Transcript
18172534796 (00:00) hi, sorry, I couldn’t join through the zoom meeting again. I don’t know what the, it people have done to block me, but I can’t get in. So I just called in from my cell phone because I couldn’t get in. So I put another support ticket in because I cannot get into zoom meetings.
Amy Barfield (00:18) Yeah. No, that’s not a problem. Sorry, you’re having trouble with that?
18172534796 (00:24) It’s not you. I think it’s our wonderful because zoom is the only one right now that they haven’t fixed and it keeps blocking me.
Amy Barfield (00:34) Yeah. Do you typically use teams?
18172534796 (00:39) Yeah. We always use teams but it just for some reason, our new it company doesn’t like zoom, I guess, and it keeps blocking me and I’m like, well, okay. And I was already running late because I couldn’t get in. I’m like I’ll just call in sure.
Amy Barfield (00:55) Sure. If it continues to be a problem and it can’t fix it. Let me know. I do have another client. I have teams set up for that. I could probably change our meeting to teams so that you can join more easily. Okay? Awesome?
18172534796 (01:11) Maybe, yeah, yeah.
Amy Barfield (01:14) For sure. Okay. Maureen is joining right now.
Maureen Murphy (01:23) I was saying hello, but you couldn’t hear me because I’m at audio.
Amy Barfield (01:26) Hi, Maureen.
Maureen Murphy (01:27) Yes.
Amy Barfield (01:29) Welcome. Oh, that is Sheila. She cannot get into zoom.
18172534796 (01:32) It’s me. Okay? I was having a problem. I was waiting a while, so I.
Maureen Murphy (01:37) went out. I left and then I tried to get back in, yeah.
Amy Barfield (01:41) I was just telling Sheila because she mentioned that you use teams internally. And then if it continues to be a problem, we can always switch to teams. I do have another client I use teams for. So if I need to do that to make it easier, I.
Maureen Murphy (01:56) Don’t normally have a problem getting in. It was just today, so I don’t know, you know, so I’m not concerned.
Amy Barfield (02:00) Okay, cool. So Kalia did decline today’s. Call. She said she was working on a priority project, so I didn’t know if you had anything specifically for me today.
Maureen Murphy (02:15) I don’t know if Kalia gave any specifics to Sheila before she declined.
18172534796 (02:19) No, okay. No, not this week. I actually talked to Kalia a little bit earlier just to confirm, told her I would be on the call but no, I don’t have any major specifics.
18172534796 (02:29) I know she’s working on a project. She’s probably going to give you some feedback, Amy on some things because they’re doing like they’re jumping in and doing a lot of the crna stuff. So we’ll be getting feedback on that because we kind of had to take over some projects, some additional stuff to get it done. If.
Amy Barfield (02:47) you don’t mind, I’ll review with you what we kind of talked about last week because maybe you can clarify some things for me. I know we had reviewed a lot of stuff because in our last few calls, Kalia’s, only had like maybe a few items that we would address and, you know, we would kind of look through things or train on something particular, but no real major issues. But from what I understand on one of your calls with Nick that there were possibly some support tickets or issues that were brought up or maybe payer processes and that you’re getting more correspondence from payers about how we’re submitting things. And that just hasn’t been relayed to me. I did stress to Kalia, like if you’re seeing, you know, something happening consecutively, they’re not just like one offs that can be sent to support like let me know so we can resolve it. And a lot of times when I see something happening with a payer, that maybe we’re just missing a gap in communication or maybe a way to streamline a process since we have so many clients. They get bombarded by medallion. We hear that a lot. I can meet with the payer and create like an sop or, you know, help navigate maybe some of the administrative burden for them to get things moving in the right direction. But if I don’t know, then I can’t do anything about it.
Amy Barfield (04:20) So I did stress to her like if you start seeing things like do let me know if support’s not answering in a way that you are getting resolution, I need to know that too. So… stress that in our call.
18172534796 (04:34) So, I do know Amy that we’ve put you in the loop on everything that we’ve gotten back unless we’ve gotten it back two or three or even four times, we’ve had a couple payers that have sent things back to us three and four times asking to not have communication with y all.
