Transcript
Amy Barfield (00:00) hello? I,
Brittany Dees (00:01) can’t remember? Was this one of the meetings that Svetlana was not going to join or she is going to join that’s? Why we moved it to Monday? Okay?
Svetlana Vinokur (00:13) Okay. I can hardly hear.
La Toya Pough (00:19) You Amy?
Amy Barfield (00:23) Speaker might take a minute to like kick in. Okay?
La Toya Pough (00:30) My volume’s.
Amy Barfield (00:31) out… James doesn’t like me?
Svetlana Vinokur (00:39) It’s.
Brittany Dees (00:40) kind of, it’s like how it was before you got your speaker?
La Toya Pough (00:44) It’s, very low, like we can hardly hear you.
Amy Barfield (00:48) I mean, it’s on.
Svetlana Vinokur (00:51) Hold on. I can hear you. Oh,
Brittany Dees (00:53) there you go.
Amy Barfield (00:53) Oh, good. Okay.
Brittany Dees (00:55) Yep. There you go. Okay?
Amy Barfield (00:56) Sometimes it takes a minute to kick in. Maybe I needed to wiggle the cord or something.
Svetlana Vinokur (01:05) Okay. I am so glad I got the medicaid Massachusetts done. So, the… only issue is, yeah. So, Latoya, we need to get that one provider.
Svetlana Vinokur (01:30) Enrolled. Yes.
La Toya Pough (01:32) I did see your email and I responded. I’ve started on the application. Okay?
Svetlana Vinokur (01:37) Okay. So, hold on, Kelsey is doing something?
Svetlana Vinokur (01:53) I just got an email from Kelsey that… Massachusetts is trying to get a hold of me. Oh, because they’re sending emails, medallion is still sending emails. Well, hopefully, they will stop, because now they marked it as completed a task. So, okay. Okay. I wish they were so eager on other stuff, you know?
Amy Barfield (02:20) I know, right? They’re like stop, okay?
Svetlana Vinokur (02:23) You know, it’s like where do we? Okay. So I still noted that Kansas medicaid pay providers is still pending dependencies versus med dependencies.
Amy Barfield (02:44) Yeah. I mean, as I told you last week, the process is, once it’s submitted, it flips from it won’t you won’t see like dependencies met. It’ll go right into submission based on how it’s reported to our team.
Svetlana Vinokur (02:58) Okay. But I just want to make sure that it’s Kansas providers are being released.
Amy Barfield (03:04) Yes, it, they’ll be released once they’re submitted. So, it happens all at the same time.
Svetlana Vinokur (03:10) Okay. It just, I, because, okay… I want to talk to you about the Georgia medicaid and then we get to complex care. So, this Martha, yeah. So medallion… is telling us that it was submitted not in time but that’s not actually correct… because as I looked at, there are so many requests actually. So, let me see Martha gross and I’ll share my screen.
Svetlana Vinokur (03:55) So, if I look at her, so it’s true that initial one was done in 912, effective seven one.
Svetlana Vinokur (04:04) And then immediately we asked for demo demographics update and it says here polling location required retrobacked at 310. So, right? On 912, the same day as… we as the… we received the effective… day, we asked for the retro… and I… see that our 925 medallions are working on it.
Svetlana Vinokur (04:46) And… get it. Effective nine one… and completed the task even though we asked for very clearly here. It’s 310. And then I guess there… was another task open… again on 11 five asking for 310… and it says it was closed because it was a duplicate. So, so we did request 310. And then again, something was done again on 12 30 now, because, and we asked for again, so we asked for this retro three times from… medallion. So when medallion now comes and say we submitted it too late on 1,210, 12 30 whatever that, that’s not correct, because that’s not what we did.
Amy Barfield (05:55) You research that, and then I will get with the specialist.
Svetlana Vinokur (05:59) Okay. So… and I think there is another one to the Hebrew love or something like that. I think her last name or something. Love. I remember love in there.
Brittany Dees (06:13) Love Glenn. Yeah.
Svetlana Vinokur (06:15) I found the love. Yeah, there’s not a lot of love here but, you know, so the thing here, so she was affected by one. Then we asked for the demo and… we asked immediately, like, for the retros.
