Transcript
Connor Morley (00:00) hello? Hey, Hector. How’s it going good? How are you doing good?
Connor Morley (00:15) I think we’re just waiting on a couple people to join. Yeah.
Connor Morley (00:34) Do you know if Jonas or Mary are going to be able to join today?
Mary Saiz (00:37) I know Jonas is out, but I’m.
Connor Morley (00:39) pinging.
Niko Byron (00:39) Mary right now?
Connor Morley (00:41) Okay. Yeah. I need to ask Mary about one of the pieces of the credentialing packet that we’re putting together… but.
Connor Morley (01:02) I guess we can wait. Let me just type.
Niko Byron (01:06) In her real quick.
Connor Morley (01:08) Okay. Give me one second, let.
Niko Byron (01:09) Me get her a call.
Connor Morley (01:13) Hey, Mary. Hello? Good morning. I’m.
Mary Saiz (01:21) not sure if I’m supposed to be on here. Jonas is off today, so I got on.
Connor Morley (01:27) No worries. I just wanted to touch on a few things that we talked about yesterday really quickly. One is the death master verification in the credentialing packet. Yeah, we.
Mary Saiz (01:41) haven’t requested that yet at this time. Okay? So, when we looked at the agreement, the credentialing delegation, we noticed that wasn’t checked off. And so, I don’t know why I thought we would, you know, negotiated that as well.
Mary Saiz (02:04) But right now and then, to be quite Frank, we haven’t paid for it, we haven’t inked the contract yet for the other carrier. That is medicare specific. So, until that happens, we won’t need… the death master right now.
Connor Morley (02:25) Okay. So if I understand correctly, you guys do not require the death master in the credentialing file at this time at.
Mary Saiz (02:33) This time, okay?
Connor Morley (02:34) Correct? And if things change, just let us know, yes, that’s what we told.
Mary Saiz (02:39) Nick. Yeah, we let him know and all that, yes. Thank you. Okay. So, yeah, we can’t and we don’t want to stop this process from moving forward yep.
Connor Morley (02:48) No problem. I’m just going to respond and just make sure that, you know, confirm this in writing. If you can just confirm it, I’ll send an email right after this, just because I want to make sure that our team. We put the packet together exactly how you guys want, right? Okay. One thing that came up yesterday was the question on the termination for provider terminations? Yes. So, Nico you and I talked a little bit about this after the call yesterday, and it sounds like we do not get a termination date through the API.
Niko Byron (03:28) Right. Nico. Yeah. So I guess it depends on what you mean by termination because I think for cred customers and other customers, it’s kind of two different things. So I assume when you guys are referring to termination, you mean making it such that the providers, all their outstanding associated requests are canceled within medallion, right?
Mary Saiz (03:50) Well, it would be, yeah, because that provider in essence would no longer be part of the network. So for whatever reason, whether the carrier asks us to terminate them or whether they’re we’ve you know, something came up and they’re flagged in their npps or something that, you know, committee said, no, we don’t want this type of provider or they pass away because we do find out in other ways, you know, no.
Niko Byron (04:13) That makes sense. So the best way to go about that is to use the.
Niko Byron (04:21) Deactivation like workflow through the API. So there’s an API for organizational memberships is what it’s called, which is sort of the linking between a provider and the organization. And you can, this is gonna be a little technical, but I’m sure Hector will understand, but you can patch that to be inactive, which essentially deactivates the organizational membership for the provider. That will make it such that you can no longer even like see the provider profile and platform. If in platform, you can go to your memberships and see that it’s inactive there. But you can’t get the… like if you were to try to perform a get on the provider via the API, it’ll say that you’ll get a four or four not found after you terminate that organizational membership and there isn’t a way through the API to have like a termination date essentially. So you’d have to say if you got a 200 request from that organizational membership deactivation… you’d have to just take the date that you got that successful request. And that would be your termination date you’d wanna store internally.
Mary Saiz (05:23) Okay. So we would have to monitor the, we would do that at the ninetieth day. Yeah. Well, in our case, whenever we have, they have to drop off because we have to give them notice. Yeah.
Connor Morley (05:33) Yeah, Mary, essentially, yeah. When you give the provider the 90 day notice of termination, then on the ninetieth day, on the actual termination date, that’s when you would send that deactivation over to medallion and we would confirm.
Mary Saiz (05:46) That, okay. So, Hector, we have to somehow program that because that’s gonna be difficult, to monitor, you know, and kind of keep tabs, of that. The only issue I have with that, and that we ran across this, with Andros as well. Because it coincides with the, when you start, let’s say, oh, we don’t have re creds. We won’t have re creds with you guys, never mind. Never mind. Because everything we’re gonna send you is gonna be new for you and for us with, you know? So it’ll be a new initial, but, you know, it’s just re creds where it becomes a little bit more convoluted, yeah.
