Transcript
Naomi Denson (00:17) you don’t need to jump? Are you talking to me? Hello? Sorry, I was getting my dog’s water.
Niccole Russell (00:38) Okay. I thought so, but I was like,
Naomi Denson (00:40) wasn’t sure. Okay. Okay. They’re here. Okay?
Naomi Denson (00:53) Hello… morning. How we doing good? How are you? Good? All right. I think we have everybody.
Nancy Rodriguez (01:08) Yeah, we can see Jasmine, so.
Jasmine Feliz (01:10) Getting there, one moment, please?
Nancy Rodriguez (01:16) But you can start. Okay, yeah.
Naomi Denson (01:18) So, just the first part of this meeting, a few minutes, I’m just going to go through our implementation transition, so we’re going to hand off officially to Niccole today.
Naomi Denson (01:27) So, I just have some slides here. So we’re going to go through our implementation transition deck, walk through platform, comfort, check, implementation progress, go forward, resources, and there’ll be a post implementation survey and then next steps. So, just jumping into our implementation progress. We have a 38 active provider profiles, 37 of those providers have accepted their invitations and 25 provider profiles are at 100 percent complete. We’ve completed training on medallion basics, ongoing monitoring, platform, payers, platform and analytics and report builder. This is an overview of the data imports that we ran. So through the initial phase of implementation, we imported 41 providers, one group profile, seven practices, six facilities, 10 existing group enrollments, 23 of the providers’, external accounts. So the caqh logins, 19 provider licenses, and 18 provider medical program or education history. Currently, you have 362 total payer enrollment requests in the system 196 of them are, 22 of them are sitting in requested. This is as of this morning. So, these numbers may have fluctuated a little bit 196 are processing, and there are 130 that need client attention, and there are 29 open tasks. Just wanted to pause there to see if those numbers seem correct. If you have any questions about any of the tasks?
Nancy Rodriguez (03:06) Yeah, I do. Okay. So, we have noticed that, the tasks are mainly for caqh… and npi that code doesn’t match and we have one specific person, his name is Winston, Vera, and he said he checked and it matches, but then your team is saying that there’s something wrong. I want to know exactly what is wrong with his file?
Naomi Denson (03:42) You said Winston?
Nancy Rodriguez (03:43) Yeah, he said he checked, and,
Naomi Denson (03:48) Cesar, yes… C, see.
Niccole Russell (04:20) Yes… I was able to get in.
Naomi Denson (04:33) Yeah. So it’s not that caqh profile errors.
Niccole Russell (04:40) Let’s see, then… it must be initial fall complete or re established.
Niccole Russell (05:10) Yeah.
Naomi Denson (05:34) Let’s see next, submit your documents for approval. It looks like it’s missing documents, the federal tort claim act, the ftca coverage document that was updated uploaded, failed. Let’s see why did it fail?
Nancy Rodriguez (06:01) Where did that fail? Because Jasmine uploaded all the ftca for each provider. Let’s see.
Naomi Denson (06:10) Yeah, it’s showing it failed. And, this is failed. I’m just looking at the information. So it likely failed because the, okay, wait, expiration date, 115 27.
Jasmine Feliz (06:28) No… RX race, 12 31, 26.
Naomi Denson (06:37) So, this is the, this is what was uploaded?
Nancy Rodriguez (06:44) Okay. That’s the liability.
Naomi Denson (06:46) It’s the wrong. It’s the wrong form. So it needs to be the ftca form.
Nancy Rodriguez (06:51) Where is this in caqh?
Naomi Denson (06:53) Or is this? Yeah, this is the caqh profile. So it’s I’m covered by ftca. And then when you went to the documents to upload, when for the, this document that it’s requiring… yeah. Is that fsw, it’s this document… it’s not the ftca letter.
Nancy Rodriguez (07:17) Oh, okay. But, but your instructions are not clear because you keep talking about caqh in their code. So that’s why he was like, wait a minute. My code and my mpi are correct. So that’s why we were like, and then I sent an email, this, it a note this morning. I said, can you please specify exactly what you’re missing? Because it’s totally different than the message that we got, right? Jasmine.
