Transcript
Kyle Rice (00:00) Kyle, hey, Audra, happy Monday. How you doing?
Audra Ficken (00:03) Doing good. How are you doing?
Kyle Rice (00:05) Good. It’s been a weird day today. I feel like.
Audra Ficken (00:08) it’s been a day.
Kyle Rice (00:10) I hear that.
Merritt Miller (00:13) That’s alright?
Audra Ficken (00:18) Just trying to get caught up from meetings.
Kyle Rice (00:20) I hear that.
Kyle Rice (00:27) We’re just waiting for merit from our side of the house too.
Audra Ficken (00:31) Yeah. Meaghan will be joining us shortly.
Merritt Miller (00:33) Awesome.
Merritt Miller (01:11) Hey, merit. Hi, how’s everybody doing?
Audra Ficken (01:15) Good. How are you?
Merritt Miller (01:17) I’m good. It’s my last call on a Monday so I can’t complain me too, me?
Audra Ficken (01:21) Too, last call of the day.
Merritt Miller (01:26) Hi, Meaghan. Hey.
Meaghan Bowman (01:28) How’s it going? Merit?
Merritt Miller (01:29) It’s going well, just adjusting to the spiky temperatures here. I don’t know if you guys are having any of that. It was very hot this weekend. Oh, yeah.
Audra Ficken (01:37) Yeah, it was 90 degrees this weekend, which is crazy for March. So I.
Kyle Rice (01:44) feel like I feel like spring kind of roars in and then you go back into like false winter for a little bit and then like it kind of just hits you in waves like all the way through April.
Audra Ficken (01:52) Yeah. We’re having bad wildfires, really bad wildfires everywhere. There’s been like three, several 1,000 acre wildfires, and like people’s homes are burning down and I’m like it’s March. We have all summer before we have wildfire season. So it’s kind of not good. Oh.
Merritt Miller (02:12) Gosh, you’re in Colorado?
Audra Ficken (02:14) I’m in, South Dakota.
Merritt Miller (02:16) Wow. I don’t know if I’ve heard of that. That’s pretty wild. Yeah. Oh, goodness, do you all know if Kate will be joining?
Meaghan Bowman (02:26) I think she’s double booked. Okay. Not a.
Merritt Miller (02:31) Problem. Well, we can probably get into it. I don’t have anything super formal prepared. I’ve got some of your policies pulled up that we can take a look at. I provided a lot of suggestions in them and started reviewing them and wanted to kind of chat through some of what I saw in there. And then I’ve been partnering with Kyle on some of the ongoing monitoring questions. We can also chat through any of that or the npdb so what would be best for you? All? I’m happy to start anywhere?
Audra Ficken (03:00) Meaghan, I defer to you. I think npdb is like the biggest one. I.
Meaghan Bowman (03:03) was going to say, I think npdb is the last one because, you know, we flagged Sade keys, Hannah sabig, and Olivia sibenik, and it does look like that was truly a data integration. I just pulled a full sanctions audit log and everything appears to be happening there for those providers, which is awesome and a huge relief. But for the npdb, I’m still confused because like Krista ruboski would be who I’m looking at specifically… and it’s… differing information. So, I had reached out to Bridget about an issue with Krista ruboski and Mike michif, and I was like, hey, you know, why aren’t you all like flagging these, what’s going on with these two providers?
Meaghan Bowman (03:50) And she informed us that they actually didn’t have npdb enrollment going on right now. She told us that there is no option to auto re, enroll in medallion and that we would have to do this ourselves. And I mean, it kind of makes sense because we flagged that with her on February. And then now that we’ve got this resolved, now, we’re starting to get a lot of emails come through to us because ruboski does have sanctions on her npdb. So how do we, but you’re saying that this has always been going on in the background? Yeah?
Merritt Miller (04:27) Do you want to show me what you can see on your screen for that one? If that’s not too hard to pull up? It does seem like our support rep might have been confused with the npdb verification. So, I think as part of this, Kyle and I can take back and kind of make sure they know what to investigate. But my suspicion is they are confused because when I looked into this, everything seemed to be happening as expected on my side.