Niko Byron (06:21) But, those initials will turn into re creds, like after a committee approval is received on our side for an initial, we’ll schedule a re, cred 36 months after that.
Mary Saiz (06:29) Provider, yeah, right. Three years, three years from now, right? Got it.
Niko Byron (06:32) Yeah. So those you’ll still want to cancel those? I imagine, oh, no.
Mary Saiz (06:35) For sure. But that’s my issue was, you know, with Andros, obviously, we have re creds initial and they start 90 days. It used to be, six, six months before, but they start 90 days ahead. And if we, yeah, have to give 90 days notice, we need to, that, we have it’s just, tough to, I.
Niko Byron (06:52) see what you’re saying, you know?
Mary Saiz (06:53) What I mean, to have the deactivation before you start the re, cred, yeah, and, but it’s not really gonna happen until 90 days, but we know ahead of time, whatever we won’t have to deal that with you.
Niko Byron (07:05) Yeah, we got at least three years before we come upon that one. So.
Mary Saiz (07:08) Exactly. And,
Connor Morley (07:10) and Nico, just to confirm, let’s say a provider three years from now, that a provider, you know, they’re scheduled for a re, cred, 90 days before, the termination date, and then, or they’re scheduled for a re, cred, 90 days before the re cred date, and they get termed like a month before the re cred date. If we get that deactivation would that stop? That would stop the re, credentialing process, right? Yeah.
Niko Byron (07:35) That would stop the re, credentialing process. I guess the one thing I’m not 100 percent sure is like how the billing for that would work? Like whether that’s.
Mary Saiz (07:41) exactly. Yeah.
Niko Byron (07:42) Like whether since we’ve started work on that re, cred request. So, they, you might have, they might be charged essentially for it. Yeah.
Mary Saiz (07:50) I’m not 100 percent sure, which is part of our concern as well. We want to not be charged and, et cetera. Et cetera. Yep. But again, I don’t you know, we don’t need to worry about it because we’re not going to have any re, creds with you for three years until three years from now.
Hector A (08:02) Okay. That sounds good. Clarify something real quick. Nico, you said that for a termination, there is no endpoint right now, from medallion, no, there is to send that information there is.
Niko Byron (08:12) One, okay. There’s, no, there’s no like term date, like to get the term date after you term them, but you can via the, the, I’m not sure if you have our docs up right now, but it’s the memberships section, and then within there, you can patch an organizational membership. All right, members is what it’s called. Yeah, okay.
Mary Saiz (08:38) Okay. Yeah, should not be a problem.
Niko Byron (08:41) Okay.
Connor Morley (08:42) So, just looking through my notes, we went through the training yesterday, I did just want to highlight and I included this in the notes as well, if you want to add anyone else to either the production or sandbox environment and they need to have the view of that credentialing process that I showed yesterday, and they haven’t been added already. Just let me know or create a ticket within medallion because I do have to grant them additional user access to view that credentialing module in medallion. I.
Mary Saiz (09:15) Think, Jonas, did it yesterday. We added a few of us like credentials.
Connor Morley (09:20) I saw that and I added there. I added the access for those providers for credentialing and compliance at bsnnet. Com. Yeah. But if anyone else comes up in the future, you know, I’m just thinking like maintenance just, you can put in a support ticket so that they can get granted, that credentialing access and be able to view that. Okay. All right. So, we have confirmation that the verifications are death, master verification is not needed. It looks like everyone has access to production, Hector and Nico is prod hooked.
Mary Saiz (10:04) Up,
Niko Byron (10:07) Yeah, the webhook subscriptions have been hooked up in prod now as well.
Mary Saiz (10:11) Okay, perfect. And then,
Connor Morley (10:14) Mary, it sounded like you wanted, we wanted to run three.
Hector A (10:19) test.
Connor Morley (10:20) Users through, correct. Yeah, yeah.
Mary Saiz (10:24) I want to try three different types, of files. So, I’ll get, I guess I get with Hector to submit those for now.
Mary Saiz (10:33) Okay? Yep. And Connor, I, you know, before everybody, well, everybody leaves, I do want a sidebar with you. Okay. Yep.
Connor Morley (10:41) No problem. So.
Hector A (10:43) Are we, if we’re ready to? So if we’re ready to do the testing, I will propose just to, yeah, can you hear me? Yeah?
Mary Saiz (10:52) I don’t know. Wait, they froze… no. Okay. You’re back. Hello, can you see me? Did you hear me? Connor, yeah.
Connor Morley (11:01) Yeah, I can hear you. I.