Svetlana Vinokur (06:43) And then medallion marked it as complete.
Svetlana Vinokur (06:51) Saying it’s effective one 126.
Svetlana Vinokur (07:00) Like, I guess like they shouldn’t be completing them, if that’s not true, right? If we’re asking for the retro, and then one 126. And then we put it in February again, kind of right? Again asking for the retros. So it’s the same thing. We ask for retros immediately and medallion closed the task by adding the facilities but not following the retro request.
Svetlana Vinokur (07:35) And I don’t know Amy kind of if we can go back and claim we did ask and they just didn’t I don’t know. Yeah.
Amy Barfield (07:44) I mean, if we’ve got proof that we did request that date, I’ll have to look and see.
Svetlana Vinokur (07:50) Okay. Yeah. But I know that we did, right. So, okay.
Svetlana Vinokur (08:00) Yeah… that’s why I think we’re just getting these tasks out.
Svetlana Vinokur (08:11) So I was looking and, you know, I have a call with Derek right after this and Nicole. So I will block to her again that medicare in Michigan is still says rejected in pcos?
Svetlana Vinokur (08:39) Okay. And so they had.
Amy Barfield (08:43) conferences last week, so.
Lori Durkin (08:45) Amy.
Svetlana Vinokur (08:49) They, when, and I’ll talk to Nicole, right? Like, so she’s gonna reach out for this Karen, Teresa… west, but I, we also have dr williams, right? And… and Alexandra wright. So that on the medicare that we need to… try to work.
Svetlana Vinokur (09:23) Because if I look at my, are they all for the same state or no? No, they’re actually different states we had, we have issues with… miss Missouri, right? That one P town, but I don’t think anything we can do anymore. They gave us one extra week… but if I look at this guys?
Svetlana Vinokur (10:07) Oh, I miss medicare, Georgia. Probably, I don’t know where’s my medicare Georgia?
Lori Durkin (10:27) All right. So.
Svetlana Vinokur (10:31) But, yeah, like, you know, Teresa, but Kumar was the Kumar and her like were the same issues.
Svetlana Vinokur (10:57) So, we requested on 514 and.
Svetlana Vinokur (11:17) 828. So I guess we, nothing we can do on this 828 day 29. So I guess they gave us as much as they could because it took us forever. Okay? So here he, him, we can’t what… is with all the PC?
Svetlana Vinokur (11:53) I guess all of BC was still waiting but yeah… we requested 625.
Svetlana Vinokur (12:07) If we’re still waiting for that rejection.
Svetlana Vinokur (12:15) See what happens there?
Svetlana Vinokur (12:22) Okay. Connie harris was denied. So let’s see what Karianna says she is.
Svetlana Vinokur (12:36) So, Connie harris, we asked for 424.
Svetlana Vinokur (12:44) Provider tentative standard is may 523. So 528, right? Was submitted. So you would think that we should be easily getting Connie harris, 228. Laurie, can we look at? How is it possible that she has earliest date of service 228, but I’m reading notes, provider, tentative start date is may 25.
Lori Durkin (13:18) Probably the CCM hang on. Let me get her pulled up here. One second. Connie harris, you said I’m sorry. Yeah, yeah. One second. Sorry, I had to hop on my phone here. I can’t get on teams on my computer one second here.
Svetlana Vinokur (13:34) So, but she was rejected feeling because non responsive development. So it might be the same issue that?
Lori Durkin (13:45) Brother you said she started when?
Svetlana Vinokur (13:50) Dom’s note says provider’s tentative start date is may twelfth 20 25?
Lori Durkin (13:57) So, so far it’s chronic care management? Yeah.
Svetlana Vinokur (14:01) It says 512. Yeah, it says 512.
Lori Durkin (14:07) It’s all CCM Svetlana from what I’m seeing… here.
Svetlana Vinokur (14:13) Now the system is signing me out. That’s just great. I,
Lori Durkin (14:21) know, don’t you hate that it’s like insane. And then you forget your.
Svetlana Vinokur (14:25) password.