Jasmine Feliz (07:45) That’s correct?
Nancy Rodriguez (07:48) But we, Jasmine, can you reach out and tell him, to upload the?
Naomi Denson (07:53) Correct. Yeah. If you look at, if you look at the task, I don’t… and to provide a busy reflect the text on the profile, yes, but I’m looking at this here, initial profile complete or reattestation, which there is no current attestation.
Niccole Russell (08:17) Yeah, it doesn’t say anything about the taxonomy. It’s just.
Naomi Denson (08:19) Saying, oh, wait, oh, yeah, that was from, that was from Jasmine?
Niccole Russell (08:27) So, you always need to look at the description when you’re working these tasks?
Naomi Denson (08:32) Yeah, read here and it’s saying the section that requires fixes are listed below, initial profile complete or reattestation is needed?
Nancy Rodriguez (08:46) Okay. Got it. And also, I have noticed that now that we’re talking about tasks, if you go into medallion, we have noticed, we had say, whenever you are requesting like for example, an updated license updated, let’s say Da, or anything like, that. We have to make it as an organizational task. You require the provider to like for example, for wisden, yes, put it on the provider task. But if you go into the organizational tasks, you’re going to see a lot of them that are assigned to us, not to the provider. Can you go up a little bit more and go into the admin task? You see some of them are for them… to sign, you know, caqh, login?
Niccole Russell (09:54) But that’s not a sign that’s asking for you to get their login information that’s not a signature from the provider, but.
Jasmine Feliz (10:02) There, I updated it. And then they say that they can’t use it and I verified it with the provider and it’s correct?
Niccole Russell (10:11) So, we would have to check that on our side to make sure. Well.
Jasmine Feliz (10:15) That’s Michelle Landry. She’s managing her own. So we don’t have her current username. But if you go under Angela, Rao, is one currently that… I verified it completely, it’s accurate with the provider and… they still come back and say it’s not. Yeah.
Nancy Rodriguez (10:44) And also, is this something about medicare number that they need the medicare number? What is that all about? I just saw it right now.
Jasmine Feliz (10:55) Alyssa cryer, medicaid id number.
Niccole Russell (10:58) Okay. We’ll get to that one in just a second one at a time. Let’s see what’s going on here to see if what we have in our system is correct?
Niccole Russell (11:12) So we can’t get on in based on the.
Jasmine Feliz (11:15) I don’t know what you’re typing there. You can.
Niccole Russell (11:19) Show it, Naomi, will you put it back in the?
Niccole Russell (11:29) Yeah. So that’s what someone has put in the system for her password?
Jasmine Feliz (11:34) Right. And that’s exactly what she gave me.
Niccole Russell (11:36) Now, is it the same amount of percentage signs, correct? So.
Jasmine Feliz (11:43) There’s one, I copied it exactly. Typed it to me. Okay?
Niccole Russell (11:46) Well, it’s you just saw we tried to enter it into the system, so it’s either the username or the password is incorrect?
Niccole Russell (11:59) So, when we are given that information, we do test it out before we come back and let you know that it’s actually not working on our side.
Naomi Denson (12:15) And then what was the other one? Medicaid id? Yeah.
Nancy Rodriguez (12:19) But you guys are tracking that? Why are you asking us that? This is, this is for, is this one for Alicia? Yeah… this is for Alicia that, remember that’s the one that she did the medicaid application?
Niccole Russell (12:41) Yeah. There’s not a medicaid.
Nancy Rodriguez (12:43) Right now, it’s in process right now, it’s in process. So, you guys have the reference number, you keep track of it. So why are you asking us?
Niccole Russell (12:52) We actually don’t have Alicia’s tracking number. You submitted that before you came?
Nancy Rodriguez (12:57) No, there is no tracking number, but you guys did call medicaid and got a reference number?
Niccole Russell (13:04) Yes, we did get a reference number.
Nancy Rodriguez (13:06) Okay. So then why is it attached to us for a medicaid number?
Niccole Russell (13:10) Because you did the enrollment. So when you get the approval back, we will need that medicaid number.
