Transcript
Shannon Costine (00:00) like I need my backup before I let them in.
Vanessa Persha (00:03) Good morning. How are you?
Shannon Costine (00:05) Good morning. Just exhausted, you know, how that is?
Vanessa Persha (00:10) Absolutely.
Shannon Costine (00:11) All right. I’m gonna let them in. Okay?
Shannon Costine (00:24) Oh… there it is. I was like I’ll let Amanda in. Hey guys. Good morning.
Vanessa Persha (00:33) Morning. And.
Shannon Costine (00:35) Tamara… morning. Good morning.
TamraOhnesorge (00:42) Morning.
Shannon Costine (00:45) Happy Friday. Everyone. Okay. So it sounds like the person that we need to discuss this morning is the email that you sent over Tamara, Amanda, can you explain to us what you felt like? The concern was?
TamraOhnesorge (01:04) So, we got the email from medrisk asking multiple times to confirm that the PTT locations were supposed to be under physio. So we started looking into what medrisk enrollment requests were out there. And found that when I pulled up one for provider, Scott Keffer, he was an enrollment request pending for medrisk. And so I started looking through the forms and email threads that are kept in the notes section of that request. And the first, the Loi that’s attached to his enrollment is for Aetna and it’s for a company out of California. It’s not even our group.
Shannon Costine (01:54) Okay. What was the name Genesis? That was? Genesis? Yeah.
Vanessa Persha (01:59) So, Tamara, I took a look at that one and definitely an error on the agent’s part for the attachment that they included on the note. But I did look at the original email that was sent to the payer and confirmed it was the correct Loi, correct, provider group name and everything we are taking it seriously. Though that another group’s information was attached to the note regardless shouldn’t have happened at all. So we are still investigating that piece internally, but I do want to reassure you that the information actually sent to the payer was the correct information.
Amanda Streeter (02:36) I’m not sure that it was, though. Is that fair? Tamara? Because the text, the locations were one entity, right? And the tax id and entity name was a different entity like physio and physical therapy today. PTT are two different entities, and the email did not have those aligned properly.
TamraOhnesorge (03:02) Yeah, for Scott Keffer, that may have been an oversight putting the wrong Loi in the account. But the request, there was a request sent to enroll the loop in amarillo location for PTT and the address, the tax id, the npi was all for physio not physical therapy today. I.
Vanessa Persha (03:22) See. Okay, let me go look because my biggest concern was like a different customer’s information going out to them. So I actually didn’t get that detailed, but let me go back and look at that, Tamara.
Shannon Costine (03:34) Wrong information, which was physio… okay? If we can’t find it right now while we’re on the call, I’ll do the same as we did before, which is the escalation process, have them look into it and they have to give us an answer today within 24 hours. So I would say by Monday, we should know why this happened or how it happened, what the true root cause was.
Vanessa Persha (04:02) I’m going to investigate in the background here while you go on Shannon. So I’ll have some notes ready for you after the call.
Shannon Costine (04:09) Thank you, Vanessa. I appreciate it… the deletion of locations, I sent that to you guys on Monday. Tuesday. We were good with that. There was only one and that one was reversed.
Shannon Costine (04:27) Okay? Tamara, I followed up on the resume, the CV issue that you emailed me about. They did say that payers require the CV, but if it’s something that you truly think we just need to eliminate, I’ll push back and have that taken.
TamraOhnesorge (04:45) off. Can you tell me which payers require the resume? I?
Shannon Costine (04:50) Will ask them because I could name off some off the top of my head, but I may be wrong based on your payers. So let me go back to them and ask.
TamraOhnesorge (04:59) Virginia or Virginia medicaid, that may require that. But, yeah.
Shannon Costine (05:05) Okay. Is your feeling we shouldn’t be requesting it? What’s your thoughts?
TamraOhnesorge (05:10) I just, I feel like I don’t know if it’s an absolute requirement for all payers or I mean, if we’re going to require it because some of these people have been here since the Dawn of time.
