Okay? So we have one scheduled and one closed. So it’s like, okay, well, what’s the one closed? And we can see, okay, it is a recredential, that was approved. So over time, she’s going to have two recredentials that are approved. She may shoot. There may also be ones that were cancelled for whatever reason, that would also show up here. So you have everything but you’ll easily be able to say like, okay, this one’s approved. And then just like the ones you’re working now, like you can come here and get the file and then download it. And also… there’s this like notes section so that if anything happens at the time where you’re like this is something important, never going to remember it. If I’m audited in nine years for a 10 year look back, you could like make a note here and it would just be here. Okay? Waiting to explain whatever that thing might be.
Mwinship (08:43) And what type of retention do you have before it gets archived, do?
Jason Zednick (08:47) You know, everything stays here forever.
Mwinship (08:51) Yeah.
Jason Zednick (08:52) Okay. So, as long as you’re with medallion, you’re gonna have the history of every credential record we do for you. Okay?
Mwinship (09:03) Because I didn’t know if we needed to start downloading every single time and saving it somewhere else. Yeah.
Jason Zednick (09:10) So, like that kind of thing, like I’m never gonna say that’s a bad thing but it will be here. So it’s just sort of like how you want to manage your stuff. Like that’s a lot of work to like sort internally. And also there’s some like export options that if you ever decide we do want to pull everything from medallion, you could stand up the API and you could have a team automate that process. So it’s a lot less manual work. So that, that’s an option as well. Okay, one thing to know is that if a provider is leaves and they’re deactivated, this data here, it doesn’t go away. It does get hidden. So, right, activated provider, you can’t search for but the information still exists, it can be pulled from the API. And if you didn’t have the API stood up, you can reactivate the provider, access the data and then re deactivate them and that.
Mwinship (10:14) I had to do that with the provider a couple weeks ago, look something up and that’s what I ended up doing was reactivating her and then deactivating her as soon as I found the information I needed. So, yeah.
Jason Zednick (10:26) Yeah, it’s like it’s… a bit. It’s a bit of a hole in like the UI of… like how do I easily access that information? Because because you’re figuring out if you get audited, it’s going to happen a lot. There’s going to be a lot of providers that left.
Mwinship (10:41) You, right? But.
Jason Zednick (10:43) It’s it is still there. You just have to do exactly what you did. So… all right, great. You had a question about roster enhancements around race and ethnicity, this is not… what am I trying to say? This is not on my radar. Is this a conversation that KP that y all had? It’s just not clicking.
Mwinship (11:12) No, this is one, this is something that we just learned this week from one of our payers that has a roster and that they are, they’re going to be adding the race and ethnicity on to their data collection. And so that’s going to be an enhancement on a roster. We just don’t know when that’s going to happen. And I didn’t know if that’s information because it doesn’t have to actually, it could say, you know, they refuse to answer, didn’t provide, but if it’s there and we have captured it, they would like us to provide that to them. But I guess it’s going to be some type of a drop down box that is going to be on the roster. And I didn’t know if that’s something that we would be able to.
Mwinship (12:07) Capture since it’s going to be a drop down box on their side on the roster.
Kunal Parwani (12:13) Yeah. Is this for a delegated roster?
Mwinship (12:15) Yes, it’s going to be for our qcp quality.
Kunal Parwani (12:19) Care. Oh, I see. Yeah. I mean, so you can document it here right where Jason has it up under the identity section. So you have race and ethnicity for the drop down of on their end, we’ll have to take a look.
Mwinship (12:39) Okay.
Kunal Parwani (12:42) Technically, there is a way, but if they have like, you know, a huge list in the drop down that it’s going to take me a while to try and map it. Okay? Usually at least for like the race and ethnicity, the options are pretty standard in the, you know, across the, pretty much across the industry. So I’m hoping that.
Mwinship (13:05) They stay standard.
Kunal Parwani (13:07) Yeah. I’m hoping they kind of align, you know, somewhat similar where we don’t have to do too much of, you know, work. But yeah, I mean, once they send you that the updated template just forward that to me and I’ll take a look.
Mwinship (13:22) Okay. Yeah, because apparently that is part of the new ncqa guidelines for xxvi… again, I don’t have a book but that’s what it’s part of the updates… so that they need to collect that data.