Nancy Rodriguez (13:15) But you keep, you are tracking it?
Niccole Russell (13:18) No, no, no. That line has now been stopped… request stopped. You asked that? Remember, we went back and forth. I reached out to the PE team. You said you had submitted her application on. I believe it was no.
Nancy Rodriguez (13:37) I didn’t submit it. She did it herself before we even went over with medicaid.
Niccole Russell (13:42) Okay. Yeah, that’s fine. However, since it was submitted before us, she would still continue to follow up on that and give us the medicaid number once it’s.
Nancy Rodriguez (13:50) been completed. So, you guys won’t do it. We have to do it for you. You’ll.
Niccole Russell (13:54) have to do that one. Now, once, as I stated before, once that is complete, you can do a demographic update and we can link her to opendoor. But we will still need that medicaid id number. Okay. Yeah. And we did continue with the other ones. We just took the medicaid off of the other lines of business that you had requested for her. So those are still continuing to be worked.
Nancy Rodriguez (14:20) Now, what is this thing about Jessica Cabrera that you say the provider line belongs to behavioral health emblems, health? This is for our handle through care line behavior. As for medallion checks, there is already a care line, kindly confirm if we can proceed with the closing of this line. So, I guess this is for shendell… because I don’t know the answer for that.
Niccole Russell (14:49) But what’s missing for which one? Emblem? Yes?
Nancy Rodriguez (14:53) This is for Jessica Cabrera. Let’s.
Naomi Denson (14:55) See, the prior line belongs to behavioral health. So.
Niccole Russell (14:59) You submitted a request under emblem, but because she’s behavioral health, it’s actually supposed to be submitted under care line. Okay? So.
Nancy Rodriguez (15:13) I guess we can close that case, right?
Naomi Denson (15:16) Yeah, you give a line for both.
Nancy Rodriguez (15:21) So, if we see that we can just close it then, well.
Naomi Denson (15:26) So you’ll.
Niccole Russell (15:28) need to start it with care line and it looks like you have one on hold in care line?
Naomi Denson (15:35) I thought she was submitted under care line. She’s not submitted under care line.
Nancy Rodriguez (15:41) We did all of them. Yeah. So.
Niccole Russell (15:46) Yeah, it was on hold. So it’s on hold dependent.
Nancy Rodriguez (15:48) What does on hold mean? What is on hold it?
Niccole Russell (15:51) Can be several things. You can ask for something to be put on hold if it requires a prerequisite. It’s automatically going to go into a hold status until their medicaid or medicare have been met. And then it would fall back in line to be worked with our team.
Nancy Rodriguez (16:08) So, can I ask for a request? I have noticed that you guys are working on medicare, you’re working on the other carriers, but is there a possibility for you to start working on the medicaid? Since medicaid is the main one and it takes at least 90 days to be approved. So then you can actually do the careline, you can do Molina. You can do fidelis because those are our major carriers. So we really want medicaid to be the first one. And I see that you, thank you for working on medicare, but our population that we see here at fsw, they’re medicaid patients. So, is there a possibility that they can start with that?
Niccole Russell (16:56) First, so these are medicaid, these are the medicaid lines they’re being worked. And it looks like one needs client attention. They’re processing. I did get an update on that by the way, our team did some investigating late yesterday evening and so they are able to proceed with the new enrollments. As of now, we will continue with these paper applications for these as they work out the kinks there, but we have figured out a way to go ahead and start submitting. And there’s.
Nancy Rodriguez (17:30) no way that we can, if you were able to do that, there’s no way that we can.
Niccole Russell (17:35) I’ve reached out to the PE team as of now, we are going to continue here until I get word back from them that they can jump in here, yes.
Nancy Rodriguez (17:43) Maria or CFO and chendel can jump in. She wants these medicaid applications to be done ASAP. Yeah.
Niccole Russell (17:53) I get it. All of our clients.
Nancy Rodriguez (17:56) Do she wants to do it online? I?
