Transcript
Shannon Costine (00:00) Tristan, how are you?
Amy Frana (00:02) Good. Shannon. How are you?
Shannon Costine (00:04) Good. I’m waiting for you guys before I let them in. Good?
Tristan Sewall (00:08) Call they’re.
Shannon Costine (00:10) a brutal group. I think it’s just their culture, just very like upfront. You know what I mean? Sure?
Tristan Sewall (00:20) Yeah, just.
Shannon Costine (00:21) A heads up that’s what you’ll expect from or that’s what you’ll probably hear from them. Hi, Amy. Hi… I just told Tristan that I was waiting for you guys before I let them in because they’re a pretty brutal group. Well, I’m.
Amy Frana (00:40) sorry, I’m full transparency. I know Shannon, you’ve done an excellent job keeping me in the loop, but it’s not sticking fully in my brain. So I’m here to support and jump in, but like if you put me on the spot, it might not be the answer. I won’t.
Shannon Costine (00:56) The only thing I’ll say is that a lot of this, I’m having to push back because it’s like system issues such as the apn versus NP, Tristan. You suggested making sure they use NP versus apn. They probably won’t like that, but it’s system issues. It’s things that we can’t change. So, I may need your support there. Just, you know, backing me up. Yeah, it’s.
Tristan Sewall (01:18) how platform was configured and that’s why we don’t have like aprn, as a, you know, designation and stuff too. It’s just how it was set up initially. Not that we can’t explore adding those elements later, but.
Amy Frana (01:36) It.
Tristan Sewall (01:37) really hasn’t been too big of an issue. I haven’t heard any other client noise about it. So.
Shannon Costine (01:42) Okay. I think the, hey, merit, I was just telling them real quick that this group can be a little intense. So, just to prepare yourself, they may not like some things that we’re having to push back on, but I really appreciate your guys support here. I think it’ll help. They left me in tears the last time, so.
Merritt Miller (02:05) Oh, no. Well, we’re here to help. Thanks for the heads up.
Shannon Costine (02:08) Thank you. I really appreciate it. And if I’m summarizing something wrong or incorrect, please stop me and feel free to jump in but I’ll let you take over on the ncqa piece and then Tristan on the licensing piece, however you guys want to work it.
Amy Frana (02:25) All right. And real quick before we let them, did you already let them in? No?
Shannon Costine (02:28) No, okay.
Amy Frana (02:29) Real quick before we let them in. So Shannon and I touched base this morning that early next week, we are going to set up separate time to have like a strategic conversation of how we want to manage this client. They are a tier two that is as needy almost as a Theoria tier one. So, yes, like this one, we and they’re way behind on their consumption. So we are going to meet with ams because we just can’t we can’t support this level for where they’re at compared to other customers. So don’t if we, if they get mad, I don’t really care like ams have already said, it’s okay. Like if we lose them, so just be honest and don’t like cave to their asks don’t.
Shannon Costine (03:17) Sugarcoat anything. Yeah.
Amy Frana (03:19) Okay. Go ahead. Sorry. I just wanted everybody’s alignment on that.
Shannon Costine (03:32) Hey guys. Thank you so much for joining. Happy Thursday. Hi. How are you? I’m good. How are you? Very good. We have some extra people on the call today. So before we begin with our presentation, I’m going to let them introduce themselves, Amy, you want to go first? Yeah.
Amy Frana (03:52) Absolutely. It’s very nice to meet you all. I’m Amy frana, I am head of engagement management here at medallion. So Shannon is part of my team. I also have 13 other engagement managers that I help support. I’ve been with medallion about seven months now, almost eight. And prior to that, medallion was actually a vendor of mine for two and a half years. So very familiar with it, but excited to meet you all and be able to help partner with Shannon on your account?
Shannon Costine (04:21) Nice to meet you, Amy. Thank you, Amy merit. Do you want to go next? Yeah?
Merritt Miller (04:26) Nice to meet you. All. My name is merit. I’m one of our directors of operations here.