Kunal Parwani (13:44) Interesting.
Jason Zednick (13:47) So, yeah. So it sounds like assuming the options are limited KP, you do have the ability to map values to other values. I.
Kunal Parwani (14:02) Mean, what I’ll essentially have to do if the values are too far and they’re you know, let’s say they don’t accept R’S then I would have to map each value from R’S like R dropdown to their dropdown which is just annoying, but.
Jason Zednick (14:22) There’s not that many. I just pulled it up. Well.
Kunal Parwani (14:26) R’S is not that many. I guess R’S is not that many. Yeah, but depending on what you come back with, right? Yeah. Okay.
Mwinship (14:35) Okay. Perfect. Thank you.
Jason Zednick (14:37) Yeah. So just share that when you get it. Yep. And we’ll take a look for you.
Mwinship (14:41) Okay.
Kunal Parwani (14:42) And then since we’re on the topic, I know Alyssa had a couple of things to discuss for delegated rosters.
Allissa.Chute (14:51) Yes. So, I have a question, yes, the data on the add tabs, the update tabs and the term tabs that’ll all be deleted, right?
Kunal Parwani (15:01) Yeah. So, okay. What do you mean by deleted?
Allissa.Chute (15:05) They don’t need to be there. All that needs to be there is the full roster tabs?
Kunal Parwani (15:12) Oh, so you don’t need to submit, like the well.
Allissa.Chute (15:16) All of that information has already been submitted. Okay?
Mwinship (15:20) So, Alyssa, are you saying that once you have added done the add or done the term, then the next month, it will be removed?
Allissa.Chute (15:29) Exactly. You’re not.
Mwinship (15:30) Always submitting. Okay. So that’s right? One month, it’ll need to be there and then the following months?
Allissa.Chute (15:36) It’d be blank. It would be blank because I fill it up, every month, I fill it up. And when I go to the next month, I delete the previous month.
Kunal Parwani (15:45) Does that make sense? Yeah. So essentially, you’re only capturing changes like adds updates and terminations from the previous time you sent the roster?
Allissa.Chute (15:54) Exactly. Yep.
Kunal Parwani (15:55) Exactly. So it’s going to be the same process here. The only difference is going to be you really don’t need to do anything manual on the roster itself. Okay? As long as, let me, sorry, let me put it in a good way. So as long as you’re capturing everything in medallion that will flow onto the roster itself. Okay? And I can send you guys a little email with the different events that can happen in medallion that will trigger either an add or an update or a termination, just so you have more clarity and insight into what triggers it. Okay? But yeah, and yes, Alyssa, it will be each month that I generate the rosters, it’s only going to grab, you know, whatever has happened after the previous generation. Okay? So it will be that new stuff. And then the full roster if there’s any sheet on any of the files that’s going to be the full anyway?
Allissa.Chute (16:57) Okay. Perfect. Yep. So.
Kunal Parwani (17:01) Did you get a chance to kind of go over them? Were the columns? Fine? Were the mappings? Fine?
Allissa.Chute (17:07) Everything was perfect.
Kunal Parwani (17:08) Oh, beautiful. Okay. So in that case, I’ll have you guys already submitted for this month or?
Allissa.Chute (17:17) Oh, no, we submit the last day of the month.
Kunal Parwani (17:19) Okay. So that’s fine. Let me activate the rosters for you guys, you know, starting this month. So between the 20 first and the 20 fifth, I’ll send you over the rosters. So you have a few days to check and any changes if you need to, you know, if you need me to make any changes, I’ll do that and then you can submit them. But that’s essentially how it’s going to go every month is between the 20 first and 20 fifth. I’ll send them over to you. You’ll review them, take a look at them if they’re good. You forward to your peers, if they’re not, you’ll come back to me and, you know, we’ll try to figure out what’s going on. Okay? I think I had to mention one more thing about that, but I can’t recall.
Mwinship (18:10) It’ll.
Kunal Parwani (18:11) come to me when we’re talking about other stuff.
Jason Zednick (18:16) Well, that’s great. Glad to hear that the drafts look good. That’s huge. It’s a big step. Thank you.
