Transcript
Connor Morley (00:00) hey, Shannon.
Connor Morley (00:28) Good morning. Hey, Rick. Good morning. Who?
Rick Vance (00:33) Else? Do we have? We’ve got Shannon fantastic. Don’t see Nikki yet. Let’s see if I can open my, there, we go. There we go. I’ll check in with Nikki. It’s 11 three. Give me a second. No problem.
Rick Vance (01:05) Connor, Shannon, one thing I wanted to mention, we’ve got, I don’t know what information you’ve gotten so far. We have a app that was at oops, we lost Shannon space… coast and her full name. We call her Vic. Let’s see what her full name is. It’s got a lot of consonants… it’s on our website.
Rick Vance (01:32) I’ll tell you what, and space coast is off of our website at this point because it’s now Gomez, Gi, we had two locations that merged, but this individual is going to be seeing patients at a different address. So we’re going to need to credential her.
Rick Vance (01:58) With a different tax id number. So, is that as simple as adding addresses?
Connor Morley (02:04) Essentially. Yeah. But we also need to do… like a bulk demographic update with the payers that she’s associated with the new address that she’s moved to, which I think you said was Gomez. I also don’t see her on Gomez. Hang.
Rick Vance (02:23) On just a second. It’s she’s not going to be working at Gomez anymore. Space coast is now called Gomez. So that’s just a bit informational. She has a new address that she’s going to be working at, and I was wondering if Shannon could reach out to the office administrator, Karen to get the details about that?
Rick Vance (02:54) Once she joins?
Shannon Costine (03:00) Details on the address?
Rick Vance (03:03) Yes.
Shannon Costine (03:06) So that’s not something that we as engagement managers will do. You guys will need to put that information into the system?
Rick Vance (03:15) Okay. I’m still wondering if you can connect with the office administrator and walk her through the process?
Shannon Costine (03:23) Okay.
Rick Vance (03:24) Just to know what you need. Yeah, or what she needs to do.
Nicky (03:29) She should be updated to have those addresses.
Rick Vance (03:33) We don’t have the new address. She’s not working at titusville, Nikki, at space coast?
Nicky (03:40) Yeah, it’s the address on Sheldon.
Rick Vance (03:44) I don’t know. I haven’t seen it.
Nicky (03:47) So, this new location is happening for Gomez, the satellite office, okay?
Rick Vance (03:54) Not for Gomez for Sierra. Okay. She is now employed by Sierra as a new address. That’s why I’m asking Shannon to connect with Karen to get the details and then walk Karen through, you know, what is Karen? What’s Karen’s part in order to get your database updated?
Nicky (04:17) Oh, I’m sorry, it is already loaded. It’s south Hopkins avenue.
Rick Vance (04:23) Oh, okay. Then the website still has 1,268 rockledge boulevard on it. So I have the address.
Nicky (04:32) Right. So, he has two locations now.
Rick Vance (04:36) Technically, yeah, for Vic.
Nicky (04:39) Okay. Is she the only person going there?
Rick Vance (04:42) I believe so. Yeah, okay. Shannon, just for your awareness, the app’s name is Marivic, M a RIVIC, and her last name is quintanita. QUINTINIT a.
Shannon Costine (05:04) QUINTI a. Okay. Got it.
Rick Vance (05:08) QUINTINIT a… quintanita… got it. Okay. So, it sounds like the new address is in there. But if there’s anything else you need to get that address change and that group change, that would be great.
Shannon Costine (05:30) No problem. You got it.
Rick Vance (05:32) Thank you. Okay.
Connor Morley (05:35) And just so I understand. So the practices I see for maravich, quintanita is Brevard digestive, health in rockledge, Brevard, digestive, health in titusville and space coast gastro in titusville, yeah.
Rick Vance (05:51) That needs to get cleaned up. Now, it’s by dates, right? So, as of the sixteenth, it’s Brevard in rockledge… and Brevard in titusville and space coast is no longer going forward.
Nicky (06:13) Gomez GI.
Rick Vance (06:15) Gomez, which is now Gomez GI. Yes.
Connor Morley (06:25) Yeah, I think it would be helpful. So you all have the ability to go in and make some of these changes. But Shannon, I think this would be helpful as like a continuing education to kind of walk them through what exactly they need to do when some of these providers shift, or if the practice locations change or the practice names change and things like that. So we can do that as Ed and Shannon, all, you know, kind of lean on you to kind of have that training session. We did walk them through like some of the practice and group updates on the provider profile during training already, but it might be helpful to have like another training session on that. And then when we’re going through the training session, let’s be clear what the office administrators are able to do and what the admin are able to do as well because the office administrators only have a team manager… role. So I think they can add locations… but they only have the ability to do that for providers that are already under their team. So if let’s say you have a team at Gomez and it’s I think it was like three providers or something, but someone else needs to move to Gomez. The office administrator at Gomez would not have the ability to access that provider’s profile. But the office administrators of where they’re moving from, would and should be able to be able to do that. So, I think we just need to define what that workflow looks like and who has to do what? Because it might be a little, it might be opposite of what everyone’s thinking that not the person that they’re going to or the office admin, the office manager that they’re going to, has to change it. It has to be the office administrator that they are coming from. Does that make sense? Yeah.