18172534796 (04:49) And we’ve already notified you and they continue to let us know that you’re still trying to reach out. I have seen several emails where Kalia’s kept you in the loop. So that’s when we had the meeting with Nick that’s what we were talking about was, you know, we do have payers that refuse. They don’t want to have any communication with medallion anymore that hasn’t changed… if we need to put together. I mean, I know at one point, I had the entire list that we sent over to you and Nick and those payers were even in that list of which ones didn’t want to communicate to you. So if we need to send that list back over to you, we can definitely.
Maureen Murphy (05:29) Because I’ve been on those emails as well that go to you and Nick. Because when Nick said that to Sheila and I last week, that like he wasn’t aware of this, and, you know, he’s going to check with you and we were like, okay, so definitely check with Amy, but I went back and checked because I saw I was on a bunch of those emails and they were from to you, but Nick was cc’d on all of them as well.
Maureen Murphy (05:49) We have had a number of, you know, payers saying we don’t want to do what we’re doing anymore. Have them stop contacting us having we only want to do what you and your team kind of thing. And as they come through, we’ve been sending them on to you guys. So I’m not sure, you know where the disconnect might be, but, you know, we do have a list of a bunch, we can resend that.
Amy Barfield (06:11) Yeah, I would.
Maureen Murphy (06:12) Like as new ones come up, we’ll forward those as well. But yeah.
Amy Barfield (06:16) Because when I, when Nick and I were talking about it, I went back in my email. I haven’t received anything I out of all the emails that I’ve received from unio staff. I had four emails. Two were from Kalia about issues and two were from a payer that’s it from January to present. So, yeah, I’m confused.
18172534796 (06:41) So, I wonder if your emails because.
Maureen Murphy (06:44) I know some of these were in the fall Q4. Yeah. The one, the one I just found right now was in December of 20 25 and it was health excel. I’m looking at the email right now, I can forward it to you if you want.
Amy Barfield (06:56) You.
Maureen Murphy (06:57) know, literally, health excel declined to work with medallion, says hi, Amy, this is from Kalia to you. I’m CC on it, Sheila CC, dot nix CC on health excel has declined to work with medallion. If medallion needs to say anything to health excel, please let me know and I’ll get it over to them. And then she cut and pasted into the message. The actual message that came from sue harris, the credentialing manager at zymed medical group, health excel, ipa. So it’s a bot. This is just the first one I found. I’ll forward it again right now, Amy.
Amy Barfield (07:23) But.
Maureen Murphy (07:24) I know I saw a bunch of those, yeah.
Amy Barfield (07:27) So, I see a recent roster sent from health excel January seventh that was forwarded to the team, health. Let’s see health excel, December eighteenth. I did send this to the team. If I’m not seeing if I don’t get anything else after, right? That’s.
Maureen Murphy (07:49) fine. That’s fine look. And we’re not saying that we’re continuing to get specifically from health excel. I think the point is, you know, I think what Sheila is trying to say what she had said to Nick the other day is, you know, we’re still getting reach outs from some payers. Now, I can’t tell you specifically which ones right now off the top of my head, Amy, and I can’t tell you how recently that is something that we will go back to Kalia and say, okay Kalia, you know, the last one I saw doing a very quick and very dirty search in my emails was in December of 20 25. So, who in 20 26 have told us they don’t want to deal with medallion? If so we need the list exactly who, and when please forward that back over to Amy so that she knows, you know, who and when, so that, to your point, you know, it’s March of 20 26. So, yeah, you guys have laid off on the ones that we, as we sent them to you. Okay, those ones are now resolved. But your point is well taken that if there are newer ones who are indicating they don’t want to deal with you then, and you’re saying you don’t have anything in this year, we can check with Kalia to make sure if there are any in this year to make sure that she gets those over to you right away. Yeah.
Amy Barfield (08:59) And if she’s continuing to see that, which is not uncommon, like we try to change the process or update the process on our side. Sometimes there’s some stragglers who have issues with following direction. Unfortunately, that’s just nature of the beast. But I need to push those with the team or escalate it in some way. It hasn’t got to that point where I felt like an escalation was needing because the communication stopped after a certain point, so I assumed it was resolved, but I’ll look back into this health excel issue if it’s still an issue or some way that we can repair relationship with health excel. But yes, that would be wonderful Maureen, Sheila. If you could put a list together for me, get with Kalia, if there’s anything we can, yeah, we.