Shannon Costine (05:22) And they’re probably old.
TamraOhnesorge (05:25) If you ask them to create a resume, it’s like starting from scratch because that’s they had to have one. And I don’t want to start tasking providers to provide me a resume. If it’s required for a one off payer in another state.
Shannon Costine (05:38) That’s my opinion for sure. Completely fair. And.
Vanessa Persha (05:43) Shannon, I think in terms of configuration, I don’t know that we can custom configure the platform to only request it for Virginia medicaid requests, but if we turn it off, the alternative there is that we would just have to task it out anytime we need it for a particular request. So if that’s okay with you, Tamara like that’s an option we could go.
TamraOhnesorge (06:07) Yeah, I think it’s easier having to try to find resumes and getting tasks to upload a resume when it may not be needed. Okay?
Shannon Costine (06:15) I’ve been saying they need a system where, you know, you pull in all the caqh info and template the resume.
TamraOhnesorge (06:21) Yeah, that’d be fantastic.
Shannon Costine (06:23) Right. Because so many of these places are older guys like you’re. Saying they don’t have one because they’ve been doing this for so long or been in the same place forever. We.
Vanessa Persha (06:32) Should bring that up Shannon to our epd team about like a system enhancement. I know that I’ve used credentialing databases in the past that can generate a CV, just pulling all the work history and everything together from the system. Yeah. So we should talk to epd and see if that’s something they can put on their roadmap.
Shannon Costine (06:52) Okay. That’s a good idea. I’ll do that. Have you found anything yet? Vanessa? Are you still digging so?
Vanessa Persha (07:01) So far, what I see is the request was to add the provider to a physio north location, 660 Merriman avenue, suite C. That’s what the actual request itself says. And then I’m going into the attachment that was sent.
Shannon Costine (07:28) Yeah. We just… Tamara while she’s doing that. Was there any other issues or concerns that you wanted to address or go over or Amanda anybody?
TamraOhnesorge (07:41) I just, Vanessa while you’re looking at that, are you looking at the enrollment request under physical therapy today? That went out to medrisk?
Vanessa Persha (07:48) I’m looking, yes, I’m sorry, right now, I’m looking at the actual service request in medallion for Scott Keffer?
TamraOhnesorge (07:57) Okay. The other issue is actually under physical therapy today of Lubbock.
Amanda Streeter (08:02) Yeah. Let me share my screen. I have it here. It’s in the word… document that we attached.
Amanda Streeter (08:17) Yeah. Medrisk, credentialing team was informed that she would like to add a location. Amarillo and Lubbock are part of physical therapy today, under the tin for physio that’s this is not accurate because these are completely separate locations from this tax id number yep.
Vanessa Persha (08:38) That I missed. Okay. So this is not necessarily Scott Keffer related. This is a different request.
TamraOhnesorge (08:45) There’s two. Yeah, there’s two different issues going on.
Vanessa Persha (08:48) Okay. All right. Both were.
TamraOhnesorge (08:53) Done by me and Preet, yeah.
Amanda Streeter (08:55) I said this to Peter yesterday. I’ve probably you guys have probably heard me say it before. If I know your name, it’s probably not a good thing. That’s what we have going on with this person here. So, maybe they’re a great employee. But if I know your name and I’m very far removed from you and I’m hearing about it, it’s probably not a good thing.
Shannon Costine (09:17) Vanessa, can we request to have them pulled off? I probably shouldn’t be discussing that right now, but that would be my first thought. Yeah.
Vanessa Persha (09:27) We can take that back to the ops team and have a look at like what their like their quality, what it’s been like and have an audit done, okay?
Shannon Costine (09:38) Okay. Let me make a note of that. I’m more concerned with correcting this.
TamraOhnesorge (09:44) We did respond in an email to medrisk and advise them that those are two separate entities that we want to add any PTT locations under a different tax id. So they… responded back and said that they’ve corrected this on their end.
Vanessa Persha (10:02) Did they say what request? Like what group named this? Trying to find? What request we would have even sent this on?