Lori Durkin (14:25) I don’t.
Svetlana Vinokur (14:25) even know my password. Okay? I guess it’s remembered. Okay, good. Yeah.
Lori Durkin (14:31) It’s all CCM. So it’s like non applicable basically.
Svetlana Vinokur (14:36) Okay. So, honeycares. Okay. So we need to see if we knew. Okay. Oh, this is really messing us up.
Lori Durkin (14:47) I’m going to nudge Jacqueline too, because these just got to get moved into that compliance hold bucket. Yeah.
Svetlana Vinokur (14:53) So, then they’re not on my, right? Yeah. So they’re not okay. So I have enough issues as it is. Did we need to do anything with Connie? No, no, no.
Svetlana Vinokur (15:09) Connie harris, we are good, but we do need the adams and wright, right? They’re in the same category as Teresa west. Okay. So medicare… oh, medicaid, you know, medicaid, Kentucky was just again resubmitted on March nineteens. I mean, it’s just not good.
Svetlana Vinokur (15:39) It’s looking at medicaid’s. It’s trying to get at least medicaid’s Laurie, have we set up a majority of medicaid’s already kind of to be able to bill? Like medicaid, Massachusetts should be good to go. Okay?
Lori Durkin (15:59) One second. Yeah, I mean, we’re plowing through there’s some I need access to, but hang. on. Hang on. Okay?
Svetlana Vinokur (16:05) I just want to make sure medicaid Massachusetts is up and running.
Lori Durkin (16:08) Massachusetts. Yeah. Which one is that? Under which complex?
Svetlana Vinokur (16:12) Midwest M, M… I just got confirmation for one. We are effective.
Lori Durkin (16:26) Medicaid Massachusetts. It is here, but it is not complete. So we will prioritize that one right now. Okay? Can.
Svetlana Vinokur (16:33) you? Yeah, because that’s Dawn you?
Lori Durkin (16:36) Got a, you got a provider number there that if you got it up in front of you though, send me a second, happen to have one or no. I can’t see. Sorry, what do you need? What do you need? Do we have a group provider number?
Svetlana Vinokur (16:47) So, I have this confirmations that… provider id is?
Lori Durkin (16:54) That, yeah, just forward that over to me and Dale, just forward that email over to us that’s.
Svetlana Vinokur (16:58) all I’m just curious if it’s the same. So it’s different for different location. It looks like.
Lori Durkin (17:05) Okay. Then we’re, that was gonna be my question.
Amy Barfield (17:07) Each location.
Lori Durkin (17:09) Ooh, yeah, a group provider number for each location, it?
Svetlana Vinokur (17:13) Looks like provider service location. Yeah, it looks like it because that’s what I’m I just got.
Lori Durkin (17:20) Oh my God. Okay. Then I gotta get buffy to put every single one of these in, yeah. And,
Amy Barfield (17:25) you can look it up on the mass medicaid website. You can just plug in the, and it should give you.
Svetlana Vinokur (17:36) Okay. Yeah… because I got… okay.
Svetlana Vinokur (17:51) Bernadette, I have like the best, my best friend, Bernadette now.
Svetlana Vinokur (18:01) Amy, where do you look that up at? I’m sorry, I’m.
Amy Barfield (18:04) looking it up.
Svetlana Vinokur (18:06) Here I can forward it to you, Laurie, it’s like right here please?
Lori Durkin (18:12) Do, yeah, because I’ll need buffy to put one in for every single group.
Svetlana Vinokur (18:19) Okay. So I forwarded to you. Thank you. Okay. So, Illinois… Indiana, I think finally it was released or at least… oh, no, it still shows pending dependencies. Yeah. Well, Indiana still shows and I know you told me because some of them are showing a sign. See like this one’s showing a sign there’s.
Amy Barfield (18:55) some that are requests out because they were term, providers. Yeah.
Svetlana Vinokur (18:58) Which is fine. But this one see, this one still says pending dependency, but other ones says, assigned, yeah.
Amy Barfield (19:05) Let me, I don’t understand that.
