Transcript
Naomi Denson (00:00) good morning.
Naomi Denson (00:04) I’m good. How are you? Good?
ShirleyHooker (00:07) Did you have a good weekend?
Naomi Denson (00:09) I did. How about you? You sound really far away?
ShirleyHooker (00:11) Oh, do I, yeah, I have no idea.
Naomi Denson (00:16) All right. Let me let Lia and Shirley in. All right?
Naomi Denson (00:31) Good morning. Hope. Everybody had a nice weekend for sure. Awesome. All right. Maybe.
Naomi Denson (00:50) All right. Okay. So we, I… got the custom provider invite that you sent over Lia. I sent that over to KP to start building. We’ll send you a sample of what it looks like before we finalize it for you to approve. Okay? So we did that… and then let’s… see. We did that. The data import template we had said last week that we would have the existing provider and group enrollment data by end of day after our call, but I have not seen that come through yet. Shirley. Is that ready?
ShirleyHooker (01:31) The group one is the group one is ready to go but not the provider one. I still have to make some adjustments on the provider one, but I’m just making a couple copy paste right here and the group one is ready to go for to be sent over. Okay. So on these, I have a question. Nope. I’m good. Never mind. I’m good. It was the true false that’s just been taken so long, you know, to go back through and just make.
Naomi Denson (02:13) sure that that’s all updated.
ShirleyHooker (02:14) And stuff.
Naomi Denson (02:15) Yeah. So.
ShirleyHooker (02:17) That’s just the only thing that we, that I had… it was just those last columns on the true false, putting the true, what, you know, true, false part.
Naomi Denson (02:30) Understood. Okay, perfect. I will keep an eye out for that. Just shoot me an email when you drop that, so that I can make sure that I… pull it out and get it ready.
ShirleyHooker (02:44) Okay. Sounds good. I, Leah can show me or Leah can drop it over where it needs to go.
Naomi Denson (02:52) Okay. And in the agenda in the meeting agenda, it’s linked to our invite. You have this couch drop link so you can put it right in there. Okay? And unless Leah needs to look at it first before you send it over.
ShirleyHooker (03:06) Yeah, she can. Yeah.
Lia Hood (03:08) I mean, Cheryl, you’re welcome to drop it. Let’s just keep a copy of what we send for that drop.
ShirleyHooker (03:14) Absolutely. Sounds good. Yeah, I can do that. Perfect.
Naomi Denson (03:18) And then I sent an email this morning to caqh bulk imports that we ran last week. Only 17 of those failed. I sent a report over to you to show you why they failed. A lot of them looked like it was a mismatch with either their npi or their social security number, not matching medallion to what is in caqh. So if you guys want to take a look at that report and let me know if any changes are made in medallion to update this, sometimes there’s numbers in caqh on their social or npi that are flipped or maybe we have the wrong caqh id in some cases. So it’s looking for a different provider. And then there were two providers on that list that need to log in to caqh to authorize medallion to view their profiles.
ShirleyHooker (04:08) Okay. And you sent that over? You said, was it this?
Naomi Denson (04:10) Morning? Yes, it looks like this. So these are the providers’ names. All of these are npi or social security number issues. There were two that it was, these are the two that need to update their authorizations. And then there was just one that it was confirmed that it was the social security number that was mismatched. So, sometimes when it is npi or social security number, it could either be both or it could be that we have the wrong caqh id.
ShirleyHooker (04:41) Okay. I can.
Naomi Denson (04:41) Take a look at that. So just review those provider profiles and just make sure we have the correct information and that it’s matching what the provider has in caqh.
ShirleyHooker (04:49) Okay. Do you want me to just reply on the sheet then? Or where do?
Naomi Denson (04:53) You want me to reply? This isn’t a live sheet. So if you just reply to the email, you can make notes in the sheet and send it back to me if you want.
ShirleyHooker (05:00) Okay. I can do that. Awesome.
Naomi Denson (05:05) And then for the payer enrollment piece, Niccole did have a question. We’re working on mapping all of the rosters that you shared with us. We don’t have the contact information on where those should be sent. Okay. So in the payer process scoping sheet, if you could, in the client notes section here, add the contact details on where those need to be sent.
ShirleyHooker (05:31) Okay. So roster contacts? Okay. Yep. I’ll do that, and.
Naomi Denson (05:35) Just to add there, Naomi.