Mwinship (18:22) Now, just hopefully that the payers will ingest that data with no problems. So that’s going to be the next hurdle. So I have two more questions. Well, one’s not a question, but can we get the provider notifications turned back on? We have all of our providers up to at least 85 percent completion in medallion. So we would like to go ahead and get those provider or to get all the providers turned back on.
Jason Zednick (18:56) Interesting. Give me one second.
Mwinship (18:59) Unless you’re seeing something different than what?
Jason Zednick (19:01) We’re seeing? No, no, no, not at all.
Jason Zednick (19:34) Okay. Yeah. So… yeah, I can turn it on. Let me just turn it on. So I have currently is what is off, is profile reminders and to do tasks. Let me just say tasks, I can turn those both on. So.
Jason Zednick (19:59) One thing that happens that’s worth calling out is that with the profile reminders, there’s… always something on the profile that like… a provider doesn’t have, they’re like, I don’t care about that and we have identified it as required for something even though it may not be required for like something that copc needs us to do. In which case, the provider’s like, I don’t want to do that and you’re like I don’t want to do that, which is fine. Like we don’t need it, but the system will still identify it as being missing and we’ll still sort of like ping them to remind them. So I say that just to say that if a provider gets annoyed by notifications, they can go into their account and they can turn off profile reminders at the user level, so they can turn it off for themselves.
Mwinship (20:59) How often does it remind them? So say they get weekly. Okay, that’s what I thought, but I just wanted to go.
Jason Zednick (21:06) Cause I think it’s every Monday, there’s an email that goes up. It’s like, hey, this is all the things we need like this on your profile on these tasks. And if, there’s nothing and we don’t send it, but they might get that. Okay. So just something to be aware of. All right, I’m going to turn it off. All right. Sounds good. If you change your mind, we can turn off again. All right.
Mwinship (21:30) And then… amen.
Mwinship (21:50) All right. And then the last one, it looks like Alyssa… this is your question of not understanding.
Allissa.Chute (22:00) The comment under the task?
Mwinship (22:02) Comment under the task for Troy Jensen. Do you remember what was it a specific?
Allissa.Chute (22:10) Do you want me to read it to you?
Jason Zednick (22:14) What is which?
Mwinship (22:15) One, is it, it’s the?
Allissa.Chute (22:17) Third, there’s four tasks total. It’s the third one down for Troy Jensen.
Mwinship (22:21) Okay. Let’s see here. It says as per rep, the provider is listed as in network. Is that the one you’re talking about? Yep, that’s it. Okay? Oh, I do remember this one. So it says, per rep, it says provider… is listed as in network and linked to the tax id medicaid plan is not on file according to rep medicaid plan was not loaded. Okay? Due to market is presently closed. Typically the market will reopen after six to 12 months depending on the state kindly guide, how we should proceed or how we proceed. I’m baffled on that one myself.
Allissa.Chute (23:10) I am too.
Jason Zednick (23:12) So, without knowing, you know, what that conversation was here’s, what I think we should interpret that as.
Jason Zednick (23:25) So… on the enrollment request for uhc, we have the managed medicaid line of business and they’re saying, hey, providers, par, we’re good. Except, uhc… is telling us, they’re not accepting managed medicaid at this time, so I can’t complete that line of business. What would you like me to do?
Mwinship (23:56) Because we’re delegated… I guess one that should have been a roster, not an individual request.
Mwinship (24:13) And just to confirm Alyssa, you have never done individual requests for unitedhealthcare. It’s always been through the roster, correct? That’s.
Allissa.Chute (24:20) right. That’s exactly, right. So.
Mwinship (24:22) That shouldn’t have been an individual request, which is what I’m thinking is probably what they meant based on the comments that came back.
Jason Zednick (24:29) Yeah.
Mwinship (24:29) Because as a delegated, you know, having them as a delegated payer, we should automatically be enrolled no matter how many providers that we enroll in during, you know, that time frame. Yeah.
Jason Zednick (24:43) Okay. So great. So, like, yeah. So for uhc, you do not need to send submit these requests. They’re going to be captured and sent over the roster. And in that case, because they’re delegated, we can just close this request like there’s no need to, okay?
Mwinship (24:58) Should.