Niccole Russell (17:57) Get it. I totally understand all of our clients do it is a big money maker, totally understand that. However… they have to get their process down before they can start this, right? So there has to be training done. They have to get the process done. So, I have followed back up with them. As of now, we are continuing with paper. Once I hear something different, then we’ll be able to proceed with the online. Okay. Yeah, but I get it. I mean, we wish we could do them all portal.
Nancy Rodriguez (18:27) Chendel, I will talk to you later about this. Okay. Yeah. After the meeting. Okay? All right. So now, I understand the hold you are working on the medicaid application, so we can let Maria know on Thursday, and we would also let her know that basically all these providers, we have to do paper because you still, your team is still working on the online applications, right?
Niccole Russell (18:56) Until I hear something different, absolutely.
Nancy Rodriguez (18:58) Oh, okay. Yeah. Because, you know, it requires a lot of steps, right? Like Lupita, she did sign the application. So we are going to mail it. And then Jasmine’s going to give you the tracking number, so you can start tracking on that perfect. Yeah.
Niccole Russell (19:20) I think we can jump back into the implementation dismissal if you want Naomi.
Naomi Denson (19:25) Okay. All right. And then I did enable the 24 providers for caqh management that we had talked about last time that enabling those, except for the three that you said are managing their own, that had a 100 percent complete profile. So just as a reminder as you need other providers to be included in the caqh management as they complete their profiles, you’ll just have to check this box to turn it on for them. So you can see the ones that I enabled that we had talked about 100 percent complete. Except for the three providers that you had told me to leave off.
Nancy Rodriguez (20:07) Oh, okay. So we got to check the box if they don’t want, if they.
Naomi Denson (20:11) Want us, if they want us to manage their caqh?
Nancy Rodriguez (20:15) They have to check the box. Oh, so we have to do a few of them then… yeah, because.
Naomi Denson (20:21) We had agreed that only the providers with 100 percent complete profiles, I would turn on. So as you’re ready to request vidalian to manage their caqh profiles for them, you’ll check this box to turn it on. So.
Nancy Rodriguez (20:34) Jasmine, can you do that except those three people? Can you, can you do the checkbox?
Naomi Denson (20:45) And then as you enable them, so you can see in the payers tab here, you have the caqh management tab, where do you?
Jasmine Feliz (20:53) Have that option?
Naomi Denson (20:57) And, and which option oh.
Nancy Rodriguez (21:00) To check the caqh management?
Naomi Denson (21:02) To turn it on is in the providers directory tab all the way to the right, there’s a checkbox here.
Niccole Russell (21:10) And only if they’re 100 percent complete?
Nancy Rodriguez (21:14) Oh, after they’re 100?
Naomi Denson (21:15) Percent complete, but that was, you can turn it on now. Oh, okay. But you guys had said in our last call that you only wanted 100 percent complete providers to be turned on for now. Gotcha, that was what I did. You can go ahead and turn it on. It’ll, cue the request up. If there’s anything missing that we don’t have, the team will, again, they’ll task out for it, but like if the login doesn’t work or something like that, but yeah, you can, and you can track those. You can see. Since I’ve enabled it. They’ve already worked several of them. So it pulls in their latest attestation last attestation date, and then their next reattestation due date. Okay?
Nancy Rodriguez (21:55) So, just to confirm you guys are doing the attestation for them, correct? Yes.
Naomi Denson (21:59) We’ll maintain, the attestations it pertains to anything that is in the provider’s medallion profile. So, if there’s anything that’s updated, so you would keep their medallion profile updated, with their, you know, any Coi, information or, you know, any changes, that happen. And then our team will take that back and update caqh.
Nancy Rodriguez (22:19) Okay. So then why can you do it for, for Winston Vera? When you have all that information, what can, why he needs to do that, for medallion? Why can, you guys do it? I see? Because the.
Jasmine Feliz (22:37) documents are there, maybe the,
Nancy Rodriguez (22:39) box is not checked in. Maybe that, could that be it?
Naomi Denson (22:41) It is turned on? Let me see. Because, I… me check his real quick, see if they’ve because there are two different teams, that manage it. Yeah, that’s the confusing part it was assigned out. So what we can do is.