18172534796 (09:45) Have one, we’ll just add to it. We’ll just make sure the one we have is current. I know Kalia keeps it current. We’ll get it back on with you. I mean, okay.
Amy Barfield (09:51) Perfect. Yeah. I want to be the one to help you help resolve these issues so that, you know, we’re a benefit to you, right? So, the other thing that we discussed and… Nick didn’t tell me until I think yesterday, but it looks like there may be some duplicate efforts on the credentialing side of things where you’re signed up for the product credentialing, but it sounds like you’re handling that in house. I have gone over. We had talked about that a little bit on our last call because Kalia didn’t have access to the credentialing tab. So I gave her access to that. There is one provider requested for credentialing but like your committees aren’t set up or anything like that. So just kind of confused on where we need to move with that. I was, she’s supposed to none of the providers. Well, I shouldn’t say none, but the majority of the providers don’t have initial and recred dates in medallion stored. So whether we’re using credentialing services or not with medallion, I don’t know if that’s important for you to have that stored in medallion. So that’s one thing I flagged, she’s supposed to get me those updated dates by the end of the month. However, I don’t want it to be a wasted effort if it’s not needed. So just kind of shine in some light there, no.
Maureen Murphy (11:16) I think by the way, I believe we’re paying for the credentialing. So why would we use the credentialing right? I.
Amy Barfield (11:22) Mean, that’s my thing.
18172534796 (11:23) And I know she’s been trying to get rosters right? Like we don’t have those dates that’s probably why they’re not in there. That’s one of the projects she’s on right now is trying to get all the data so we can load it in there.
Amy Barfield (11:36) Okay. For initialing and re, credentialing dates, yes?
18172534796 (11:41) Okay. And.
Amy Barfield (11:43) then, yeah, because we really got to make sure that their credentialing is up to date because we don’t want to lapse. I’ve seen them come back where they realize that they’re not credentialed so I would… stress to kind of get moving on that if you want to. If we’re going to be managing your credentialing moving forward. Also, we probably need to, well, the,
18172534796 (12:06) problem is Amy, is we’re at the mercy of the payers to get us the rosters? No, I don’t okay. Who?
Amy Barfield (12:16) Handled your credentialing not pay enrollment, credentialing?
18172534796 (12:21) To me it’s the same. It’s the same team for us. It’s the same team, but.
Maureen Murphy (12:27) clearly for you, they’re different, Amy, so please explain they.
Amy Barfield (12:29) Are so like primary source verification. Yeah… do you need primary source verification for credentialing? Do you have any delegated contracts you work with anything like that?
18172534796 (12:44) Well, when we do, when they come on new hire as far as HR handles getting documentation, but if you’re asking if we like what, I guess the piece I’m trying to understand is the different definitions of what we look at compared to what you’re talking about, I want to make sure we’re on the same.
Amy Barfield (13:03) Page. So doctors who have hospital affiliations or we have, or if you have delegated contracts, which means you have an agreement, with the payer that you will manage your own credentialing?
Maureen Murphy (13:22) To the best of our knowledge, we have none of those, right? Sheila.
18172534796 (13:27) Correct. We don’t no.
Amy Barfield (13:28) Okay. So it sounds like it’s just, we have you signed up for true credentialing when true credentialing is not actually needed, you just need provider enrollment.
18172534796 (13:42) To payers. Yeah.
Maureen Murphy (13:44) I mean, I guess my question is again, you’re you know, you’re speaking to me. So if you’re saying we really just need to be enrolled with providers versus, and your definition of true credentialing is where you do first person verification on every piece of paper.
Amy Barfield (14:00) Yes. So this.
18172534796 (14:02) See that’s what I was trying to get through. Mo, thank you. Yeah.
Amy Barfield (14:05) So, with, if we’re doing true like just payer enrollment, the credentialing process. The reason why we have to send license and Coi, and all these things is because the pay, if we do payer enrollment with a payer under a group contract, the payer will do the credentialing piece, where they do primary source verification to verify all of those documents we send. If you have a delegated contract, you’re in an agreement with the payer that you’re saying we’ll handle the credentialing piece. We’ll do all the primary source verification. We just need you to link them to our contracts. So you send a roster, okay?