Merritt Miller (04:30) I oversee a couple different of our operations teams, licensing, credentialing, and privileging, I’ve been at medallion for a little over five years and I’ve helped kind of take these workflows from zero to one. So really excited to meet with you all today. And Tristan is a part of my team so I can hand it over to her hi.
Tristan Sewall (04:51) Yes, I’m Tristan, I am head of our licensing operations team, been with medallion for about two and a half years now, just here to help support any licensing questions today. Thank.
Shannon Costine (05:03) You guys so much. All right. So I am going to share my screen with our presentation. We’re going to go over some of the issues that you brought to light last week, Lupe, in hopes that we can resolve some of this. Can everyone see my screen? Okay? Yep. Okay, perfect. So we’re going to discuss ncqa, availability, apn versus NP, documentation and licensing. So first thing I want to look at and I know Lupe, you sent me some information today on this or some questions is the availability access issues. We unfortunately cannot do it through sanitas platform that’s just with our compliance rules and regulations. So we will need to gain access through our admin profile. I know there was some concerns around that with who has access to it, but rest assured, that is the best way for us to do it because we can see who has access and who’s accessing your profile. So we give admin access. And then we assign each individual user. Underneath. Next thing I want to address is the apn versus hold on before.
MonicaKather_3oizd6s (06:12) We move on. So let me just understand the availability access issue, right? Because as of this moment, we have our instance in availability where we have of course, the payer spaces to manage providers, but it also includes roster information and phi, right? Because it includes chi, and is the same access. Is that our compliance and security team says, okay, we can give, of course a third party access. We are not saying that you need to use the email address to access, but we are creating your user under the sanitas email address. So the only request that we’re making in regards of creating the users is for them to be able to access to that mysanitas email account so that they can get associated with that account, generated a user id and a password to access our instance inability, which contains phi.
Shannon Costine (07:01) We unfortunately are not able to access the sanitas email that’s what I’m saying here. So.
MonicaKather_3oizd6s (07:10) If that’s the case, that would mean that and we, of course, by regulation cannot provide access through somebody in outside our domain as well. So that to me, raises a big concern that we will have to bring back to compliance. Okay? Because pretty much that will mean that you will guys not be able to process any kind of enrollment. We’ll not be able to use any of our payer platforms nor availability for Florida blue or the unitedhealthcare platform for, well, unitedhealthcare. And of course, that’s already a big portion of the reason why we outsource the service. So.
Shannon Costine (07:44) All of our clients that’s how we do it, we do it through our admin profile, and then we add the individual users underneath the admin profile. So the same users that you had signed the forms is the ones that we would add access to. This is the best way to do it because if anybody wants to leave, we want to make sure that the necessary users have access.
MonicaKather_3oizd6s (08:09) But if you want to, this would require further conversation and I will advise you to have both compliance teams just because there’s very specific regulations, right? Like particularly one of the things that flagged the request when we requested our team to create that first user, that was like, I don’t know like a generic email address, team support, whatever medallion com is. We do not provide for the state of Florida in particular. And eventually Texas will be the same access to group email accounts. We do need to have an individual associated with the email account because we cannot manage or store any kind of phi outside the us. That is a Florida hipaa regulation that is not a sanitas requirement. It’s a Florida state requirement that I’m very aware that was changed probably like two or three years ago because we had same similar scenario with other vendors for other services that we had offshore in which they had access to phi. And once that regulation of phi for Florida healthcare information changed, we were forced pretty much to move some of our offshore vendors to us local locations, right? Concerning is that this type of information of what is our hipaa requirements? Our questionnaire was reviewed upon the RFP. And now it seems like services that are core for this partnership are being taken out of the table. I.
Shannon Costine (09:35) Will take this back to our team just to make sure that I’m not missing anything else here. Okay? Let you know. And if you want to do the same, that we can reconvene on that specific issue.
MonicaKather_3oizd6s (09:45) Yes, please. Okay.
Shannon Costine (09:47) On the apn versus NP, we would suggest that you only use NP, and that will solve your supervising physician questions. Any questions there?
MonicaKather_3oizd6s (10:01) I do.
