Transcript
Peter Bosworth (00:00) hey, Amanda.
Amanda Streeter (00:01) Hey, how’s it going?
Peter Bosworth (00:03) Doing well. Thanks. How are you?
Amanda Streeter (00:05) Good, good.
Peter Bosworth (00:08) Awesome. Okay. So… quick kind of agenda for the call was just to go through some of the payr enrollment metrics that we looked at last week and then just kind of compare them week over week.
Amanda Streeter (00:26) Sure.
Peter Bosworth (00:28) But before I do that, anything else you want to discuss on today’s? Call?
Amanda Streeter (00:35) I’m going to send you and Shannon and Vanessa an email of an enrollment that was just, very wrong. Hopefully we can spend a minute on it and I can walk you through it. I’ll walk them through it on tomorrow’s.
Amanda Streeter (00:51) Call it’s so wrong that it has another company’s information attached to one of our providers. So it’s not giving us a lot of warm and fuzzies when they come across stuff like this. And then the other thing for tomorrow’s call just a heads up. And for your information, that worries me, we have maybe you’re going to go over this in your numbers like 130… enrollment requests that are pending a dependency right now of some kind. It doesn’t say that I can see unless you tell me otherwise, what dependency they’re pending for, but some of these, I find it hard to believe that we have that many dependencies. When we’ve asked for the project plan to be refined to take out things like medicare and medicaid in a lot of cases.
Peter Bosworth (01:56) Okay. So let’s start with the.
Amanda Streeter (02:02) Payr.
Peter Bosworth (02:03) Enrollment that’s really wrong and has the information incorrect. Sure. Yeah. Which one is that I?
Amanda Streeter (02:11) Can share my screen here because I am not going to be great at describing this. Sure. But I had Tamara send some screenshots.
Amanda Streeter (02:28) Okay. So medrisk actually reached out to us… or somebody, I guess… yeah, we received an email from them. This is the email that they forwarded to us, I think directionally… but basically somehow a request was sent to add locations that are part of our physical therapy today group under our physio group’s tax id number. So completely separate states, completely separate tax ids, completely separate entities. So, and these are Texas. This one is North Carolina. So medrisk caught that. That was weird and they reached out to us. So they went and looked in the file for Scott Keffer and this enrollment request. And this is what was in the file.
Peter Bosworth (03:39) Okay. So the group is wrong… and not only wrong, not part of your network.
Amanda Streeter (03:48) Well, I actually think two separate things. Yes, and yes, the group is wrong in the request, and then what was attached to the request was wrong, but in a different way, wrong?
Peter Bosworth (04:05) What do you mean by in a different way, wrong?
Amanda Streeter (04:07) This is pulled from that request. And this is not our group. I don’t know what Genesis healthcare partners is, and I don’t know who this person is, but this is what was attached to the request when we went to look at what was going on there. Oh.
Amanda Streeter (04:35) I think… it’s under Scott Keffer.
Peter Bosworth (04:43) Yeah, I found Scott… and.
Amanda Streeter (04:46) I think it’s for medrisk is where they found this enrollment, this request.
Peter Bosworth (05:00) So, but this document, are you able to send this document? Yeah.
Amanda Streeter (05:07) I’ll send this file to you.
Amanda Streeter (05:14) Okay. Thanks. But according to our team, this Loi is what’s in the file for… that request?
Peter Bosworth (05:28) Yeah. So I see the Scott Keffer enrollment with medrisk and it was marked as complete. And then in the notes… I just don’t have like that, I can’t find that exact screenshot, so that’s.
Amanda Streeter (05:42) okay. Okay. Yep. I’ll send this to you now. Okay?
Peter Bosworth (05:49) Or actually, I did find it, but… okay. Yeah. Okay. I do wonder if it has something to do with… the mpi, the group being an mpi zero and some kind of like related to that workflow, Genesis healthcare partners. I don’t know where that comes from. That’s not like a medallion customer or anything. So I’ll yeah, I’m going to put that to… the group right now.