Meaghan Bowman (04:52) Okay. Let me see.
Merritt Miller (04:55) If I can, I’m looking for the thread on my end too to pull this up. Okay?
Meaghan Bowman (05:00) Can everybody see my medallion screen? Yes. Okay. So, yep, I had asked her on February 20 third. Hey, could you help me determine why the npdb verification termed on August eighth? 2025 and has not been reintegrated? For Mike michif, and then the same thing for Krista hrabowski, it looked like her npdb query termed on January fifteenth, 20 25. And this is, this was her response is that, you know, let’s see blah blah integration does not run retroactively or automatically and re enroll providers if their enrollment has ended or been termed. So since npdb verification termed on August eighth, 2025 and hasn’t been reintegrated since you don’t automatically re enroll providers, manual re, enrollment can be done by starting the npdb enrollment in the platform. Enrollment is necessary for ongoing monitoring of providers. And, I fully agree with that. And that’s why I was like, yeah, that’s a problem. And shortly after we started getting this, I started getting emails for Krista hrabowski because she does have a sanction on her report. And I just, I find it worrisome that it wasn’t happening before, but you’re saying that this has always been… monitored for her. Yeah.
Merritt Miller (06:26) And, I might be the use of like when you put npdb query termed, did you see termed somewhere in medallion? That might’ve been what she was going off of and she might not have even gone to look at the verification section, but did you see that on your side? Yeah.
Meaghan Bowman (06:41) Yeah, it’s in her verification section. Let’s bear with me if you went to the verifications.
Meaghan Bowman (06:54) And we looked at npdb. See now it says it’s sourced on 317, but at one point, it did say that it termed on 115, 2025. And then for Mike mitchif as well.
Meaghan Bowman (07:06) And we have a lot of providers who are kind of in that awkward window of when we enrolled them in August of 20 24. And now we’re coming up at that point where it’s like, hey, it’s 20 25. Did they get re enrolled or not? Yeah.
Merritt Miller (07:22) Let me know if you see that word termed, where you typically see that is on the verification status, how it says in progress on your current screen or the ongoing monitoring report, it would show that there’s like missing data or something’s wrong. And it would actually give you a message there. Like this looks totally expected to me. And you might have gotten an email. Cuz when Kyle flagged this to me, I did run an mpdb just to make sure there was nothing kind of hidden on the back end that we weren’t able to see. So that’s probably why you got a new alert for this one right after you said something. So it’s probably just Kyle and I checking into it. But the mpdb unless you see some kind of error message would be functioning as expected. It will only push a new, it will only push you a new alert. If there is something that was flagged to them to mpdb. Okay?
Meaghan Bowman (08:13) So, then why didn’t that happen? I mean, it’s still even not here on the full sanctions audit log. I pulled it today and if I look for, I’ve pivoted to anything that needs attention, you know, Katherine Gunnison, she’s onboarding that’s fine. But if I tap, if I double click on Krista ruboski’s, report or even Mike mitchoff’s you know, she only had needs attention flagged in March when we got those emails. But this sanction event was well before that, this was almost five years ago. Why didn’t we get any alerts before that? And?
Merritt Miller (08:47) So you didn’t get an alert back in 20 24 when we ran the cred file or?
Meaghan Bowman (08:52) 20 25 or before when we had our governance agenda, she wasn’t flagged at all as having any issues. So why is it just now when the issue on her npdb is coming up on five years, correct me if I’m wrong, Audra?
Merritt Miller (09:11) Yeah. How about Kyle and I, we can check the email logs for this. There should have been emails sent around those dates, to your team. So why don’t, we just do a double check and make sure everything went out as expected there for her because I, I’m just not seeing anything in the system that indicates it’s not working as expected. But if you never got notified about this issue, that should have happened.
Meaghan Bowman (09:34) When it should still exist in the sanctions log too, right?
Merritt Miller (09:38) Yeah, it should, yeah, remind me here.