Nicky (08:28) Connor, I think it’s all up to date. I just wasn’t aware it was live like it was actually the transition happened. So I think it should be up to date now for medallion, how?
Shannon Costine (08:43) Are you feeling working in the system Nikki?
Nicky (08:47) Okay. Yeah. Okay.
Shannon Costine (08:49) Yeah. It seems like you’re moving right along. So just wanted to make sure you were comfortable, yeah.
Nicky (08:57) Sometimes I struggle with the requests. It’s almost like it’s a different language. I’m not sure when.
Shannon Costine (09:04) I do too, Nikki. So don’t feel bad. I’m still learning it takes time. So don’t feel bad if you need to ask any questions.
Connor Morley (09:19) Okay. And just following up on the existing enrollments, Nikki, I apologize. I saw your email. So what we’re going to need to do now, unfortunately, we still can’t use that spreadsheet that was sent to us. Essentially what we’re going to need to do is we have this list of say like Aetna and all of the providers here. So what we’re going to need you all to do is essentially take Aetna and then in the data import template, hang on while I pull up my other spreadsheet, we would take Aetna and we would say for all Aetna payers, and we can just put that right here for Florida. You’ll use the fdhs medallion import in the provider enrollments tab. We can put another essentially just provider name. Whoa, that went too far. Just get the provider name for all of Aetna.
Connor Morley (10:38) Too, much, too much. And then we can make another column here and just have it be provider name. We do work off of provider… email and mpi mostly. But if you put in whoa.
Connor Morley (11:04) Having a bad day with spreadsheets today. Oh, come on, if we take all of these names, put them in here, we’re going to need their email and provider mpi, and then you can just drag down Aetna and do that for the other location and do that for the other payers as well. And if you see like and Shannon, correct me if I’m wrong, the Aetna versus Aetna aca plan, it’s essentially the same, right? It would just be a different line of business. Yeah.
Shannon Costine (11:41) I was going to say the line of business is going to be different, but yeah, it’s the same.
Connor Morley (11:45) Yeah. So if you see something like that, the line of business for commercial, it looks like would be true and medicare advantage would also be true for Aetna for all of these Aetna providers. And then we… would just need on top of that to match the location entities that they’re at too. So if you just put in all of the, you can just copy paste all of these entities as the practice or is this the group itself?
Nicky (12:20) The group?
Connor Morley (12:20) This is the group. Okay. Do you know if… there is any specific doesn’t… sound like you have any specific practice location information on here? Which is fine. We can pull that from the provider practice groups information and load that into the practice column… where’s the practice column. Yeah, the practice name and npi and… add that there.
Nicky (13:04) So the physical.
Connor Morley (13:05) Location? Yeah, we need the group information, but the group is just, it’s just one group. And then we need the practice location as well. So that’s where like if a practice does change, that’s where you would go into the system and then do… like a single or a bulk demographic update. So.
Nicky (13:25) Our practices don’t have individual npis. We only have a group npi. Would I leave that blank?
Connor Morley (13:32) You can just put in the group npi here or actually, sorry leave the practice npi blank. And then we can just put in a group and the group npi in column aa.
Shannon Costine (13:49) Do the practices use the group npi? They don’t have one at all?
Nicky (13:55) They have individual npis but for billing they use.
Connor Morley (14:00) The group, are.
Shannon Costine (14:02) you needing individual npis Connor, or just what they use for billing?
Connor Morley (14:06) Are the individual practice npis in the system right now?
Nicky (14:12) We don’t have practice npis, just the provider npi, like the location doesn’t have its own npi, just the provider.
Connor Morley (14:21) Yeah, there are none. We don’t need it. If it’s na, if you don’t have any practice npis, that’s fine. We can just leave column V blank… but we’re going to need this spreadsheet put into our data import template. And if you can just pull the provider names in here and their emails and provider npis, we can actually look that up if it’s easier to do like out of the report builder, we can take all the providers just so you don’t have to kind of by full name email.
Nicky (15:05) Npi. So on this sheet and on the spreadsheet, I don’t get the email. We don’t what do you need the doctor’s email for? What email is that?
Connor Morley (15:17) Yeah. The reason we need the email is that is the email and the npi are essentially are two like identifying components because they have to be unique per provider, like provider names, they can be close to unique. They can be close to unique, but, they’re not a good identifier. So, we always require two unique identifiers and typically, it’s provider email and provider npi, just because provider email because these two have to be unique, okay?