Svetlana Vinokur (19:07) Yeah, Paul knows. So he says, okay. So, but then this is for midwest M, but then for midwest H, they still all say pending dependency… like a bunch of them here… some of them are completed and some of them are pending dependencies. Yeah.
Svetlana Vinokur (19:49) Okay. So, Kansas now it is fully complete. So dependency math. Okay. So that’s but this one is still being… partial and I have some… of them completed, some of them pending dependence.
Svetlana Vinokur (20:33) So, really concerned that Kentucky, we basically started just from scratch and Missouri is still not.
Svetlana Vinokur (20:45) Like Missouri… Kentucky and Missouri are like huge issues because see here, it says that they don’t even know like 319 received the email that it was rejected.
Svetlana Vinokur (21:05) Yeah, I just, yeah, I know.
Amy Barfield (21:10) We talked about that something about the W9, but they actually don’t accept the W9. They want that letter. So, I’m supposed to wish but today.
Svetlana Vinokur (21:28) So, North Carolina, unable to complete the tasks and select the tech team support versus what the heck does that mean?
Svetlana Vinokur (21:45) It’s North Carolina, midwest M is.
Amy Barfield (21:48) That, that QA code or something unable?
Svetlana Vinokur (21:52) To complete line, send slack to tech support for assistant, but majority of them at least were released. I thought that paramount North Carolina, we cancelled. We stopped, didn’t we not, I don’t.
Lori Durkin (22:08) know why that’s showing. Yeah.
Svetlana Vinokur (22:10) So,
Svetlana Vinokur (22:37) can we maybe release New Hampshire because it looks like we at least have something, we have a few… effective. So, can we release New Hampshire providers? Yeah.
Svetlana Vinokur (23:08) Okay. Texas large backlog that’s great.
Svetlana Vinokur (23:41) So this partially completed thing for Wisconsin medicaid… I don’t even know why would Farid be a midwest M? Because he is not midwest, M, he’s midwest H… like why would he even?
Svetlana Vinokur (24:09) Yeah, we don’t need midwest M for him?
Svetlana Vinokur (24:24) Just… yeah, like here… yeah, that enrollment, we don’t need this because he is midwest H, not M and popley is the same… but we need to release any… providers because it’s partially completed.
Svetlana Vinokur (24:57) And have we, Latoya, have we started complex care medicaid, Wisconsin? Kind of, do we have the same process as we have for Theoria?
La Toya Pough (25:11) We haven’t started Wisconsin yet. I haven’t gotten a provider for Wisconsin.
Svetlana Vinokur (25:17) Okay. But we haven’t kind of started the same process as we have for medicaid. Like all day. We haven’t done that. Yes. Oh, we didn’t.
Amy Barfield (25:26) yeah.
Svetlana Vinokur (25:30) Okay. So, so Amy on the medicaid, Kentucky, Missouri are the two that we like really don’t have anything. And then on Wisconsin, New Hampshire, North Carolina, we should, Indiana, Kansas, we should just release the provider because at least we’ve partially done… that. Thank you on the united, right? I finally signed a few contracts today because I actually got the information I needed. I.
Amy Barfield (26:05) Pushed so hard on Friday. I actually stayed up late on Tuesday and got a few.
Svetlana Vinokur (26:12) Oh, I know I seen like I was traveling. You see, I was on the airport really late myself, right? So, yeah. So, I saw all your emails, I know.
Amy Barfield (26:19) I was like, she’s responding. She’s at it too, you know, but yeah, I like timed out things to go out to them like starting at like six a. M the next morning so that they would like get on it. I’m looking.
Svetlana Vinokur (26:37) At the blue crosses, right? And our blue crosses on complex care have not moved at all like in a really long time. And so, I don’t know kind of like I’m just.
Svetlana Vinokur (26:55) Yeah.
Amy Barfield (26:55) I had a meeting with our team leads and managers on about… getting having a team focus on complex techniques and putting them in place. Blue cross blue shield was the topic of discussion. They know that blue cross blue shield, medicare providers since you have your group and medicaid’s a priority. I also added unitedhealthcare on that list since.
Svetlana Vinokur (27:30) Medicaid lines.