Peter Bosworth (06:40) Okay. And then pending dependencies. So, regarding… that, I know that we have the medicaid dependency… has been… documented and so is the medicare for medicare advantage plans.
Amanda Streeter (07:07) So,
Peter Bosworth (07:08) those… should not be pending. There are like instances, I imagine where… I don’t know that just kind of fall out of those two specific definitions. I’ll try to find that status of… pending dependencies and… just filter for that.
Amanda Streeter (08:18) Yeah, I went to payers and then enrollment requests, and then I filtered by status… and… that’s when I got.
Amanda Streeter (08:53) That number?
Peter Bosworth (09:00) Okay. So.
Peter Bosworth (09:12) Yeah.
Peter Bosworth (09:19) I’m seeing 129. Is that what you said? Yeah.
Peter Bosworth (09:28) So blocked by?
Peter Bosworth (09:33) One example is like medicaid? Okay?
Amanda Streeter (10:11) Okay. I think those are my two concerns last week’s concern with the payer who was told to disenroll seems to be isolated. So that was a good thing. That was a fire drill, but that turned out. Okay.
Peter Bosworth (10:37) So, I talked to Shannon about that yesterday, and so she said that they sent you a cap or like a document outlining our research into the others because you asked us to do an audit. And so they did do an audit and I think that they found that there was, only one other and that that’s also been remedied. Yeah. Okay. That’s a.
Amanda Streeter (11:02) Good, good outcome. Okay. The.
Peter Bosworth (11:06) Scott Keffer thing, I, am going to type that up and put it to the team right after we hang up.
Amanda Streeter (11:14) Okay. Yeah, just sent you an email on it.
Peter Bosworth (11:20) Okay, perfect. Okay. So… in progress requests, so we have 2000 which is up from 1,800 last week. The majority of those are medallion owned, which is good, like we’d like to see that we’re doing the work. The completed request number has jumped slightly from two, yeah, from 244 up to 267. Still a lot of requests in client owned. And I guess something that I just wanted to bring up is like, how is the process going of using that spreadsheet to like offload them to? Medallion? Yeah.
Amanda Streeter (12:09) She told me she was through about 400 of them. Gosh, I don’t even know where I have that Google doc saved. Let’s see if I can find it.
Amanda Streeter (12:25) And she told me this morning, she was getting through about 50 a day was the goal. So, at that rate, I would think within the next two weeks, we should be through all of them is.
Peter Bosworth (12:38) That Colleen?
Amanda Streeter (12:41) That is Lindsay.
Peter Bosworth (12:42) On your team,
Amanda Streeter (12:44) Okay. Cool. Yeah. But I’m looking to see if I can find where that document is, so that we can actually look at it… but keep going and I’ll see if I can find it.
Peter Bosworth (13:01) Okay. So… just, the… other thing is just these statuses and there were kind of holding steady in terms of like what these turnaround times look like. So total business days from apps submitted to request complete was 27 a week ago. It’s 29 today. And… yeah, total business days is kind of how we’re… the number we care the most about as well as medallion owned days because that’s where there’s room for the most improvement.
Peter Bosworth (13:44) So these definitions exclude… when we are pending a task of yours. Okay. Client owned would be where we’re actually waiting on something from you. But yeah. And then,
Amanda Streeter (14:06) if you go back to the prior page just to make sure I understand the 267 requests that are completed as of today, is that what’s being used to measure these timeframes or is that what it depends on? Yes. Okay.
Peter Bosworth (14:22) Yeah, exactly. So, the data just only gets like more enriched once we complete more requests. Okay? Yep. And then again, like all of this is like filterable and exportable, in this tab. So, if you wanted to just select the… last three months?
Peter Bosworth (14:58) OK, you can do that.