Shannon Costine (10:42) Right. Tax id, wrong addresses? Am I saying that? Right? Tamara? No, I.
TamraOhnesorge (10:48) don’t even know why this request went out. I mean, Colleen and I have looked to see if it’s something which it would have been. It would have been Colleen if she was submitting for physical therapy today, but we don’t those locations weren’t sent. So I would like to know why it was.
Shannon Costine (11:07) Why it was even sent to them. Yes, physical therapy. So we’ve got the request wasn’t sent, right? It should have been sent and then the wrong address is wrong tax id, correct?
Vanessa Persha (11:22) Okay. The physical therapy today request?
Vanessa Persha (11:40) So this was a new group enrollment request for physical therapy today of Lubbock was the group name, and the request was to add two locations, PTT amarillo PTT loop, south loop?
TamraOhnesorge (11:56) Was that an on hold that got moved or we actually submitted the request. Let me?
Vanessa Persha (12:01) Take a look at it. I don’t recall submitting it, but it could be possibly I could have, but I don’t think I would have just because those are older locations. It looks like this was one that was probably an on hold that got released because it was part of the import… it was data that was imported. Okay? That makes sense?
Vanessa Persha (12:31) So, how, so you guys have already corrected this with the payr, do we, I’m assuming we need to tweak your existing enrollments in the platform so that these locations don’t show up as par under that tax id and group information? Is that fair to say? Yes. Okay. So let me go look at your existing enrollments.
Shannon Costine (13:04) How are we doing on the… adopted lines? Whew, I lost my train of thought there… I talked.
Amanda Streeter (13:14) With Lindsay, is Lindsay out there?
Shannon Costine (13:16) Yeah, I think so. Somebody’s on a cell.
17724534418 (13:21) I’m here. Okay?
Amanda Streeter (13:22) Yeah. You’re chipping away at them, right? Lindsay?
17724534418 (13:26) Yes, we’ve got about a little over 400 done.
Shannon Costine (13:30) Are they in the spreadsheet? Lindsay? Yes, they are, as I checked yesterday, and I didn’t see anything. So, what I may need you to do is just forward me what you’ve done so far? Gotcha. Yeah, because nothing’s updating on the live sheet. Do you mind doing that?
17724534418 (13:54) Yeah, I can do that.
Shannon Costine (13:55) Perfect. And then, are there ones that I’m assuming we need to stop? And then also release? Is it like a mixture of both?
17724534418 (14:05) Yes, there’s some that are opened and some that are closed? Okay?
Shannon Costine (14:09) Yeah. Go ahead and send them over to me and I’ll get those moving. Gotcha. So, you said about 400, did you have any questions on those?
17724534418 (14:21) I did have a question on like, so this one is for tricare west. I have a couple that are credentialed at one location, but the location that is on the spreadsheet, is a different location, so I wasn’t sure if those should be open or closed.
Shannon Costine (14:43) And they’re already credentialed. Yeah.
17724534418 (14:46) Like they’re in tricare’s system, but it’s just for a different location that’s mentioned on the spreadsheet. I didn’t know how specific it needed to be. Yeah.
Shannon Costine (14:56) Close that. But if we needed to add a new location, then yeah, you would want to keep those open. But if they’re already credentialed for that specific location on there, then yes, I would close it.
17724534418 (15:08) Right. They’re credentialed for a different location that’s mentioned on there. So I should keep that open. I.
Amanda Streeter (15:14) Wonder though, hold on just a minute though. I wonder if that’s a result of the import mismatch. Like if our team, if I think about the way that would have occurred, our team prior to medallion would have requested it, they would have known what location this person is attached to. Then it made its way into medallion. Probably got a little bit off track with respect to what location it was attached to during the import. And now it’s appearing at a different location. But, and Tamara tell me if you disagree, if it’s approved somewhere else, then someone at that point had knowledge about where it should be linked to and was probably accurate. Is that a fair assessment? Yeah.