Amy Barfield (27:31) Of business we’re having trouble with. So we got those lips out on Friday to contract states to try to transfer from.
Amy Barfield (27:45) If you have those lines of business with. So… those are the top four. Yeah. And then.
Svetlana Vinokur (28:01) Amy can, do you mark priority health kind of on something, hold whatever so that they don’t contact? Yeah.
Amy Barfield (28:11) I thought we did, but I’ll double check.
Svetlana Vinokur (28:16) Because they’re still contacting and we should just pause until we got the contract. We got kind of everything.
Svetlana Vinokur (28:28) I also got a bunch of Michigan.
Svetlana Vinokur (28:40) And I also got a bunch of records for them approved so we’re gonna, I’m gonna send it. Yeah. So we need to process that in the system just so we have it for our records and I’m and I went back to them a little more. Yeah.
Amy Barfield (28:55) I saw the email imported that this morning. So at the end of the day, they’ll have it updated.
Svetlana Vinokur (29:01) Okay. And.
Amy Barfield (29:03) I did tell them to hold all.
Svetlana Vinokur (29:09) You disappeared, Amy? We cannot hear you.
Svetlana Vinokur (29:17) Yeah. Now, it’s gonna be went on and off it’s.
Lori Durkin (29:20) very breaky. Yeah. Every other word, almost let.
Amy Barfield (29:24) Me turn off my cameras. Can you hear me better now? Yeah.
Svetlana Vinokur (29:29) Yeah.
Amy Barfield (29:30) The priority health lines have been put on hold this morning. Okay? Gave that list of providers to our team leads to those updated by the end of the day. Okay?
Svetlana Vinokur (29:42) Okay. So, Laurie, let’s just make sure we can build priority health also on starting kind of four one or whatever, right? Like they said, they will give us a little bit of a grace… but a bit, we should set them up. So, so.
Lori Durkin (30:01) Align longevity and… priority.
Svetlana Vinokur (30:07) Priority priority. Got it. Yeah. And in, I assume paramount Ohio as well on your list. It is not paramount.
Lori Durkin (30:20) Ohio? Yeah.
Svetlana Vinokur (30:21) Paramount, Ohio. That’s for midwest M only because all our providers, will be able to bill only under midwest only. Okay?
Lori Durkin (30:29) A line?
Brittany Dees (30:31) Emailed me this morning and wanted to confirm as a four one. All providers can start billing. Okay? Yeah.
Svetlana Vinokur (30:38) Yeah. I saw that email then.
Svetlana Vinokur (30:40) Thank you. Okay. So, and blue cross blue shield of North Carolina… I’m actually working with them directly and it will be effective for one. The only thing is she asked maybe to hold claims for a little bit so that it loaded in the system. So, blue cross blue shield of North Carolina, by the way, I got the midwest M as well because it wasn’t so I signed, but she said I’ll be able to make for one but you will need to hold status until you receive executed contract from me. Reasons being that we must just give a little bit of time but make sure that blue cross blue shield of… North Carolina goes for mid atlantic H and M midwest M, ready to go as well because I have those contracts done.
Svetlana Vinokur (31:52) Laurie? Yeah. Okay. And see it’s both see I have medicare, blue cross, blue, medicare. So we have a medicare alliance and I think Amy, I forwarded those to you guys or if not, you should make sure that the mcdalian knows that I’ve been working on those on the blues, on the blues for North Carolina yep?
Amy Barfield (32:15) Yeah. Do you want me to? I was trying to pull them up?
Amy Barfield (32:24) For the providers or the I?
Svetlana Vinokur (32:28) Well, she said the roster, the groups I’m just confirming, she said, like I asked her before, and she said she doesn’t need rosters because she has everything and we… did the, we did the training. Let me see if I.
Svetlana Vinokur (32:55) Because I, she said she calls me ma’am, she loves that. Yeah.
Svetlana Vinokur (33:08) So just trying to see my communication with her?
Amy Barfield (33:15) So those are all medallion owned right now. Do you want to keep them medallion owned? Put them on hold until you get, yeah.