ShirleyHooker (05:37) Leah.
Naomi Denson (05:39) I never received.
ShirleyHooker (05:40) The information on evolent?
Lia Hood (05:42) I’m going to get that to you. Okay?
Naomi Denson (05:43) Perfect. Yeah.
Lia Hood (05:45) No, but I, so I have questions about this about why we’re having to provide that contact. So my understanding of this process was… we’re just sending them to make sure they match.
Lia Hood (05:58) You have the process. We’re just sending them to make sure it matches. But now you’re coming back and asking for more that you didn’t ask for before.
Naomi Denson (06:08) So the rosters that you shared?
Niccole Russell (06:13) Only three of them we already had in house. Yeah. So I’m creating a project plan specific for you that shows the pay your enrollment team, the application or the roster that needs to be sent plus the details in which it needs to be sent to. So if it’s.
Lia Hood (06:33) a portal?
Niccole Russell (06:34) An email, anything like that?
Lia Hood (06:36) Context is incredibly helpful. Thank you. That makes me feel better.
Naomi Denson (06:41) Yes, thank you, Niccole, you’re welcome. Yeah, perfect. And then the payer mapping that I had sent over a couple weeks ago, I’m still showing that this has not been reviewed by your team. So we took all the payer names that you provided us on that sheet and then we did the payer mapping exercise to standardize them to how they are in medallion’s platform. So there’s some notes here from our ops team where they could not confirm or standardize the name that we need your communication on. And then just checking these boxes to confirm that we can move forward with the map names.
Naomi Denson (07:31) So I can resend this. It’s also linked in the meeting agenda, and.
Niccole Russell (07:37) Just to clarify on the ones that are red, we are not finding those as payers. So if there is some sort of process that you all go by where claims are being paid, then you need that process.
ShirleyHooker (07:54) Yes, benefitsmart is a, is not a provider payer but it is a payer and it is for location. It’s just for location. So where should I, where should we put that information at? Just over here?
Lia Hood (08:13) Shirley with benefitsmart. Let’s you and I talk about that one?
ShirleyHooker (08:17) Okay. Sounds good. Yeah.
Naomi Denson (08:20) If you have any feedback or notes or anything to add, you can put them in this column here. Okay? And then we did have a question I put in the reporting ticket for the enrollment reporting that we had talked about in our training session with the combined reporting with the existing enrollments and the enrollment requests, the team’s just asking for a little bit more context on the, why we like what you use that report for?
Lia Hood (08:54) So, what we do is we send a master list on a weekly basis that tells the practice and the RCM team of who is participating at, which payor at which line of business at which location, and if they’re in process or if they are participating or if they are non par, we send one master, complete list of all of that, so that they’re not having to look at two different spreadsheets to say, okay, well, these are onboarding, and these are your existing. They get a master list, a refreshed master list every week and we send, we, I don’t want to have to pull two reports and combine them into one because that’s not efficient.
Naomi Denson (09:37) And this is for like scheduling purposes only.
Lia Hood (09:40) It’s for scheduling it’s for RCM billing purposes. It’s for anything a practice would need a master provider list for.
Naomi Denson (09:48) Okay. All right. Thank you. I will share that. Yeah.
Lia Hood (09:51) And it’s it is something that we pull out of mdstaff and we can run and we pull and all the practices really like it. And it’s easy on us because it’s a report that we can set to auto run.
Naomi Denson (10:04) Okay, perfect. I will share that context.
Lia Hood (10:07) I’m just surprised no one else has asked for that. I.
Naomi Denson (10:11) Have had it asked for a few times. Our team is just trying to figure out if we need to make this a more standardized report like across the board. Yeah, because it is, it comes up every once in a while, but it’s not every customer that I’ve worked with brings this up. Okay?
Naomi Denson (10:33) So, yeah, our head of technical solutions was just asking for more context on what you’re doing with it, so he can try to determine if we need to make it more standardized.
Lia Hood (10:42) I would recommend it standardized.
Naomi Denson (10:45) Yeah. I mean, I don’t hate the idea either for sure. All right. And then, so I’ll push that back to him. I did send over the recordings of our trainings as well. Yes, I saw that this morning. So any update on the hospital applications piece? I don’t no. Okay. All right. No update yet. Okay? So opening up the floor to questions, comments, anything that you guys have on your radar that you want to discuss today?