Peter Bosworth (15:09) And it’ll bring that filter down to all of these different views. Okay? And then we talked about, a regular kind of like report that goes out. Did you, would it be helpful to like, build that, and have that regularly sent to you? Yeah.
Amanda Streeter (15:35) Is that something I need to do? Or how does that happen?
Peter Bosworth (15:38) We can kind of, I can do it. I can do it for you. Like even on this call, okay. I think it might, actually… I’ll probably.
Peter Bosworth (16:03) I might want to put these in a better order, but when I hit, save… it’s… just going to go to all the admins. Sure that works, that’s okay. Okay. Yep. Okay. And then is weekly? Okay?
Amanda Streeter (16:26) Yeah, absolutely. That would be great.
Peter Bosworth (16:28) Okay.
Peter Bosworth (16:44) Okay. So this will go, the only, the filter is medallion owned, right? Because we don’t want to send you all of the client owned ones. So, this is now complete, it’s going to show provider name, the payer, the status the day it was submitted, if it was submitted yet, and then… all of the different practices and groups associated.
Amanda Streeter (17:21) Okay. That’s very helpful. Okay. So.
Peter Bosworth (17:24) That’s going to go out on Monday, and then it’s going to go out on every Monday thereafter. Okay. Cool. Yeah. Okay. So, the Scott Keffer thing is definitely a big item for me to bring back.
Peter Bosworth (17:45) And I’ll log like an incident so that we track it and then also like do discovery onto what happened there? Do you have? So the Genesis thing there’s no, you?
Amanda Streeter (17:55) Don’t know what? That is no idea. I have no idea what that is no, okay.
Peter Bosworth (17:59) Because it’s not anything. Yeah.
Amanda Streeter (18:03) We’ll check in. Yeah, I mean more, so it wasn’t there. Let me get back to the screenshot. There was a name too. Provider name, Jacob salcon is also on there. I don’t think that’s our person and we definitely don’t operate in California. So.
Peter Bosworth (18:31) Okay. Z, zalkan, S a.
Amanda Streeter (18:38) H a.
Peter Bosworth (18:41) K,
Amanda Streeter (18:45) I a K, I a N stop. I don’t know. I’m not even going to try to pronounce that again because I’ve already butchered it once. Okay?
Peter Bosworth (18:54) That’s the,
Amanda Streeter (18:56) provider information that’s listed under that, Genesis, health care partners.
Peter Bosworth (19:03) Got it.
Peter Bosworth (19:09) Just.
Peter Bosworth (19:14) all right. That provider does not exist in H2 health. Okay? So, no.
Amanda Streeter (19:18) It does not. Yeah. I will say, you know, I hate to, I hate to pile on one person, but the person who touched this enrollment, our team knows their name well, and I always tell people sometimes if I know your name well, that’s not a good thing.
Peter Bosworth (19:33) But they’re.
Amanda Streeter (19:34) they’re they indicated that doesn’t surprise them because they’re used to getting a lot of unnecessary tasks from this medallion representative, is.
Peter Bosworth (19:47) that Shilpa?
Peter Bosworth (19:57) Does it say medallion agent or?
Amanda Streeter (20:01) Man, Manpreet? Sohal, S o H a L. Okay?
Peter Bosworth (20:33) Yeah. Let me log this and then we’ll investigate what happened? Okay?
Amanda Streeter (20:42) Yeah. Those are the, just the things that when they bring to me, they’re always bringing them to me like what’s going on that we don’t know about when the payer doesn’t contact us that, what’s wrong that we aren’t checking. So, need the team to feel more confident. Yeah.
Peter Bosworth (20:59) 100 percent. I recognize that. Okay. We’ll get you a document explaining what happened. Okay? I appreciate it. Okay. Well, thank you, Amanda and I’ll see if we can on Friday’s tomorrow’s. Call, they’ll address the dependency issue. Okay? All right. Sounds good. Thank you have.
Amanda Streeter (21:25) A good afternoon, you too.
Peter Bosworth (21:26) Bye.