GuadalupeRengifo (10:03) Shannon, you know, how we manage the medallion issue tracker for all the concerns that we have. Can we, since these issues have been reported from the very beginning since the new vendor took over, which is medallion, but we don’t have a tracking id or tracking number of your internal submissions. So before we move to the next item in the agenda, would you be able to provide an internal medallion id or tracking number for the ability slash unitedhealthcare user access restriction? Do you have anything internal that you can provide to us so that we can put it in the tracker?
Shannon Costine (10:51) No, I do not, we don’t have an internal.
GuadalupeRengifo (10:53) So this is a request that we have from sanitas. And as you are aware, I’m opening tickets to keep track of the amount of time that medallion has been responding to our request. And like I say, in this particular, the ability and unitedhealthcare, the enrollments. No, I mean your team hasn’t enrolled any of my providers neither with unitedhealthcare or with ability. That responsibility rely on my shoulders in December. And it’s been three months. So I do need priority on this resolution. I know you had said that you’re going to talk internally to your team. But if you can please open a ticket and provide me with a tracking number, and if we can follow up between today or tomorrow that.
Shannon Costine (11:40) Is not something that we normally open tickets on Amy, please feel free to correct me if I’m wrong. But that is not something that we would send over to support about gaining access to availity. Is that correct? Amy, we wouldn’t send that over?
Amy Frana (11:56) Yeah, that would be correct. So I think what we just need to understand and sorry if you said, and I missed it, but we.
Amy Frana (12:10) we typically have our own and I’ll take this back to our group and Shannon unless you’ve already talked to them. Like we typically really limit who we give access to because it can throw off some of the work that’s done if extra people have it. But usually we do have a couple of people with the business that’s tied in to the availity. So we just need to understand who we would want to add and then work with our ops team to get that done.
GuadalupeRengifo (12:42) Yeah, that’s totally fine. But what I’m asking here is something to point in reference of a tracking system because we’ve been going back and forth different emails, different reps. Shannon is our second rep that was assigned to this account. And this has been an ongoing issue since the beginning. And so I do need to have something to reference of if you can create something, I can do it myself and like the same way I’ve been doing it, but I do need a resolution as soon as possible because like I said, the enrollment is relying on my shoulders right now.
Amy Frana (13:15) Okay. Shannon, let’s take that one offline and we can review internally and get back to you.
GuadalupeRengifo (13:22) Yes, sounds.
Shannon Costine (13:23) Good. Again, back to the apn, NP, just make sure that you’re selecting the NP versus apn on document duplication when you upload a new document, you,
GuadalupeRengifo (13:35) will, Shannon, but that was, I’m sorry to interrupt. But on the NP, that wasn’t the question was what was triggering what? And for what I learned working these profiles is that NP triggers the collaborative agreement. But if I select apn as advanced practice nurse, it recognizes, I guess that the provider is autonomous. So therefore the collaborative agreement is not required. So then the instruction should be for those providers that are nurse practitioners who do not have an autonomous license. So then the license type should be NP, but for the ones that are autonomous that do not require supervision. So then the specialty type has to be apn. And that’s the clarification I needed from you.
Shannon Costine (14:25) That’s what I’m saying it will be interesting. Do you want to take that one?
Tristan Sewall (14:32) Yeah, that’s something merit and I can connect on regarding the apn versus the NP. I think, are you utilizing this more for credentialing purposes or more for licensing purposes.
GuadalupeRengifo (14:50) Both. Okay.
Tristan Sewall (14:52) Yeah. Let’s I’ll bring this one back again. But the way platform was initially set up regardless if a provider was a nurse practitioner, advanced practice, registered nurse or apn. The recommendation was to utilize the NP designation. We do have designations for licenses for autonomous registration, and that’s how those can be determined that they don’t require supervision. But in terms of how they need to be specialty listed wise, it was recommended to utilize NP, so we can see what changes occur by switching from apn to NP, and how those licenses are listed. And I can take that back to connect with our engineering team on.