Svetlana Vinokur (33:22) Put put medallion owned, but put them on hold because I just want to make sure kind of, and then we’ll flip it to us… or you can flip it to us. That’s fine. I’ll just need to update. So, I asked her, do you need the roster of the providers? And she said no ma’am, I don’t… okay. So I assume once it’s all done, we should be okay with North Carolina. And then we are working on Kansas City… 316.
Svetlana Vinokur (33:59) So full up with her on that later this week kind of they’re working on that. But Amy, like Wisconsin, right? Kansas, like all of that is still kind of not even close of being done for anything. So as, you know, yeah. And I know Nicole was pushing the team. So, and has there been any kind of on the medic on blue cross of Michigan? I talked to her. I think that was on my kind of right? That nothing is moving. We still like, I don’t even understand this… Michigan blue care network. Lori, did we ever get paid even on that on anyone? No?
Lori Durkin (34:56) It’s been a nightmare to be quite honest, and I think it’s a let’s see. Well, wait a minute. I think we got some payments, but I think it’s a narrow network or something. One day, it’s been a nightmare from day.
Amy Barfield (35:11) One. Oh, that narrow network has to be through a hospital.
Lori Durkin (35:15) That’s the Henry ford. I believe that’s what I want to make sure. So.
Svetlana Vinokur (35:20) I’m trying to kind of write. So this is the medic. So, so we still have this medicare lines are the biggest. And then regular blue cross blue shield of Michigan. Is that commercial or what is that one?
Lori Durkin (35:37) Connected care that’s different?
Svetlana Vinokur (35:44) I can see who the patient providers are, but we have tons of them… and we have the same issue with complex care because complex care only got medicaid so far. Yeah, look at this, Patricia blank. How big those?
Svetlana Vinokur (36:20) So on her, like, I don’t know what’s going on with Patricia blank?
Svetlana Vinokur (36:32) Is she good? Yeah, both have been pending since August… like look at this follow up 310, unable to connect on 226, unable to connect. Like, I mean, how are they, how effective this follow ups, right? Like nothing, portal’s still not showing. So basically for the portal’s still not showing. So this is what an application resubmitted again on 1,216.
Svetlana Vinokur (37:12) So, they submitted the wrong application… and then on 12 six, I mean, this is… maybe I should show this to Nicole on my next call as an example.
Amy Barfield (37:28) Yeah, that’d be a great example.
Svetlana Vinokur (37:31) Okay. Yeah. And I have 30 grand on her sitting.
Svetlana Vinokur (37:41) Just on this Michigan blue, what is there? Julie?
Svetlana Vinokur (37:49) Julie toff… oh, Laurie, by the way, did you get all this information to ecw for that person to rebuild license issue, right? Deal?
Lori Durkin (38:01) Yeah. You know, I’m working directly with medicare on it. I should have an update. Okay?
Lori Durkin (38:11) BCN is not that narrow network with Henry ford. It’s an hmo plan by the way? No.
Svetlana Vinokur (38:18) This is, I don’t even, it’s blue cross blue shield of Michigan. Like direct. It’s it’s Michigan blue care network. Yeah.
Lori Durkin (38:29) It’s separate from just traditional BCBS. So it’s like an hmo plan that requires enrollment as well.
Svetlana Vinokur (38:54) Yeah. So it’s hmo plan.
Lori Durkin (38:57) They got, they got, yeah, and they make numbers like pick a PCP and it’s just a little bit more strict that.
Svetlana Vinokur (39:06) Point back to my data provider is just, okay. Patricia. Okay. Julie taffo. Okay. So, since 24, okay. I mean… several application faxed on behalf of provider and I advise that the fax would reach to one of the October caring advice that only the fact that she’s seeing that this provider received on and currently working on this application. So a year and a half later.
Lori Durkin (39:46) It’s been a nightmare. Yeah.
Svetlana Vinokur (39:48) Okay. I’m gonna show this kind of, but… this is that this is part of the normal like request when we request, right?
Svetlana Vinokur (40:07) Right. So, why this one is only showing commercial exchange aca?