TamraOhnesorge (16:04) I would be very suspicious if the enrollments that came across were for like main locations, right? Or practices somewhere else because then that means they were probably approved for multiple, but it pulled if it wasn’t location specific in credentialstream, it assigned them to the main location.
Amanda Streeter (16:24) Yeah. Did, does chicare require location specific credentialing?
TamraOhnesorge (16:29) We’ve seen lately where they were getting some claim issues for not having the location added. So we’ve been trying to add all locations.
Amanda Streeter (16:38) Okay. I wonder if Lindsay, maybe you could circulate a couple of those and we would be able to tell if it’s clearly the main location that’s listed on the spreadsheet. And that would kind of prove out Tamara’s thought that they just got attached to that one and it’s not necessarily needs to be a new enrollment.
17724534418 (17:00) Okay. I will circulate those to you and then Shannon after we kind of talk internally about that. I’ll get to the spreadsheet. Okay?
Shannon Costine (17:08) Perfect. And, yeah, on tricare west, it used to be where you could just attach them to the main tax id. Now, they’re requiring every location.
Amanda Streeter (17:16) Okay.
Shannon Costine (17:17) To be lumped under that provider.
Vanessa Persha (17:22) I’m in the existing enrollment for medrisk for PTT of Lubbock, can you guys remind me the two location names that need to be removed?
TamraOhnesorge (17:33) Amarillo and south loop?
Amanda Streeter (17:35) Not not removed from PTT, though removed from physio is the wrong one. Those those locations that she just mentioned are accurate for PTT. The request was to put them under physio and physio is not accurate. Oh, okay. Sorry.
Vanessa Persha (17:51) Give me one second. Because I think what I looked at before was,
Shannon Costine (18:00) have you seen where it could have come from, Vanessa?
Vanessa Persha (18:04) No, because the first request that I mentioned was for physical therapy today of Lubbock, it wasn’t for physio, but let me go back.
Shannon Costine (18:18) While she was doing that, is there anything else you guys had or wanted to go over? Yeah. Oh, sorry, go ahead.
Amanda Streeter (18:26) No. Finish your thought first. Sorry.
Shannon Costine (18:27) I was just going to say, I know you had brought up to Peter about the dependencies. I pushed that again to the team yesterday and said we have got to release these dependencies. We’ve talked about it a few times. They said yesterday that they were pushing more out that they were down to, I believe.
Amanda Streeter (18:51) Yeah. After I hung up with Peter, I went through some of those and it looks like someone is making phone calls to the medicaid advantage plan to ask if medicaid enrollment is required and they’re being told, yes, medicaid enrollment is required. So I just want to acknowledge that I appreciate that they did that step and are trying to check things, but I think where the disconnect is, our team knows that medicaid enrollment is required. But we also know that the payer will backdate once it’s approved. And so that’s what we’re trying to accomplish here. So they did work on them. But it wasn’t with the kind of mindset that we’re looking at these as, and so I think that’s adding to the disconnect… my.
Shannon Costine (19:45) request to them was to Tamara had said you guys were putting the atn numbers on the applications. So that was my request was apply then get the advantage plans done, use the atn number on the application. So I will circle back to make sure they’re following those steps because it doesn’t sound like they are okay?
Amanda Streeter (20:05) Okay. And I don’t know, I don’t have the advantage of knowing what’s what in there as much, but I saw calls with notes like that. So I just wanted to like they’re doing more work than they need to. Honestly, they could just send it out instead of, yeah, instead of making phone calls. And then I don’t think we’ll be able to tackle it today, but it’s been on the back of my mind for a future call and Tamara, is going to have to help me with this, but we have, in our Aba business, we have registered behavior technicians that require credentialing for random payers here. And there, I don’t ask me which ones, but these are employees who not only do they not have a CV, they don’t have a license. They might not even have a degree of any kind, like they passed like a two week certification test to be able to achieve this. So the fact that the payers requiring credentialing is obnoxious, but that’s you know, neither here nor there, but those guys just don’t fit into your system with the level of specificity that are needed right now. I mean, like, you know, work history is these are college kids, you know, they just graduated high school, you know, or like there’s barely anything to. So like right now, Tamara, I don’t even know. Are you putting enrollment requests in medallion for them? Or is it just useless because you can’t get the data?