Allissa.Chute (24:58) I leave a comment or just close it?
Jason Zednick (25:01) I would leave a comment. Okay? And you… know, you can just ask them to… complete the… enrollment as is delegated payer. I’m not exactly sure what the wording is, but just let them know that.
Mwinship (25:22) So, then I guess this is the next question I have when we’re going down and doing enrollments… and we’re selecting the payers. Should we be selecting the delegated payers? You?
Jason Zednick (25:36) Should not.
Mwinship (25:37) Okay. That’s big because that’s not, yes. Okay. Yeah.
Jason Zednick (25:41) Here is sort of a… very good topic. So, do.
Mwinship (25:50) Not select the delegated payers?
Jason Zednick (25:52) Or for the requests when you’re submitting the enrollments only submit payers, who you need us to actively reach out and request credentialing. Okay? Or delegated, you don’t need us to do that. And so you shouldn’t.
Mwinship (26:13) okay. And that’s not going to impact the spreadsheets in any way shape or form.
Jason Zednick (26:18) No, the spreadsheets are governed by other mechanisms is the best way to say it. KP, you might have a better way to phrase that.
Kunal Parwani (26:28) Yeah. So you don’t need to have an active request or an enrollment for those delegated… payers, we should be able to, based on the credentialing events, we should be able to populate the providers on those spreadsheets.
Mwinship (26:47) Okay.
Allissa.Chute (26:50) Yeah. So, let me ask a question. So you’re saying that when we are enrolling a provider, we do not select the delegated payers like, uhc, correct? Okay.
Mwinship (27:03) Yeah. Okay. That makes sense.
Jason Zednick (27:05) In fact… what I think we should do and I can help with this is… if that’s been happening?
Mwinship (27:18) Which it has because it has, we weren’t.
Jason Zednick (27:20) yeah. Yeah. I should, we should go identify all of the open requests for all of the delegated payers and I should just have my team stop them because there’s no need for it. Okay? They’re going to be captured by the rosters and it’s just sort of a necessary work? Okay? Yeah.
Mwinship (27:44) Okay.
Jason Zednick (27:47) KP, can you do me a favor?
Kunal Parwani (27:49) Yes, can.
Jason Zednick (27:50) You just send me the list of rosters… that we have. So I have the list of payers and then I can go pull.
Kunal Parwani (27:57) That, yeah, of course. Awesome. Thank you.
Jason Zednick (28:00) Yeah. I’ll take care of that. And I’ll Ohio team. I’ll sort… of run it by you confirm before I ask my people to stop or just to like triple check.
Mwinship (28:10) Yeah. Okay. Perfect. Yeah.
Kunal Parwani (28:14) I had a couple of questions as well. First one is the one that I had forgotten. It just came back to me the, so the rosters for this month, I’m going to be generating them next week. What I wanted to ask is what… date should I be using to capture the differences from, for last month? So, February first or 20 eighth, like after that date, it’ll capture all the changes. So each, it’ll be fine moving forward because I’ll know which day I generated the rosters. So it’ll be automatic in the future, but just for the first one this month since we didn’t run your rosters. Should I be choosing like the third week of feb, and then capture any changes from there… till, you know, this month’s generation?
Allissa.Chute (29:14) I would think Melissa tell me if I’m wrong, I would think you would use the last day of the month, well?
Mwinship (29:20) When did you, is that the last day that you added information onto the roster before you submitted it? Yes. Okay. Then I would agree.
Kunal Parwani (29:27) Okay. Yep. Sweet. Yeah, that’s exactly kind of what I wanted to ask is till what date you were capturing and added all that information in. Okay. So the last day of February? Yeah, I’ll write that down. Sweet. Okay. So that was one question. Thank you for that. The second question, Jason, can I take over screen share real quick please? So I’ve been working on identifying the essentially the duplicate enrollments and it’s been a little more challenging than I had hoped. So, I kind of wanted to get some clarity and put some examples in front of you guys to just confirm if my understanding is correct. So I have this provider, right? In their existing enrollments. So as an example, we have two enrollments for anthem, blue cross blue shield for the same practice. It has all the same dates as well. The only thing different in between these two lines is essentially the line of business, is my understanding, right? That these two are the same enrollment?