Svetlana Vinokur (40:21) Is even bad worry? Like, we did not even recall. So, so complex care, is that all correctly? All the… but this one?
Svetlana Vinokur (40:38) Only asking for commercial exchange. So no medicare medicaid?
Svetlana Vinokur (40:47) But then it was put on pet dependency.
Svetlana Vinokur (40:57) We’re receiving questions?
Svetlana Vinokur (41:11) I don’t know, what are they? Like, what are they showing here? That it’s not available? Or like what are they showing this with this printout?
Svetlana Vinokur (41:31) Basically showing that she’s not in the in on the screen?
Svetlana Vinokur (41:41) Jamie, how do we add to this one to make sure that, they, I’m sure they are requesting everything because see, it says line need to replacement dependency because medicaid enrollment is still pending. So that means that they were planning on requesting everything.
Svetlana Vinokur (42:17) Trying to see what?
Svetlana Vinokur (42:27) I would say I would set that on an application. You would, it would be what you’re requesting, right? Yeah… there should be like check boxes.
Svetlana Vinokur (42:50) I’ll see you here.
Svetlana Vinokur (42:59) That’s for complete Michigan, which is, yeah. So they said that it’s the wrong form that they completed to begin with. Okay? This?
Lori Durkin (43:10) Should all be done on availability though? Really? Are we not using availability? Let’s?
Svetlana Vinokur (43:17) See.
Svetlana Vinokur (43:23) Is it? So this is the new that they started in December?
Svetlana Vinokur (43:34) Okay. So they are requesting?
Svetlana Vinokur (43:40) So, they are requesting everything that we need. Okay? So that’s good. But it’s only in December that it was done.
Svetlana Vinokur (43:57) And then after December?
Svetlana Vinokur (44:05) There’s like a bunch of like pull ups that nothing is happening.
Svetlana Vinokur (44:23) Yeah. Okay.
Svetlana Vinokur (44:32) I mean, you know, where to push.
Svetlana Vinokur (44:38) And after your call with Nicole, we have the internal team. Okay. I’ll push her right now in Michigan kind of in blue crosses like this is, yeah. And a few many case, Kentucky, Missouri… completely not done…
Brittany Dees (45:03) Amy, I have a couple, just a couple things. Sure. I received an email for Nikki speck, SPECK… for her Indiana medicaid. We have a demo update to add a location, 2002 west 80 sixth street. However, I received an email from medicaid saying that they’re not going to process that request because the provider is not a rendering. IHCP.
Brittany Dees (45:37) And it says, you know, please refer to your respective state website to enroll or update. Once active, please resubmit request. Is that?
Brittany Dees (45:53) Do you want me to forward you the email? Yeah, if you’ll do that, okay?
Svetlana Vinokur (45:59) What is it? ICPHI.
Brittany Dees (46:02) HCP. That is not a rendering, IHCP.
Svetlana Vinokur (46:12) Indiana health coverage program provider setup under Indiana coverage program.
Svetlana Vinokur (46:22) Rendering provider should be in ppamd billing provider is Groupon clinic, IHCP equal Indiana medicaid program. So they’re saying it’s not active, but we do have… her effective 11, 720 25.
Svetlana Vinokur (46:52) Who has access to Indiana medicaid? Yeah, it’s.
Lori Durkin (46:58) it’s medallion and it goes by each individual location. Yeah.
Svetlana Vinokur (47:04) So, she was enrolled only was one location and we are asking… what are we asking? Well, we actually ask for?
Svetlana Vinokur (47:21) Retro… this 86 Indianapolis, and I think that’s the one that she’s enrolled. Yeah. So she’s enrolled with that location and we ask for the retro.
Amy Barfield (47:35) But Brittany’s talking about the 2002 west? Yes.
Svetlana Vinokur (47:41) 2002. Yeah.
Brittany Dees (47:44) There’s a demo update out for it. 2002 west 80 sixth street.
Svetlana Vinokur (47:51) I don’t see it.
Brittany Dees (47:54) Let me screen.
Svetlana Vinokur (47:57) Yeah, yeah, no, no, no, but it’s not 2002. It is 86, two, 2002 weight, 86. And that’s the one that they are enrolled with. So we just need the retro. So.