Audra Ficken (09:44) Shouldn’t this be running every 30 days?
Meaghan Bowman (09:49) Not,
Merritt Miller (09:49) npdb. It only runs when there’s a new query to it. If that makes sense. Like ncqa describes npdb as one of its continuous monitoring sources. So our, that’s where I provided a lot of edits and suggested edits to you all on your ongoing monitoring policy like npdb, unless you run a report every 30 days is not gonna, it’s continuous. And that’s how they kind of explain it on their site, that only when a new alert is pushed through on their end, will you get a new sanction information for them.
Meaghan Bowman (10:26) But we should still check it every 30 days to be within ncqa compliance. I.
Merritt Miller (10:31) Can, let me show, maybe I can show you some of the language I proposed and what ncqa says about this. I think Kyle sent you an email that had some of it as well. The way ncqa frames it all. Let me grab this statement. It’s within 30 every 30 days or within 30 days of a calendar alert for continuous monitoring such as npdb. So in the case of npdb, if you get an alert, you have 30 days to review an action based on that alert, not every 30 days. So.
Meaghan Bowman (11:07) Since this is her result and she’s got all of these issues flagged on here. Why didn’t they show up? Like even on the 20 24?
Merritt Miller (11:17) That’s what I want to go back and check the email alerts for the 20 24. I’m not sure if Kyle and I can check the logs on that one, but does it make sense that like that only would have come up at that time and it wouldn’t be monthly?
Meaghan Bowman (11:30) Then why is it coming up now on the fifth and the seventeenth multiple times that?
Merritt Miller (11:36) Was probably from Kyle and I testing it like we were making sure the integration was still working as expected. So you probably got a new hit from us running it?
Meaghan Bowman (11:46) Okay. So, is it trigger?
Merritt Miller (11:50) It like I had to push a button to run it. I just wanted to make sure since you guys had some concerns that everything was running as expected.
Meaghan Bowman (11:57) Yeah… because I feel like it should have done it here as well. Like it should still at least be on the sanctions log too, even if it’s like an email fine. But if we’re reporting to our delegated credentialing committee, we should see sanctions and it’s still not here either.
Merritt Miller (12:19) Yeah. Let Kyle and I check into the 20 24 one and see what email was sent for that, because it should have been sent at that time that it was run. You should have gotten an alert for that.
Meaghan Bowman (12:33) Okay. And same for Mike michif, he’s got some stuff on his too. And then it looks like as soon as we brought it up to medallion, you know, in February that’s when things started populating again in March. Yep. So I think it’s like, is it really, is it really happening? Yeah?
Merritt Miller (12:53) No, I totally get the concern you’re like, well, now that I see this now that I’ve said something and that’s just from me testing to make sure everything is still expected. There were no error messages like I’m just going to run one just to like triple check, but we’ll check back on the emails that were sent for the alerts because that’s how they’re going to come over from medallion and make sure it was sent during that window.
Merritt Miller (13:17) Okay. I guess if.
Meaghan Bowman (13:19) there’s issues with it, should we still be checking our own nptb… because right now, it seems like there’s a few glitches and bugs and I can’t really get consistent data from these medallion logs.
Merritt Miller (13:33) No, it’s all functioning as expected. I just want to check and make sure the emails were sent out. I think what I’m trying to convey is like the way nptb works, it’s not every 30 days. It’s just 30 days after you have alert. Do you need to make sure it was monitored? So you might not see anything ever again. If there’s no issue that comes back up on their nptb report or at a re, credentialing event, we would pull an nptb and put one in the file that’s how the continuous monitoring works and how you’ll just want to make sure that’s written in your policies.
Meaghan Bowman (14:08) I guess I’m confused why this is running as expected. Yeah. How for a year and a half, nothing populates… that’s.
Merritt Miller (14:22) correct. It’s. Only 30 days after you get an alert from nptb. So if something gets reported to nptb, you’ll get an email and it’s going to pull on your reports as an alert and an issue. And then that’s what you would need to take to your committee.
Audra Ficken (14:39) Go back to the Krista urboski one.