Mwinship (30:38) Yes, that would be correct.
Kunal Parwani (30:42) Okay. And then kind of another example on that note is on the Aetna side, same provider… in here, Aetna has three. We have three enrollments for the same practice for the same group. The difference here is… I have two lines of business or I have two enrollments with the same line of business, commercial and government. And then also those are being captured in this one. So are these all three like… one enrollment? The only difference that I found in this case was the dates. So if you see medicare advantage is 221, managed medicaid is 221 and government and commercial are four one. Whereas on… the other ones, the date is 221 for commercial and government as well. But in here it’s four… one. So do we treat these as the same enrollment even though the dates are different?
Jason Zednick (31:58) I think we do because you can, if you go back into edit, you can do varied by lob and location… that last option on the enrollment details, right?
Kunal Parwani (32:15) Well, I mean there’s only one location, right on the enrollment.
Jason Zednick (32:19) Oh, well, actually that’s even Symplr because then, yeah, because yeah, we can just if an lob has a different effective date, we can record it in a one enrollment and.
Mwinship (32:32) This probably all stems from that import when we were going through and I was putting all of the lines of business that we had for each payer. Yeah. So because I broke it out by, you know, was it medicare? Because some of our payers, we didn’t have all lines of business?
Kunal Parwani (32:48) Right. No. So breaking it out, I think was perfectly fine. That didn’t result in the duplication. Okay? What resulted in duplication is during the breakout of the lines. Obviously, there’s that let me actually show you.
Kunal Parwani (33:11) Yeah, just easier to show you since, you know, you’ve filled it out. So, What’s that?
Kunal Parwani (33:23) Yeah. So breaking them out was fine. For example, this… provider, the only reason it’s creating different enrollments is because of this payor id. Gotcha. So essentially, if you see over here for this provider for anthem… we have a three four as one of the payor ids and we have the SH o five. So all the a three four lines are showing up in one enrollment and the SH o H5 is showing up on the second enrollment. Okay? Which is why we’re seeing a split of the line of business because the SH o H5 is only for managed medicaid. So managed medicaid correct has its own enrollment versus all the other a three four lines, commercial medicare advantage exchange… and government. Those are all under.
Mwinship (34:21) One enrollment. Okay. Let me ask you a quick question. How important are the payor ids? Because we did have some payor ids change for some of the medicaid plans for 20 26.
Kunal Parwani (34:35) So, let me ask you this is… are the payor ids that we’re discussing here? Are they the ids that are assigned to providers after the like the submission is complete? No?
Mwinship (34:48) That’s just, it’s the payor that’s how claims are submitted to the payor, it has nothing to do with the individual provider. Oh.
Kunal Parwani (34:57) So it’s your internal kind of billing payor id?
Mwinship (35:01) Yeah. It has nothing to do with the provider individually, other than claim submission and electronic remittances received?
Kunal Parwani (35:12) Right. So I mean, we don’t really use this payor id essentially anywhere. So if we want to just remove it from all enrollments, we can do that. If we want to keep them well, then we would have the duplicates because it differs by the line of business.
Mwinship (35:36) Now, do you think that would fix the duplicate issue if you just removed all the payor ids?
Kunal Parwani (35:40) Yeah, I already tried that. Just removing the just blanking out the payor ids does not automatically kind of roll them up. Okay, you will have to do, you know, some magic there. And that’s part of the reason on what I was struggling with and why I kind of want some confirmation is because like some providers for some payors have only two duplicates and they’re pretty easy to tell that they’re duplicates because it’s a different line of business.
Kunal Parwani (36:12) But some of them, for example, this Aetna one, each provider has three and it’s a little difficult to tell if they’re duplicates because the dates sometimes differ, like for example, right? Like in here, it says government is effective for 120 25, but in the separate enrollment from government, the effective date is 221 20 25. So like which date to use in that scenario for the commercial and government effective dates. Does that make sense? Yes.
Mwinship (36:45) So,
Kunal Parwani (36:46) it’s a little tricky because… essentially, what’s going to happen is I will have to pick a line to be the original in which I will roll up all the other duplicate lines. But if the data is different, then I wouldn’t know what to roll up and like what to keep and what to discard. If the date was the same, then it’s you know, then that’s no problem.