Lia Hood (11:17) What I think there’s a list of things that you need in order for us to give you new providers. So if I get, so, I think it was like a W9.
Naomi Denson (11:30) And.
Lia Hood (11:30) I need to know what, where we are with sending you new providers, how far away? Because I have, Shirley has a list of, I don’t know, four, five, six, seven onboarding providers that I’d rather not start the work with and have you pick up, but I can’t hold them much longer. So, I’m trying to figure out where we are and the minimum amount that you need to pick that up.
Naomi Denson (11:59) Yes, I think I sent over in my email, this, did I send that over? Oncology? I did not. Okay. So.
Naomi Denson (12:24) I just responded to the email with the training recordings with the checklist for intake for the different request types.
Naomi Denson (12:36) So, these are like,
Naomi Denson (12:43) so, this is group practice info required for provider enrollment. So if you’re just adding new providers and not group enrollments, like in whole group enrollments, these are the minimum details that we need in the group and practice profiles for our intake team to push them through. And there’s one in there for just the individual providers, what we need, what intake looks for. And then there’s one for group enrollments on what we need in the group and practice profiles. Does that make sense? So let’s see.
Lia Hood (13:21) No, we have the,
ShirleyHooker (13:23) group and we have all the practice information already.
Lia Hood (13:27) Yeah, that’s yeah, I.
ShirleyHooker (13:31) gave all that, that’s already all.
Lia Hood (13:33) In there, I think we’re just missing the W9. I feel like we’ve already given a lot of this information. Yeah.
Naomi Denson (13:40) Yeah. So this is just a checklist to go by. So looking at your group profiles, they’re… so it is looking for the W9 form, irs letter, bank letter, which irs letter and bank letter are for like true group enrollments. So for provider, individual providers being linked to a group, we would just need the W9 and then answers to, these questions here. So you can see right in the platform, what’s being asked for here.
Lia Hood (14:14) Okay. Hang on one second. I’m going to grab a I’m going to grab a screenshot real quick. Okay?
Lia Hood (14:26) And that’s by, we… have to go through each location?
Naomi Denson (14:32) Yes. So these are the group profiles, yes. And then the practice profiles. So the practice location. So the practice email we would need… when?
Lia Hood (14:42) You say practice email, what email address is that?
Naomi Denson (14:49) So, that would typically be Niccole, correct me if I’m wrong because I always mix these up. The practice email is the one that would be listed in like payr directories… yes… for scheduling and things like that. For that the patients would contact for scheduling. Also where, you know, payr updates, revalidations, things like that would be sent to, right?
Lia Hood (15:17) So that’s just it, right? So, I mean, a revalidation is not going to go to the practice. It’s going to go to credentialing, but a patient’s not going to go to credentialing. They’re going to go to the practice.
Lia Hood (15:33) Does that make sense? Yeah.
Naomi Denson (15:36) Most, a lot of the times I see like a general, like if you had like a oneoncology credentialing, like general inbox, got it, that we could put on all practices. Okay? That way all the communications going to oneoncology and not to the practices directly since they’re not actually maintaining or managing that?
Naomi Denson (16:00) Or if they’re not Nicole… yes. Is that, is that your understanding, yes, that?
Niccole Russell (16:10) Is my understanding… sorry, I’m having an internet issue. So it’s kind of choppy on my side.
Lia Hood (16:17) Shirley, does that make sense? What, what email address? Do you understand that?
ShirleyHooker (16:21) Yes. And we’ve just always used the credentialing one even when we reach it’s just the credentialing email?
Lia Hood (16:29) Yeah. I mean, my problem, is I don’t want the credentialing email published… because I don’t want because I don’t want it’s not appropriate to have patients reaching out to credentialing? True?
ShirleyHooker (16:42) True.
Lia Hood (16:42) That’s why I’m struggling with what to put here and why understand why it’s a requirement?
Naomi Denson (16:51) Do you let me ask one quick? Do you want to be listed in directories?
Lia Hood (16:57) We want all of our providers to be listed in directories, absolutely. But, but that, so that’s why I’m getting that’s. Why I’m getting confused because like we would put like an info at right info at SMS, but you’re telling me this is going to be used in multiple places and I have and depending on where it goes would depend on how we would list it, right?
Naomi Denson (17:21) Right?
Lia Hood (17:22) That’s what I’m struggling to.