Amy Barfield (48:14) You’re you’re saying she is enrolled with that? She?
Svetlana Vinokur (48:17) Is enrolled with that facility effective five 525. And we ask that we need retro?
Svetlana Vinokur (48:32) No, we need retro to 522 and she’s enrolled effective 11 seven.
Svetlana Vinokur (48:42) So, it’s a regular retro that we’ve been, we’re asking for the location that she’s already in. Yeah.
Brittany Dees (48:48) And then the email is just saying they’re… unable to process the request at location because the provider is not rendering an ihcp so.
Svetlana Vinokur (49:02) Which basically says they’re saying that she’s not in medicaid. Yeah.
Amy Barfield (49:08) We need to confirm enrollment again in effect.
Svetlana Vinokur (49:11) Yeah. Can you, Amy, can you look into that… please?
Brittany Dees (49:21) Okay. And then, Amy, I’m getting okay. And then this is just one of the emails and I’ll share my screen, but I’m getting a lot of emails from payers essentially just saying like, hey, this provider’s already enrolled. It’s like almost like we’re duplicating efforts here. And then I got this email from meriden saying that please note this is the join our network request submitted for this group within the past year. So, I’m not sure if this.
Svetlana Vinokur (49:54) Has, which state is this? Let’s see? Does it say it’s meridian? No?
Brittany Dees (50:03) Not Georgia Michigan.
Svetlana Vinokur (50:06) Meridian, Michigan. And what’s the payer… meridian? It says meridian wellcare all the same, but we already enrolled with them. Yeah. So we’re adding the providers maybe that’s.
Brittany Dees (50:22) what they’re saying that this is the 20 fifth and we’re already, you know, enrolled with them.
Svetlana Vinokur (50:30) Okay. But do you see what they’re saying the contracting team does not process the following for the following existing contracts. So, so they’re saying, if it’s if you want to enroll the practitioner, it’s a different, it’s a different process and.
Brittany Dees (50:48) Then there’s a different process for demo updates. And then, yeah.
Svetlana Vinokur (50:52) So they’re just doing it incorrectly. Okay. Yeah. And, and forward it to, Latoya, can you document that, for our internal process as well… for the meridian?
Svetlana Vinokur (51:16) So, Brittany just respond to them and just tell them thank you for the email. Appreciate the feedback. We’ll we’ll provide it to our credentialing vendor medallion going forward. Okay?
Brittany Dees (51:29) Yes, yes, I can. Okay. But so, but then I’m kind of getting a lot of these emails. Amy and I’m not sure. So like I’m getting a lot of these ones where it just says practitioners already an existing member. And I’m it’s this is for blue cross North Carolina. Okay?
Svetlana Vinokur (51:54) So, so I think Britney, we just need to look at those kind of who is the problem later?
Brittany Dees (52:01) The proof it is, let’s.
Svetlana Vinokur (52:05) See. Okay. And now that’s not initial requests.
Amy Barfield (52:12) Trying to link them that way because that’s the way it’s requested in medallion rather than just sending a demographic to link them. Okay?
Brittany Dees (52:20) Okay. So then, and so then that’s why they’re sending back an email saying, hey, this, they’re already. Yeah. When that happens, I would that.
Amy Barfield (52:29) Does support and say this provider is already enrolled with medic with blue cross with shield. They submit a demographic update. Okay?
Svetlana Vinokur (52:39) I’m.
Brittany Dees (52:41) not even seeing a provider’s name on here. I… guess they have an id number, but, okay, because I have a lot of these ones. So I’ll go ahead and.
Svetlana Vinokur (52:54) Yeah, let’s review them, Brittany, creative. And, and if it’s a process kind of that we need to go through, make sure Latoya understands the process, kind of right? And, and we discussed with medallion as well. Okay. Thank… you. Okay. Sounds good.
Svetlana Vinokur (53:22) I will not be on the Friday call but, or maybe I will, I don’t know it depends. Yeah. Okay. Thank you, everyone. Okay?
Brittany Dees (53:36) Thanks. All. Bye bye.