Mary Saiz (11:03) No, I asked that, you know, before, when we’re done here, if you could stay on real quick, just a sidebar with me. Yeah, no problem. Okay. Thank you.
Hector A (11:13) In terms of testing, if we’re ready, I will suggest just to do it Monday, you know, this Friday, I don’t want to be doing anything so we can schedule something for Monday.
Mary Saiz (11:24) I agree. And, no, what I,
Hector A (11:29) say is like, I can get with you and Jonas on team Monday, and we can let medallion know before we send those providers, but, you know, it should be straightforward. We send it. We get the response back. You guys take it from there. Okay. Right. Okay.
Connor Morley (11:53) All right. That’s all I had for today. Any other questions?
Mary Saiz (12:02) I’m going to ask you on a sidebar.
Hector A (12:04) Not on my own. No problem. Thank you. And I will just come back right now so you guys can talk.
Mary Saiz (12:11) Thank you guys all.
Niko Byron (12:12) Right. Thank you. Bye.
Connor Morley (12:16) Connor.
Mary Saiz (12:16) I wanted to ask you, from your compliance perspective… talking about the death master, it is our understanding and, you know, we do our own, you know, we do audits multiple times, you know, yearly… with our carriers, but since we don’t have primarily a medicare carrier, per say, we have one that has not requested in their audits, the death master, you know, monitoring, however in the past, we had one that, you know, obviously sold and, you know, that’s no, they are no longer our clients that did ask us for, and they were exclusively medicare, everything that we’ve read, points to medicare providers, credentialing, the death master has to be done on, at initial and at re, cred, not necessarily throughout the year.
Mary Saiz (13:11) It’s not a very reliable database. It’s humongous, it’s probably very costly. And that’s probably why you guys, you know, charge a lot for it, but I need you to confirm that if you could, for me, you guys are the, maybe the experts at credentialing and, you know, we rely on you, for that. If you could just confirm that is just, you know, a database that needs to be checked for medicare providers… gotcha. Yeah, I.
Connor Morley (13:39) I can confirm, I can, check with my credentialing experts, yes on that, and, the, to confirm what payers are actually looking for death master and check with them to see if it is just, medicare that requires it. I, I’m sorry, I don’t know off the top of my head but no.
Mary Saiz (14:03) No, no, I didn’t expect you to know that’s why I’m telling, I’m, asking you to take it up, take it up to your compliance. And, and remember, it’s Florida, this is Florida specific, which is very different than other states. You know, once Florida goes as, you know, they’re talking about credentialing, all the medicaid providers, moving forward in 20 27, they, Florida does Florida medicaid does check the master death master when they apply. So that’s the rationale that I guess they, why the medicaid, carriers don’t ask for that, you know, as a requirement. Yeah.
Connor Morley (14:44) Let, let me double check. Because one, the one thing that I want to check as well is like what happens with like a medicare advantage plan, right? That’s what I’m talking about? Yeah, yeah.
Mary Saiz (14:57) Yeah, we are working towards that and a possible client coming on board that’s it’s going to be very, you know, very large and, and we want to make sure that that’s why we don’t know they… haven’t paid. They haven’t inked the paper yet, right? So, we want to make sure we have that. And at that point, and it may take another six months. We don’t know this is a, very big corporation, you know, how they work very slow. Yeah. So, but in the meantime, I would appreciate your guidance, your compliance folks, guidance, on the death master. Yeah, let me let.
Connor Morley (15:35) me double check. What I will say, like if you turn around and say, like, I mean, we can get you live without death master verification right now. If we find out that, you know, it’s not a problem with any other payers other than medicare and medicare advantage. And then if we say like in a month, like, hey, we do, we need medicare, we need medicare and medicare advantage and we need death master, we can absolutely then add that into the platform very quickly. Yeah, it’s actually very quickly, to add it into the platform itself and into our sops for our credentialing team. When they put the packets together, it’s just the contract and I need approval… from my bosses to turn it on. No, I get.
Mary Saiz (16:21) It, I get it. And there’s a cost that we’ve already been quoted and all that, and we’re kind of looking at that… but I just need you to confirm what I believe, I know, right?
Mary Saiz (16:31) Which is, which is what I’ve said. You know, I do have a little experience, but just want to just want to confirm from your end. Okay? Yep.
Connor Morley (16:43) No problem. Mary. I can definitely do that for you. I’ll take that back right after this call.
Mary Saiz (16:48) Thank you, Connor. Yep. Appreciate it. Thanks. Okay. Have a great weekend, huh you?
Connor Morley (16:52) As well. Thank you, Mary. Bye.
Mary Saiz (16:55) Bye now.