GuadalupeRengifo (15:45) Yes. And Tristan, just so that you understand the real issue here is what internally, what one qualification versus the other is triggering for documentation request purposes? Because the medallion supporting is requesting collaborative agreements for nurse practitioners who are autonomous who don’t need a collaborative agreement and creating a task. So the confusion is on your side. It’s not on mine because I know very well the difference between one or the other, but your team is creating tasks and requesting collaborative agreements for autonomous nurse practitioners. So this is creating a confusion on your end, right?
Tristan Sewall (16:28) I can take it back and connect with the intake team on that too. It’s just how the platform was initially set up and that’s the designation that we recommended for customers to utilize and to determine if that information was needed or not. But we can definitely connect with intake on that as well to determine what documents will and will not be needed.
GuadalupeRengifo (16:50) Thank you. And.
Merritt Miller (16:51) Just so I’m understanding it sounds like you do not want to just use the NP designation going forward. I do think we’re recommending that because that would fix some of the back and forth between the teams because the NP designation would be configured. The way I think you’re expecting. Is that something you consider listing going forward NP, instead of apn? I?
GuadalupeRengifo (17:13) Want to make sure whoever is working the caqh profiles and knowing the difference between autonomous or not can identify when a provider requires a collaborative agreement because they are creating a task requesting a provider to have a supervisor agreement, when the provider does not need supervision. So, yeah.
Merritt Miller (17:38) We’ll take one more look with Shannon on this specific example, like Tristan said, but I believe we’re recommending that the NP would kind of cut any concern with this. So we’ll just triple check on our side, but I don’t think we should expect any issues here. Going forward. Thank you Merritt.
Shannon Costine (17:56) On the document duplication, you will need to delete old documents when you’re adding in a new one. So that will create or you can also remove the expiration date on the old document and then when you add in the new one, that will allow the team to not have to request documents multiple times.
GuadalupeRengifo (18:17) Will you allow me to share my screen one moment before?
MonicaKather_3oizd6s (18:20) We go there, Lupita. I just want us to organize this better because I think that we’re not really having a structured way of addressing our concerns and I would like us to maybe take a step back before we continue just looking into issues and doing a bit of a framework of what’s happening here, right? Especially because we have new people on the call.
Merritt Miller (18:40) So, we.
MonicaKather_3oizd6s (18:42) acquired a credentialing service from medallion back in December where we were offered and sold a service that will provide us a platform that will automate services, right? And it will take information from caqh and provider profiles and update it in the medallion platform. And the second thing that we requested for is, and we were very adamant on this is we were moving from a previous vendor that had the manpower, the people that will do the maintenance of the profiles that will manage the enrollments that will manage caqh profiles. And we were assured that because we don’t have an internal team, it’s just Guadalupe, right? She’s a team of one. And then we were assured that there was going to be a team that will support the service. Now, fast forward almost five months. And what we’re seeing today is that we have issues on two different platforms.
Tristan Sewall (19:37) Big core.
MonicaKather_3oizd6s (19:38) Topics, we have issues that are operational meaning on the processes that need to be developed on the maintenance that we have to do with the caqh profiles. And we identify very basic knowledge gaps in the users that are creating tasks for Lupe, and for our providers, which raises that concern because we hired a best in the market vendor. But that’s not the service that we’re seeing the other concern that we have is more related to systems. Because although what has been mostly branded as the great added value that medallion brings to the table as this platform that is automated and simplifies things has not been the experience. On the other hand, we are seeing a lot of technical issues in which synchronizations don’t happen since we started the deployment, right? This has been going on since day one and what’s concerning is how many months have happened and how we continue like going in the same runabout. I see what you’re trying to do here, Shannon, trying to address the specific issues, and I appreciate that. But I would like us to organize this better into fractioning of what is a technical issue that is to be managed with technical teams and what is an operational issue that we need to identify how to work around it, right? So, when I think about system issues, there are simple things as we don’t get synchronizations from caqh or within your own platform. We update one tab and expiration dates, don’t get updated in other tabs. And that creates recurring notifications to providers saying that a document is missing and they continue receiving emails, but they already uploaded the email. Those are technical issues on my mind and correct me if I’m saying something wrong, right? And I think that these technical issues in an ideal technical world, we would be able to report them, create a ticket, have somebody work on them, get an eta on our response and get them resolved. Is that fair for that type of errors?