Maureen Murphy (14:45) Thank you. That’s helpful, Amy, Sheila, I think we need to get clarification probably likely out of Ross.
18172534796 (14:52) On which it.
Maureen Murphy (14:54) is, do we actually have any of these delegated where, you know? Because if we do then Amy’s right? You know, it changes it, but I think we need to get clarification out of Ross on, for all of our contracts. Are we required to send all of the underlying, you know… materials because they do, if you will first person verification of those as valid for credentialing purposes? Or does our contract allow that we or our agent in the case medallion can do that for us? In which case the payer doesn’t need to do it.
Amy Barfield (15:39) Great. So medallion works like a cbo. Yeah, we’re a cbo that’s accredited under ncqa to handle credentialing and resource verification for delegated contracts. Yep. So, yeah. So, and then the next question would be like if we’re not, why do we sign up for that service? Maybe it’s a miscommunication in what?
Maureen Murphy (16:00) No, I agree. That’s why I’m thinking since I believe Amanda wells was involved when this contract was being put in place. So the fact that they signed up for it would lead me to believe that we must have some of those that’s why we signed up for you guys to do the credentialing piece, right?
Amy Barfield (16:19) And then I think even if you don’t use it, I believe you have skuflex to, use up that purchase… spend the.
Maureen Murphy (16:29) Money in a different avenue, basically, right?
Amy Barfield (16:32) Yeah. Okay. Yeah. But we.
Maureen Murphy (16:34) need to get clarity on that. So Sheila, you and I will take that away. We’ll try and get a call with, I think you should arrange Sheila a call you me, Ross, Kalia. And if I need, if we need to get Mike involved because he would have been, you know, involved at the beginning when this contract got done, I believe. But if we, if you know the answer, we can do it without him, let’s do it without him because trying to get his schedule will be a nightmare. Yeah. Whereas you me, Kalia, and Ross can probably get this answered amongst us relatively quickly. Okay?
Amy Barfield (17:04) Perfect. The last thing that I have is a payer priority list. So originally we had medicare medicaid as your priority. You’re handling those in house have been for a little while. I asked Kalia. So what is now your payer priority for medallion, right? She was not able to give me that list at the time of our call?
Maureen Murphy (17:27) Okay. We’d have to be able to give that to you. Yeah. In order for you guys to focus on doing the things that we need most, we need to be able to articulate what our priorities are. Yeah. And maybe, you know, does it make sense now for us to, you know, give back medicare medi, cal, whatever I don’t know, but I think that needs to be something that, yeah, that we have to provide clarity. Yeah, I.
Amy Barfield (17:49) will say a lot of our medicades. And just, since you guys have taken it back in that time, our medicare applications are automated and our medicaid, a lot of our state medicaid applications are automated now, and then they go through a quality control to verify correctness before submitting. So with that, you might want to test a few providers just to see how that works. And then maybe we can release those back to medallion. Okay. Yeah. Okay. Well, thank you guys for coming today. And if, thank you, I’ll look out for that email on payer priorities. And what was the other thing? Oh, the payers that you’re still seeing issues with?
Maureen Murphy (18:42) Perfect. Amy, can I ask you to do me a favor? I will be honest, I’ve been, I’m having power problems here in my house today. I keep losing power on and off, which that’s why I’ve been late to a couple of meetings because trying to get into them when I have no power. So, can I ask you just, I’m afraid I’m going to forget because of the crazy. Could you just shoot a quick email over saying, hey here’s what we just discussed. And here are the, you know, four takeaways? I need you guys to get back to me on. Yep, absolutely. That’d be great. Really powerful. Thank you. Yeah, no.
Amy Barfield (19:09) Problem normally.
Maureen Murphy (19:10) I’m much more organized, but.
Amy Barfield (19:12) I’m.
Maureen Murphy (19:14) losing things left and right this morning as the power goes on and off.
Amy Barfield (19:17) Yeah, you’re good. I will send something out here shortly after our call.
Maureen Murphy (19:20) Perfect. Thank you so much. I really appreciate.
Amy Barfield (19:22) It, no problem. Have a great day, guys. Okay. Bye. Thank you. Bye bye.