Naomi Denson (17:24) Understand. Nicole, would the, so Nicole, would this one be the directory listing email? And then the mailing, is there a?
Naomi Denson (17:36) Trying to remember where the I,
Niccole Russell (17:40) think it’s on the group side is?
Naomi Denson (17:42) The, the contact emails where like, the credentialing and stuff information would go or like the revalidation notices or would that go to the practice email or the practice manager?
Niccole Russell (17:55) I believe that would just go to the mailing. Let me confirm that… okay?
Lia Hood (18:03) Because like, we put our, we put credentialing in certain spots, but that’s you know, I mean, that one right there is specifically billing. So that’s why we’ve it’s a billing section. Yeah. So that’s why we’ve got it under billing. I just, I just, I’m trying to figure out the appropriate places and the correct email address, so that everybody gets what they need. And surely it may be that we just list the main one. And then we just have to rely on them to forward any credentialing information over if that’s the way this is going to get set up.
ShirleyHooker (18:53) Well, there’s a difference, the billing as opposed to a patient and things like that. So, yeah, I’m just talking it through here. Yeah.
Lia Hood (19:02) So, can you Naomi, can you go back to where it was outlining the different things that we needed that we were looking?
Naomi Denson (19:08) At? Yeah. So you have it in the group profile here for the group information, but… you also have it in, the quick view on the list of groups you want me to go back to that one?
Lia Hood (19:24) Yeah. And, and we, and again, we only have to have a certain, what do we have to have these at 100 percent complete? Or was it, is this the one where it’s 80?
Naomi Denson (19:33) Minimum 85. And then the intake team will review. And if anything’s still missing, they’ll task out for it.
Lia Hood (19:40) Okay. So that, that’s yeah, if it’s missing and they have to have it, they’ll task out for it, right?
Naomi Denson (19:49) But it’s 85 percent for it to actually move forward for group enrollment requests.
Naomi Denson (19:55) If it’s a provider enrollment request, it bases off the provider’s profile, and then they’ll review the group and practice locations for information that we might need.
Lia Hood (20:05) So that’s the group profiles. Is there anything missing on the practice locations? Yeah.
Naomi Denson (20:10) So the practice locations, it’s, the practice email that was that one effective date, business license or registration is not a huge deal especially since.
Lia Hood (20:21) We’re not gonna have those. Yeah. And then the we’re not in California. So they’re most likely not required.
Naomi Denson (20:28) Yes. And then the operational info… is the, anything that doesn’t have an optional tag. So telehealth or brick and mortar… services other than English, which we have English here. So, and no other payers. So we can just say, no, there average time it takes to schedule. Oh, but,
Lia Hood (20:48) that’s not true because they should, they, I believe all of our groups have and I believe it’s a requirement where they have translate translators available.
ShirleyHooker (21:00) Translation services, yes.
Lia Hood (21:02) Thank you. So I would say yes, because they have translation translators available.
Naomi Denson (21:09) Okay. Yeah. So.
Naomi Denson (21:18) And then average time to schedule a new appointment?
Lia Hood (21:22) Are you accredited? Which we’re not going to know? We’re just not going to know and we’re not going to get that information. Yeah, I know Cleo, it’s going to take too long for us to get that… and it’s not required to fill in on a payer application. I don’t know any payer that asks for that. They ask for it. When they do surveys, when they do random check in surveys, and when we get those, we send those to the practice for completion. Okay? So we won’t be answering that question.
Naomi Denson (21:51) Okay. We could put just unknown or na, in there just to meet the requirement.
Lia Hood (21:57) But that’s but I don’t want that to be filled in as an na on an application. Does that make sense?
Naomi Denson (22:07) Yes. Let me see. Niccole. Do you know? I mean?
Lia Hood (22:21) I am not aware, I think if we just put unknown that would be fine.
Naomi Denson (22:30) Or veris, just so it completes the profile… or?
Lia Hood (22:35) Veris. Yeah, I would be better. I would be more comfortable with saying veris than unknown, same. Yeah.
Naomi Denson (22:44) And then, are you accredited? No. Okay. And then because we have the medicare ptan and the medicaid ids in here for the practices asking for the documents, but showing optional. So, let me see what that, do you know, after hour service? Do they have like answering services or voicemails that?
Lia Hood (23:03) I imagine they have an answering service?