Shannon Costine (21:41) Go ahead, Amy. Yeah. So I think.
Amy Frana (21:45) It’s fair. What I want to make sure. And I know I’m working to get up to speed with Shannon on your account a bit more because seeing the products that you have, some of what you’re saying like makes sense to me of I’m not understanding why things aren’t working that way. We do have a project tracker where we can be tracking individual incidents. And Shannon, I don’t know if we’ve done that yet here with sanitas, yes?
MonicaKather_3oizd6s (22:19) We are, I think that’s the tracker that Lupita was going to share. Yeah. And so we have a tracker and it has come to be like we have things in the tracker that have been flagged in December, January, February, we’re in March. And there is no really resolution as of this point. And that’s why I want us to find a way to organize this better because I think that we just come into these meetings and start just dropping bombs of what is not working. But we don’t have a structured plan with slas for resolutions particularly for the technical piece of it, right? And then some of those concerns and definitions on the operational side of the house. That is to me a bit more complicated because it includes human interaction, right? It includes people accessing profiles and making mistakes. Like we’re seeing now our providers with cbo files that don’t belong to them, that are within correct license compliance wise. I cannot have a vendor that is technically looking for the cbo files of my providers and adding an incorrect license, complete query on a license of a provider from someone else. That is a big, no right? I cannot have all of the documentation of a provider associated with all the malpractice history of someone else that is completely out of compliance. And that’s why I want us to maybe kind of take a step back. And instead of going through this form that… we have here, let’s use that tracker and let’s use that tracker to identify what issue is open. When was it open? What is the current status of it? And when does it get resolved? Because a tracker is nothing to me if we don’t really have a progress on those activities and we’re able to close those items. We.
Shannon Costine (23:56) Do have those. We do have progress on each of those items. The reason for this is to go over each of the issues that you brought last week. So there is resolution and Lupe can see that in there there is information in each of those items. I just wanted to address these specific items that she brought last week and we’re meeting twice a week. I’m happy to go over those tracker issues on Tuesday. I just wanted to address these issues with this team today.
GuadalupeRengifo (24:22) No, but Chano, I think that’s.
MonicaKather_3oizd6s (24:24) not what we want.
GuadalupeRengifo (24:25) No, and there is no transparency here on the real, the root of the problem. I mean the document duplication is happening for one reason. The document duplication is happening because providers are basically… mistakenly uploading documentation twice because medallion is sending these alerts to the doctors three four times when the documents are already there and there are information that are in the provider’s profiles with expiration dates. And medallion is not capturing that the weekly reports that we’re receiving with documents that are supposedly going to expire, some of the documents are already there.
MonicaKather_3oizd6s (25:08) You have a background and here’s what I want us to do. I understand what you’re trying to do Chano, but so far it has not worked. We need to start closing items and we need to identify what items are critical to us as a client. I.
Shannon Costine (25:19) Would like to be able to address the ncqa issue while we have merit here because she will not be on the other meetings that’s why I wanted to address these issues. Is that fair to say? Yeah, totally. Okay. So merit, if you don’t mind addressing their concerns or questions about the ncqa accreditation and discussing what we have on this slide presentation, which is the subdelegate?
Merritt Miller (25:47) Yeah. So as I thank you Shannon, as I understand it, you all have tried to seek accreditation in the past. Is that correct? And you’re wondering medallion’s kind of role? So we don’t typically support clients with seeking ncqa accreditation. Most of our clients subdelegate 100 percent of their cvo work to us. And then kind of payers view that as the auto credit for the cvo work. And then the only elements that isn’t covered by our certification are credentialing committees and credentialing decisions. So they’ll still ask you all for evidence of those items. But most of our customers are not ncqa accredited and just utilize us as the certified vendor and have a subdelegation agreement with us. But I’m happy to answer any questions on ncqa or if there’s anything I can clarify, I mean,
MonicaKather_3oizd6s (26:38) yes, this was as well part of our rfbn, we discussed with Nick that we were seeking for an accreditation of our own. And we wanted a certification and we needed a certified partner and he said, yes, we’re the right partner to help people to do this. So I understand that the majority of your clients don’t do that. But this is something that we specifically purchased. We said we want to go with this vendor because they’re going to help us with the ncqa accreditation?