Connor Morley (15:56) And then… if you don’t have the effective date, the revalidation date or the end date that’s okay, you can always put just put in na… par status is helpful to know especially if you want to make a request for like a non par to a non par example, to get that provider par access, you can view it in the system and then request par access or participating for that provider.
Connor Morley (16:31) Does that make sense?
Nicky (16:36) Okay. I don’t know the payer id. Do I have to?
Connor Morley (16:39) No payer id. You can leave as na, that’s really used. It’s very seldom used. If you have it, you can add it, but it’s also like if you want to just leave this blank or na, we don’t necessarily need that.
Nicky (16:58) Yeah, enrollment method.
Connor Morley (17:01) With these, so we just, we’re just curious if these are any of these are direct enrollment with the provider. How are you? If you don’t know it, that’s fine as well. We would just lump them into that payer information… in general.
Connor Morley (17:27) So, if you say like for all of Aetna, we enroll with directly with the group and we like submit a roster, then we don’t then you can say, just like no credentialing required.
Connor Morley (17:53) Okay. All right.
Connor Morley (18:02) Any questions on this?
Nicky (18:04) Okay.
Connor Morley (18:10) All right. Shannon, anything you wanted to bring up? No.
Shannon Costine (18:16) Just to say, Nikki, I know you’re still learning like we talked about. It seems like you’re doing a good job with the system, but like I said, don’t hesitate to reach out if you have any questions.
Shannon Costine (18:29) That was it? Okay?
Connor Morley (18:33) All right. Everybody.
Shannon Costine (18:36) That’s okay. Connor.
Nicky (18:38) I’m sorry, I did have a question. What if they have multiple locations? Do I just put the primary location on here?
Connor Morley (18:46) No, we want all of the locations if they have multiple locations, like let’s say it is for Adam Shelley and he has multiple locations. What… we’d want to do is have two lines essentially for Adam Shelley.
Nicky (19:08) Okay. And,
Connor Morley (19:10) one line would be one location. The second line would be the second location. If there’s a third line, if there’s a third location, that would be another line. So it has to be a unique provider payer group and practice combination. So, if Adam Shelley works at three practices, we want to load all of those practices with Aetna in them. So that if you did update a practice location, we could either remove that specific practice location or add a new one. Does that make sense? Yeah.
Nicky (19:44) So within medallion, is there a way to build a report that gives me all of these other fields? And then I can just go in and put the payer. Yep. Okay.
Connor Morley (19:56) So you, so we have, if we go to report builder, I’m pulling in full name, email npi. You can also put in group. You… can put in group tins and group npis as well as practice. So you can put in practice name, is it practice name or practice npis? And then you would be able to see the practice names here, the group profile tins, the group profile npis. And then the practice npis for each practice name, practice as well. But the practice npis. It doesn’t sound like you actually need because it all falls under the group profile npis. How?
Nicky (20:41) About the locations? Will it populate all their addresses?
Connor Morley (20:45) Yep. I think you can pop in practice address.
Connor Morley (20:52) No.
Connor Morley (20:58) So you can’t pull it in that way, but we can go to the practice locations and we can just pull in all of the, we can download this and then potentially just add if you see like I forget what it was on the report builder. But if you saw something on the report builder for a specific practice… we might have to do a little excel spreadsheet magic in order to pull in the actual address.
Nicky (21:43) So, can I make a separate worksheet for each payer? I feel like that’s going to be the simplest way for me?
Connor Morley (21:56) I mean, you could, but when we load it, we’re just going to combine it all if that’s easier for you to fill this out?
Nicky (22:07) Like I want to have a template of all the doctor information and then I just want to put the payer name.
Connor Morley (22:17) Yeah, you could do it that way. So essentially, what you’re saying is you want to put in instead of going all by Aetna. You want to go, Adam, Shelley. Maybe like, I don’t know, I don’t know, how many payers?
Nicky (22:31) Or could I insert multiple payer names?
Connor Morley (22:35) No, we need a unique payer name. So you could go by provider, put Adam Shelley with how many practice and payers he has, and then just have Aetna blue… cross, blue shield, sunshine… united… and go that way and then go to the next. That’s completely fine. It’s whatever is easiest for you. Okay. So if you want to just start with Adam, Shelley, put down this information. You’d be able to just go down with Florida all the way and then put in, the… practice names for him as well as, the group mpis, you can do it that way. Okay? I have seen customers do it both. They go by the payers, starting at Aetna with all the providers or they start with the one provider and do all the payers. It’s whatever’s easiest for you.
Connor Morley (23:40) Okay. All right. Any other questions for me? Nope. All right. Bye guys. Have a good Monday. Thanks. Thank you, everyone. Thanks. Bye. Have a good week. Bye bye. Thank you.