Nancy Rodriguez (23:13) Well, Jasmine, I guess we need to check all those tasks because if that’s what they’re requesting, then we need to send it back to medallion if they are the ones that can attest.
Naomi Denson (23:27) Okay. So now that he’s enabled, I left this note here. They’ve been enabled for caqh management, medallion team can please make the updates and close the task.
Nancy Rodriguez (23:36) Okay. So, we will, Jasmine will look at all those tasks because I think a lot of them are probably asking the same question.
Niccole Russell (23:43) Okay. Just make sure that box is checked as well, yes.
Nancy Rodriguez (23:46) Yes, of course.
Naomi Denson (23:51) All right. And then we’ll go back in here. So this is just a platform comfort check. So, I know you guys have been still working with Niccole on navigating the platform, but just want to verify that you guys have a good general understanding of the providers tab, payers tabs, where to find things, submitting your requests, managing your tasks and the reporting and support utilization. If there are any other areas that you continue to need refreshers or deeper training on. Niccole, will be again available to help support that as well as our support team. Oh, okay.
Nancy Rodriguez (24:30) I just had two questions, okay? And I know Niccole did reply to this, but I just wanted to ask again, we have a provider, we have three providers, Lupita, Alicia, and Jessica and I wanted to know if there is a way to bypass the system so that your team can actually start working on adding a new location for the three of them because I just feel like we don’t want to wait like three months for the insurances to approve. And then for us to wait another three months to add the location. Is there a way to bypass the system? Or we just have to wait until they are enrolled in one location?
Naomi Denson (25:30) Like to bypass to make the request. I’m sorry… I’m not sure what you mean by bypass the system? Like in order to submit the request or?
Niccole Russell (25:41) For there’s already some in process for her and they need to add a location, but because it’s currently in process, they’re going to have to do a demographic update once it’s been completed.
Naomi Denson (25:51) Yeah. And I think they can still go ahead and submit the demographic update, but it’s just going to hold until the it’ll give a flag until.
Niccole Russell (26:02) So, instead of doing a new request, Nancy, you could do a demo update.
Naomi Denson (26:08) So, for Lupita, so if we’re in her payers tab, and then if you needed a demographic update because we?
Nancy Rodriguez (26:19) Tried to do it with and maybe with Nicole, and didn’t let us?
Naomi Denson (26:26) So, which is the enrollment that you needed a demographic update?
Nancy Rodriguez (26:29) Which one was it? One gateway, right? The portchester? Yes.
Naomi Denson (26:33) Which payer?
Niccole Russell (26:35) It was for medicaid, right?
Nancy Rodriguez (26:37) Well, we need to add the location to all payers.
Naomi Denson (26:43) So you can do a bulk demographic update, okay? Add location, and which one was it gateway?
Nancy Rodriguez (26:50) Yeah. So.
Naomi Denson (26:54) And then, so you would check add practice locations, select the address that you’re adding. Let me take a picture.
Niccole Russell (27:01) Yeah, I think we were doing the requests and not the demo update.
Nancy Rodriguez (27:09) I know, and you’re ready, there is no way that we have to wait like three months until the other one is processed. Yeah. Well, you can.
Niccole Russell (27:18) Create this, but it’s not going to be worked until the other one’s been completed.
Nancy Rodriguez (27:25) Well, at least we did it and we don’t have to worry.
Naomi Denson (27:27) About it. Yeah, right. And then, so clicking next, it’s going to give you all of her existing enrollments. It’s going to show that there’s requests pending here. So, those are those new requests. So, when you select all of her existing enrollments, it’s going to give you this flag, pending new enrollments. Any pending new enrollments must be completed before median will begin working on these demographic updates, but you can still submit it so that it’s queued up and ready to go. Okay? So, if it’s if you need like one provider, and you need all of their existing enrollments updated with a new practice location, you would select, the bulk demographic update option from their profile and that will allow you to select from all of their existing enrollments or singles. If you just need one payer to have a change, awesome.
Niccole Russell (28:14) Okay. Thank you, Naomi.