GuadalupeRengifo (26:58) So there are just,
MonicaKather_3oizd6s (27:01) I think a few elements that Lupe has questions about because the ncqa requires us to have an auditing process on how you manage the cbo files. I’ll let her further explain into that. That’s the type of information that we’re looking for.
GuadalupeRengifo (27:13) So basically what we’re looking for is your support, and if you can describe the process, maybe we can have a separate meeting about auditing medallion. We need to create a process on how we sanitas… the client audits the vendor on everything that has to do with the ncqa accreditation. So I reach out to different departments in sanitas. And obviously, you are already accredited by the ncqa. So you went through a survey process in order to get your accreditation, right? Is that correct? So, and your accreditation renews every two or three years, I guess every three years we’re.
Merritt Miller (27:51) not, there’s a little bit of a difference between the accreditation and the certification we’re ncqa certified. And yes, that does renew every few years.
GuadalupeRengifo (27:59) Okay. But in order to do that, you go through a survey process?
Amy Frana (28:03) Yes, cvo, yes.
GuadalupeRengifo (28:05) And you are required to audit your processes?
Merritt Miller (28:10) Yes, yes, I’ve been, we, it’s really extensive. I’ve been prepping for the past year for our upcoming survey. Yeah.
GuadalupeRengifo (28:16) So that’s what we need. We need to know, we need to learn how are you doing it? What tools are you utilizing? Are you in terms of the auditing process? So I’m.
Amy Frana (28:26) just going to chime in here. Merit like that, is that’s proprietary information to medallion. So we aren’t able to give you what our process is for most clients that go for their own ncqa, us sharing our copy of certificate is sufficient for any ask tied to what you need to show specific to us. And if that’s not the case, then we just need to understand a little bit more and see where you’re being told that you need our specifics because we don’t share that information we can share with you our certificate that we have, but we don’t share any of our specifics in terms of our processes and things that we have tied to our ncqa. Well.
GuadalupeRengifo (29:17) Unfortunately, Moni, correct me if I’m wrong, but the surveyor was very specific on the steps that we were failing. And one of the main reasons why we’re failing the CR, accreditation was because we didn’t have a standard audit process for our CR vendor. In this case, they understand that we switch from advantum to medallion. And medallion is like you say, an organization that has a certification, therefore we gain some points there. But we still as an organization because accreditation will be for sanitas, we need to audit the vendor.
Amy Frana (29:54) So, yeah, and so sorry to interrupt, but I know we’re very pressed on time. So with, and I don’t have it in front of me but based off of what you’re saying, what you are needing is not our audit that we’re doing, your group will need to create some form of auditing us as your vendor.
GuadalupeRengifo (30:16) Exactly. We.
Amy Frana (30:18) Don’t have, that you will need to create that. And then let us know what you need from us to be sharing to be for you all to audit in the way that you establish.
GuadalupeRengifo (30:33) Okay. Moni, you have something to add there?
MonicaKather_3oizd6s (30:38) Sorry, I’ve been talking in mute. I understand Amy and I agree like we’re not requesting for your proprietary information. That’s not what it is. What we’re trying to do here is based on the partnership and the agreements that we have is how to come together with what will be an appropriate auditing process. Of course, we will have to follow the standards of the ncqa, but of course, it will require as well for us to request some information from you guys or, you know, like some not specifically to take exactly your process. If there’s something that you guys say like this is the easiest way to share for us information without touching whatever is proprietary and that we can use that to leverage validate, make that audit. I think that we can work around that. I don’t think that, that’s I think to me this is a construction of a process, right? That is the way that I see it us constructing a process together. It doesn’t have to be complicated. It just has to understand the requirements that we get from the ncqa. And then we can do, I don’t know a quarterly review or whatever we decide to do on how the cbo files are, like, what’s the quality of them? What’s the efficiency, what’s blah blah, the different things that we have to measure. So I don’t think that one is a big change. And I do believe that requires an, a call that is specific for that discovery of how is it that we would need to create that process? Unfortunately, we don’t have the time today.