TamraOhnesorge (21:35) For the most part, it’s useless. I’m just having to submit myself. But there are some that the overachiever rbt that they are, they actually go in when they ask them to sign their agreements, and they’ve got it up to.
Amanda Streeter (21:47) At least.
TamraOhnesorge (21:49) the 85 percent, but majority of them I’m just having to submit.
Shannon Costine (21:54) I did put in a request before for the rbts for them to not ask for that. Do you want me to push back on that again? Or are you just thinking not? Yeah, no.
Amanda Streeter (22:05) I’d love for, I don’t want our team to have to do it. We want you guys doing it. So, yeah, but I don’t want to get, I don’t want more tasks created for 85 percent on an employee that’s never going to get there.
Shannon Costine (22:18) Absolutely. Yep. I will push back on that again this morning, okay?
Vanessa Persha (22:22) Do you have a standard list of payers that you credential them with? Could you share that with us? And then I think Shannon, what we can do is just give that list to intake and just say, you know, for, if we look at what the credentialing requirements are for those payers, we can let intake know like, hey, as long as they have all of this, let the profile move past intake.
Shannon Costine (22:47) Okay. I.
Vanessa Persha (22:49) mean, you guys will still get the automated emails that say, well, this provider’s profile isn’t at 85 percent complete because we can’t like stop that from going out unless you want to stop it for all providers, but at the very least they will, and maybe we can turn off their notifications too for those specific providers. So they’re not getting any kind of notices about missing information… turn off everything except for their tasks.
Shannon Costine (23:19) That’s a good idea. Yeah.
Vanessa Persha (23:22) Because.
Shannon Costine (23:23) I don’t want them to get anything. If they don’t have to submit anything. It’s you’re probably getting phone calls and emails on that Tamara. Yes. Yeah.
Vanessa Persha (23:30) We can turn off their profile, completion, reminders… the weekly provider reports, and maybe just leave their outstanding tasks, report emails on.
Shannon Costine (23:42) Okay. Making a note on that. Vanessa, were you able to find anything else on that? I?
Vanessa Persha (23:50) Looked, I, so I don’t see there was no service request made for physio to add those locations. So we’re going to have to go through the handful of group requests that are in here for, med risk and see which one of those actually had that submission on it?
Shannon Costine (24:11) Okay. So we will continue to escalate and do some digging on our end and get back to you guys on that. I apologize. We don’t have an answer today, okay? But we will certainly look into it. Colleen. Were you going to say something? Yes?
Colleen Simpson (24:28) I was just going to say the only, well, not the only issue, one issue that I’m still seeing we’ve already discussed it is the, when we request optum and unitedhealthcare enrollments. I’m still getting pushback for unitedhealthcare where they’re saying the provider already has an open request with optum. Can we close this line. So I have to explain again that we do still need them to proceed with the uhc line as well?
Shannon Costine (24:50) Sure. I push back on that as well. Thank you. Yes, absolutely.
Vanessa Persha (24:58) And Colleen.
Shannon Costine (25:00) If you see something like that, please don’t hesitate to send it to me in an email and just tell me to, please check on this.
Colleen Simpson (25:08) Yeah, I can definitely do that. I.
Shannon Costine (25:09) Don’t want you to have to keep getting these tasks that aren’t needed, right? Anything else, Tamara, Amanda, no?
Amanda Streeter (25:20) That’s it for me all.
Shannon Costine (25:22) Right, guys. Well, we will look into this. I will push back on those issues and I will circle back to you all.
TamraOhnesorge (25:28) Right. Thank you. Thank.
Amanda Streeter (25:29) You.
Shannon Costine (25:29) Thanks, everyone.
Amanda Streeter (25:30) Bye bye bye.