Mwinship (37:12) So, I would think.
Mwinship (37:20) I don’t know why they would have two different dates. I’m going to be absolutely honest because to me, it should all be the same date unless there was some issue that back last year that I don’t remember.
Kunal Parwani (37:35) It could have different dates, but yeah, just the fact that it’s four one here. And then I.
Mwinship (37:44) would roll everything up to like those two 220 ones. Yeah, I would just roll those up into the one that is… everything’s for 221. So, yeah.
Kunal Parwani (38:01) Okay. So this is one example, right?
Mwinship (38:07) I’m thinking, do you have multiple with different dates?
Kunal Parwani (38:11) I’m still looking, but I think this one had, no, this one didn’t have multiple dates, but it did have three copies of that enrollment. I’ll take a look if there’s you know, those kind of scenarios with different dates, but it sounds like I could just treat all of them as like whichever the date is essentially the most common, I guess.
Mwinship (38:35) Yeah, I would go. Yeah, I would go with the most common date. And then I mean, if it’s something that we have an issue with, you know, we’re already past that date of two one to four one for claim submissions and timely filing and all that fun stuff. So, it’s not like we’re going to do go that big of a look back at this point in time. Yeah. So I’d be concerned if there’s anything new that is happening too. Okay?
Kunal Parwani (39:07) Yeah, it’s a tricky one… simply because our engineering team is going to ask me, okay, which enrollment to keep and which ones to delete and, you know, what to roll up to the one that we’re going to keep. And yeah… it’s just interesting. But, okay, thank you. That definitely helps me out. If I have anything else, I’ll probably send an email. Okay. Yeah, I’ll continue working on this.
Jason Zednick (39:40) So let me jump in here… if I can share because I want to like show like where this is going to like… I think like be, I want to say like be most important, I’m not sure that’s the right way to phrase it, but there’s also like other implications here with delegation that I want to point out. So like what we’re looking at here is I chose a provider at random and I’m like, hey, we need to make a demographic update. We’re going to add a location that’s just a made up scenario. And what you see here is like, so we have three Aetna enrollments here. Yep. So if you were to say like select all, add this location, you’re going to be, we’re going to… like let’s go to Aetna three times. So what KP’s going to do is he’s going to make all three of these one, right? So we’re going to make one request to go to Aetna and do that location change. But there’s another thing here with the demographic updates that I think is important for the delegated payers because for a lot of your payers providers, we have enrollments for like united which we know is delegated that information for… like, hey, there’s a new location will be captured in the delegated rosters, I believe, correct me if I’m wrong. So we don’t need to do a demographic update for any of the delegated payers even though there’s an enrollment here. So we need to be careful when we do demographic updates that we’re not just selecting all because there are some enrollments on record for delegated payers that we actually don’t need, right? Okay. That checks out, right locations is governed by the practices associated. And if one is added, then that will be added on the next roster, right?
Kunal Parwani (41:43) Yeah, correct. If you add a practice associated to the provider, it will show up on the roster saying, you know, this provider is now… also practicing at this new location as well. Okay?
Mwinship (41:57) Perfect. Okay. So when we’re enrolling, we’re not going to select the delegated payers correct? And when we’re updating demographics regardless of the demographic change, we’re not going to select it and do a bulk demographic update because that will also fall to the roster, and we won’t need to do anything with that at the time.
Jason Zednick (42:21) Correct, exactly. Correct. Perfect. Yes. And this list is going to get shorter because by about, you know, a third once KP’s done, but you still need to be careful because those delegated payers are in here. Yeah.
Mwinship (42:33) Okay. Perfect.
Kunal Parwani (42:36) Yeah, we’ll have to figure something out Jason for the already in process demographic updates. Yeah, I don’t know if I can do anything about those, but we’ll see what engineering comes back with. Yeah, but, yeah.
Jason Zednick (42:57) All right. Great. Anything else?
Mwinship (43:04) I don’t have anything else Alyssa, do you? No, I do not. I think the only other follow up I had was the email that I sent you, Jason with that document… that I had scanned in and sent over.
Jason Zednick (43:20) Oh, yeah. Actually, let me pull it. Let’s.