Naomi Denson (28:16) You’re welcome. Yeah, you can still submit them. You just can’t we just can’t work them until, the initial enrollment’s completed, because then we don’t have anything to add it to.
Nancy Rodriguez (28:25) Okay. And, and then, chendel and I, we were just talking, and I know Naomi, you had shown us that before. But can you just go back again, and let’s say, is like we would like to see like… let’s say by provider, where they are on the implementation pro, not implementation on the roaming process.
Naomi Denson (28:53) What, what do you mean?
Nancy Rodriguez (28:55) Like, for example, let’s say, Lupita, let’s pick Lupita. And in, we would like to know, instead of us looking at, every single one, every single payer, we want to see all the payers, like sort of like a dashboard and say where they are, like, is there a report not like that? But is there a report that we can see it? Or we, this is the only way that we can actually see it?
Naomi Denson (29:26) You can see it from here for like a specific provider, these are all of her requests and seeing where they are. You can export this into a, a CSV external file or you have the analytics dash that has your payer enrollment analytics reports here. So it shows, in progress requests, but this is for the entire organization. So it’s not specific by provider, okay? Or the report builder for payer enrollment requests. Can?
Nancy Rodriguez (30:01) You do one specific provider?
Naomi Denson (30:03) You can’t do specific provider, but you can pull down the report and then you can filter in excel when you export.
Niccole Russell (30:11) It. Yeah.
Naomi Denson (30:12) So it’s an,
Nancy Rodriguez (30:13) excel spreadsheet. It’s not like a dashboard.
Naomi Denson (30:16) Yes. Okay. So, this report, when you create a report through the report builder, it’s going to email you a generated report, in a spreadsheet. So,
Nancy Rodriguez (30:26) that you can manipulate it. Oh, we can’t get the report right there. We have to email.
Naomi Denson (30:31) It, yeah. So so, when you create the select the fields that you need, it’s, going to give you a preview of the report here, but you export it and download it.
Nancy Rodriguez (30:42) Can you see, I want to see what it looks like? Just curious.
Naomi Denson (30:54) I don’t know if it’s going to send that to me because I’m logged in as an admin. No, it won’t. I’ll try to do it. Yeah, I do need to hop to another call, huh. But I did just want to quickly get through this Niccole. I don’t know if you have time, but I can, definitely, I can, when I log out, I can export a report and send it to you, Nancy, so you can see what it looks like. Okay? Or if you want to play around in there and build one and export it yourself. You can send it to yourself. Okay? You can send it to.
Nancy Rodriguez (31:25) Me and then, and chendel and I, we will look around. Okay. And then.
Naomi Denson (31:31) So, there will be a survey that will come out. I’ve directed this to come to you, Nancy. It’ll only go to one person on the team to respond to that survey. Just an overview of your resources with Nic as your account manager, access to our support team, Niccole as your engagement manager, and then the in platform help center.
Nancy Rodriguez (31:51) So, so let’s say, in case Niccole is out. So, if I want to send an email, so I will have to send it to Nic is.
Naomi Denson (32:01) that?
Nancy Rodriguez (32:01) The next person online?
Naomi Denson (32:02) It depends on what the situation is. You really should be utilizing the support center, the support team for any, you know, updates that you need on requests, anything urgent that you need to flag to the team or anything.
Naomi Denson (32:16) Any findings or questions on tasks can all be routed through the support team and they can direct that either to someone that’s backing Niccole up on the em team or to the operations teams directly. And it’s more for executive and contract needs. Oh.
Niccole Russell (32:32) I’m sorry, not, Nancy, Naomi, if you need to drop, I can hang on here for a little bit and answer questions. All right. Thank.
Naomi Denson (32:41) You everybody. It’s been a pleasure working with you. Thank you, Naomi. I’m going to cancel our recurring meeting series or, Niccole, you let me know if you want me to just transfer it.
Niccole Russell (32:50) You can go ahead and cancel. I’m going to get some updates from them to see who and when they want to do it.
Naomi Denson (32:55) Okay. All right. Everybody. Have a great weekend. Thank you, Naomi. Thank you.