GuadalupeRengifo (31:52) But at the end, it’s in everybody’s best interest because you are doing the PSB process, the cbo, we’re going to be auditing you. So, I mean we don’t want to create a tool that is going to put your organization in a situation where, you know, you’re accredited on an organization. We don’t want to say things wrong. We don’t want to do things wrong. We want to work together. So, and you already did the process. So just work with us so that we can pass this accreditation that’s all we’re asking.
MonicaKather_3oizd6s (32:22) Since we’re already on time, I don’t know if we’ll be and maybe like just to take away from here to have separate meetings on the separate different topics that I would like us to address. Probably for the ncqa will be a separate meeting just for discovery and try to draft, maybe bring a proposal. We can bring a proposal of what we would think that could be an auditing process and you tell us what’s possible and not possible out of that process. What can you share? What can you not share? But I would like us.
Amy Frana (32:47) To real quick and I apologize but I really need to ask and like put a pause there in Shannon’s time. We already have two meetings a week if we need to repurpose one of those to do a review absolutely fine. But we’re not able to keep adding more meetings just because she does have extensive book of clients that her calendar is pretty much book solid every day. In terms of the ncqa, I don’t want to be taken that we’re not willing to partner with you. All we will, our preference is we’re not the right people to build that audit. The preference would be you all build what you think you need based off of what the requirement is, what you heard in your survey. And then we would gladly take that review and share how we would be able to supply information to address or where you could pull most of our clients. We don’t have to send anything. They can get what they need from going in the platform and pulling some random lines. So although I know we’re happy to help where we can. I really think it’s better for you all, for the ncqa pieces to first take a look and build because you have access to all the files, you have access to everything that you should need already with the platform.
Amy Frana (34:22) So, how about we do this?
MonicaKather_3oizd6s (34:24) I mean, I agree with you. And then what I was saying is that because you brought Meredith and Andrew said that was a little bit her scope, right? So maybe Shannon is just our point of contact but the person who will look into that documentation and tell us, yes, this is possible. Not possible. May not be Shannon, right?
Amy Frana (34:39) Yes, we will start with Shannon and then Shannon will be able to do an internal review on any pieces that her or I can’t support getting that verification. But we know what you have access to and what reporting there is. And then we would tap on merit as needed.
MonicaKather_3oizd6s (34:58) Lupita that sound good to you? We can create a draft of the auditing process and send it over. Cool. And I don’t want to continue taking your time. I really appreciate you guys staying a little bit longer. What I was saying of having a follow up call, I meant with the existing calls that we have already booked, but I do want to organize that a little bit better is what my feedback here, right? I’m trying to put together some notes because I’m really concerned about a couple of things that I named before one of them being the… availability access. Part of our msa. Does state that we need to make sure that we have confirmation on how to do the access for third parties because of phi management. And that makes it very tricky. So I don’t know if you want Shannon for us to brainstorm a little bit and which people to bring together to identify what’s the best way to be able to give the medallion team access to manage our enrolled providers. That’s the way we selected vendors because we don’t have the manpower to do the enrollments. And right now it’s all falling under loop. And I guess same thing happens for caqh with the order form that we have in our agreement, we acquired a fully managed caqh, and we have a lot of activities to do there. So to me operationally wise, those are the two big impacts that we have right now managing caqh, managing the enrollments with the payr platforms. And separate from that is okay once we start doing because Lupe is doing most of that management. What do we do about the technical issues that the platform is not syncing, that the platform is not bringing details. And those are the things that maybe I want to organize better on how we address during these meetings so that we really find solutions for the criticals?
Shannon Costine (36:43) We will plan to go over the issues tracker on Tuesday with Lupe and the team. And then I will discuss internally the other issues. Thank you guys. So much for your time. Thank you, Mary, Amy and Tristan for joining. I appreciate you all. Yeah.
Amy Frana (36:58) Thanks all.
Shannon Costine (36:59) Right. Thanks guys. Bye.