Mwinship (43:23) talk about that. Yeah, because one of the payers is requesting that this be part of our delegated review of you guys. It’s weird, but our old cbo would have something similar to that. I mean, it wasn’t as broken out as that is. It was a different kind of sheet, but it did have all of that on there and it’s something that we have to say that, yes, we viewed this. We’ve looked at everything you have done and everything you’ve done is correct, and then initial and be done with it. And they, I guess are going to be requesting this piece at our delegated audit. So, I.
Jason Zednick (44:07) didn’t know for every file for.
Mwinship (44:09) Every single file which I think is dumb myself. Yeah.
Jason Zednick (44:12) This is, but I.
Mwinship (44:14) didn’t know if this was too, if that was something that we could pull the data from, and then I could just go down and initial it and be done with it. So, what I.
Jason Zednick (44:25) would say is one, this payer is out of their mind. This is absurd two. I.
Mwinship (44:33) would agree. I.
Jason Zednick (44:34) would say to.
Mwinship (44:37) me, I’m doing their job for them without them looking at all the documents.
Jason Zednick (44:41) Yeah. So like,
Mwinship (44:44) that’s my thought but there’s.
Jason Zednick (44:46) not really anything from a systems perspective that we can do to support a document like this. What I would say is that all of this information is… available from the… let’s look at a summary it.
Kunal Parwani (45:06) Should be in the credit packet as well, right?
Jason Zednick (45:08) Yeah, that’s what I’m going to is okay.
Kunal Parwani (45:10) Okay. I.
Jason Zednick (45:12) picked the wrong one. Okay? In the cred summary page, you can see like, okay, like that element, it was checked and you could do that. It’s going to be a pain to do it for every provider. And, you know, what you, what does the document say? Yeah, I want you to date it. I.
Kunal Parwani (45:36) Was going to say you could just download that credit packet and forward that and be like here it is.
Jason Zednick (45:40) I mean, yeah, because.
Kunal Parwani (45:42) It’s the same information just in a different, you know, just in a different kind of.
Jason Zednick (45:46) Yeah, I mean, this is the information and like it’s got when we reviewed it and all of that. And then, you know, your team reviewed it when they approved it either by… you know, it’s clean, it can be approved or a committee so, but,
Mwinship (46:06) basically, what I was told is it needs to be, it’s an audit on you guys because their contract is with copc and not with medallion now.
Jason Zednick (46:15) If they’re saying like, hey, if it’s like an audit and it’s like, hey, these are the providers we’ve identified and you need to fill that out for those 15, then that’s they.
Mwinship (46:27) want it done for every provider. I said not even a sampling. She goes, no for every provider, which I thought was stupid because to me, I’m doing her job for her.
Jason Zednick (46:38) That is aggressive… and.
Mwinship (46:42) It’s one of our big it’s actually, it’s unitedhealthcare is who it is. Yeah. So, okay. Yeah. All right. Sounds.
Jason Zednick (46:53) Good. I mean, sort of backs you in a corner. There’s not much you can do, but if it makes you feel better, I think it’s you know, ridiculous.
Mwinship (47:03) I just wasn’t sure if you had anybody else. And the other thing that I’ve started, well, I did this month was I went out to the analytics page and I downloaded each one of the categories and I’m going to save a file for those. And then at the bottom, I’m just before I save it, I’m just going to put reviewed in the date and my initials and hopefully that’s good enough for them. Yeah. When they’re looking at, are we checking, you know, for sanctions and stuff like that?
Mwinship (47:40) Yeah, I.
Jason Zednick (47:40) Wish I had a different answer for you.
Mwinship (47:42) Okay. Well, no worries. It was, I told you, it was when I put in big bold wish list. Yeah, wish list. Yeah. All right.
Mwinship (47:57) All righty. And that’s all I had anybody else have anything? Deb, Alyssa? Nope. Okay. All, good.
Kunal Parwani (48:05) Well,
Jason Zednick (48:06) thank you all. Appreciate it. Have a great rest of your Thursday and a great weekend all.
Mwinship (48:11) Right. You as well. All right. Thanks. Bye bye.
Kunal Parwani (48:14) Bye bye.