Naomi Denson (23:09) And then they’re brick and mortar only or both?
Lia Hood (23:12) I don’t know. I don’t know, and, I’m not comfortable answering that.
Naomi Denson (23:17) Okay. That’s fine. Let’s see. Let’s just see what that does to the percentage.
Naomi Denson (23:27) It took it to 83. So once we have the practice email confirmed, it should push… that into that 85 percent threshold. But again, the 85 percent is only applicable if it’s a true like new group enrollment and not just linking new, like linking providers to it.
Lia Hood (23:49) Let’s see. Thanks.
Naomi Denson (23:58) Yeah. So full street address, practice, name, practice, phone hours of operation, office manager, name, office manager, email, Ada compliant, ages of patients served, and then provider start date with the practice location. So I think other than the W9, if we’re just doing individual group providers being attached to a group, we should be good to go with… them as they are though.
Lia Hood (24:29) Okay. So we need to get W nines over.
Naomi Denson (24:31) Yes.
Naomi Denson (24:39) Okay. And then your providers, so you can see with the caqh imports, these got to about 76 percent. So there’s… still some missing documents and then signing their agreements, et cetera. So, with.
Lia Hood (24:55) the documents, did that pull documents from caqh? It?
Naomi Denson (25:02) Would have, yes, but caqh, the only document they actually require to attest is their Coi… right? So they don’t require copies of licenses, copies of diplomas or anything like that. So majority of the time providers don’t put them in there.
Lia Hood (25:18) So, I’ve.
Naomi Denson (25:20) if they were in there, they didn’t require them.
Lia Hood (25:22) Okay.
ShirleyHooker (25:24) Same, I mean,
Lia Hood (25:26) that’s our standard process is that they all get everything gets uploaded. So… like this person, I’m not even going to try to say that name. We’re just saying… if we were to need to add her to a new location, you guys would reject it because you didn’t have enough information.
Naomi Denson (25:51) So it’s only set. So she hasn’t signed her agreements yet.
Lia Hood (25:56) Let’s just say she signed her agreements is what I’m trying to say. So like what are you going to tell me that you can’t submit to a payer because you don’t have those diplomas, the driver’s license, or the CV? Nope?
Naomi Denson (26:09) Those are only relevant to certain payers. So in the enrollment checklist that I sent over for the individual providers, you can see like the documents that they are looking for it. Wait, it’s a college diploma payer specific that’s only for like brand new medicare enrollments for MDS and dos, where they require the diploma… the CV resume medicare.
Lia Hood (26:36) Doesn’t require that, that’s weird.
Naomi Denson (26:43) For, not for reassignments but for a brand new enrollment, it’s our understanding that they require a copy of the diploma… and then malpractice board certification. Yeah.
Niccole Russell (26:58) And I will say Shirley and Lia, as far as the provider profile, as long as they sign the agreement, their profile has to be at least 85 percent before it falls into intake, so you can request. But until it’s 85 percent and agreement has been signed, then it will not go into intake for it to distribute to, you know, pay your enrollment.
ShirleyHooker (27:22) Right. Is the agreement that you’re speaking of needing to be signed? Is that the one that goes from within medallion over? Yes. Okay.
Naomi Denson (27:34) Yeah.
ShirleyHooker (27:38) So, is that something we can have a copy of? No?
Lia Hood (27:42) It sends out through, surely, it sends out through the system.
ShirleyHooker (27:45) Okay. Just making sure that that’s what I understand when.
Lia Hood (27:48) We so remember last week we talked about sending an invite. It’s part of that invite that goes out. Okay? Yep.
Lia Hood (28:00) Okay. All right. Surely we’re going to have to get a game plan together on this with the girls?
ShirleyHooker (28:08) Yep. I agree.
Lia Hood (28:12) I want to start, I want to start at the group level because I, we got to get these. We got to get these new people out yep.
Naomi Denson (28:21) Okay. If there’s anything else that I can help with, let me know, but, we are well on our way and then just take a look at those checklists that I sent over because it’ll show you the minimum requirements needed, for intake to push an enrollment through to operations.
Lia Hood (28:42) All righty. We’ll do that all.
Naomi Denson (28:45) Right. Thank you. Everybody. Have a great week.
Niccole Russell (28:48) Thank you all.
ShirleyHooker (28:49) Right. Thank you.
Naomi Denson (28:51) Bye bye.