Audra Ficken (14:45) So then, okay, this is just for me. So I think it pulled in 20 24 because Krista urboski, she started in 20 24, I think Meaghan, but the 20 25 one, the January fifteenth one. Yeah. What, what triggered that one? I’m not.
Merritt Miller (15:02) Sure. If we did a cred file for you during that window, Kyle and I can look and see what maybe we have tied to that event.
Audra Ficken (15:09) It might have been a cred file, Meaghan, because that was the credentialing committee meeting… the one they did in 20 25. Do you think that’s when it was, could you verify for that merit why something would have happened that day? Yeah… there was one credentialing committee meeting in 20 25 and it was in January looks.
Kyle Rice (15:36) Looks like we did her initial credentialing in January, around January 20 25 for her. I just pulled up Krista.
Merritt Miller (15:45) Yeah, that was most likely what that was.
Merritt Miller (15:53) I think what I’m just trying to get across is we like our monitoring matches in cqa’s language and they describe the time frame for reviewing and reporting, sanction exclusion and limitations on licensing within 30 days from a new alert if subscribed to a continuous monitoring service, which npdb is. So that’s why there’s not like a monthly event for you guys to tie back to it’s. Just if there’s a new alert from npdb if something gets reported. And then some of these are probably just from me pushing it out of your concern that something’s not hooked up correctly and, it runs smoothly, which shows that it’s still there and working.
Meaghan Bowman (16:31) Oh, we lost Audra.
Merritt Miller (16:33) Oh, no. It.
Kyle Rice (16:37) Looks like for, is that date for Krista? Hrabisky, is that 116, 20 25? It looks like that’s when we completed her initial credential?
Meaghan Bowman (16:44) 115, 115. Oh, her internet went out?
Merritt Miller (16:49) Oh, no.
Audra Ficken (16:50) Yeah.
Meaghan Bowman (16:56) Okay. So.
Meaghan Bowman (17:02) Then, I guess I’m… just trying to figure out how I present this stuff to the delegated credentialing committee because if I go off of what… was it?
Meaghan Bowman (17:16) I think we went off the analytics sheet and we just did ongoing monitoring and it was like in progress or, you know, like at least the full sanctions audit log says clear, whereas in progress doesn’t really look like much is going on. And then the other thing on top of that too is we don’t even know if there’s good data integration between everything. So, the files that we were pulling it was like, hey, you’re missing some providers? Yep.
Merritt Miller (17:48) No, I totally get the lack of trust from that situation happening. We, we did rectify that and there are going to be some improvements to this tab in the future. Our engineering team is actually like doing some interviews and scoping that to where you can actually like mark a sanction as reviewed and then what the outcome was at your committee. So there’s lots of stuff to come for that I think will make this workflow a lot smoother for you. And Kyle will keep you up to date as we hear more from our product team. But what I would recommend for your committee is just filtering by the look, the period that you’re bringing to them and then either the needs attention and have them review. Because the other thing that’s tough is this doesn’t show that you’ve already reviewed something or not. It’s just kind of like a big snapshot of data. So I would just drill it down to, the dates you’re looking for and then the outcome of needs attention.
Meaghan Bowman (18:39) Okay. Hang on.
Meaghan Bowman (18:40) I’m going to try and click on like Danielle labari, because like I said, it says it termed and that matches… what Bridget was saying is that npdb termed. So it’s like, okay.
Meaghan Bowman (19:02) Yeah. So if we look at this npdb clean on August eighth, 20 24 enrollment status is until August 30 first 2025.
Merritt Miller (19:18) I can call npdb and just get some more details on that message, but we renew your npdb every month that it comes up. But that makes sense like that’s something medallia known. So I don’t know why it would be sharing that everything from our end is still hooked up perfectly correct?
Merritt Miller (19:35) Like if this is just showing complete, it’s got the source on date. Everything is correct on our end. But that message is kind of strange. So I can just get some clarity on that if that’s causing any kind of lack of trust, on your side? Yeah.
Meaghan Bowman (19:49) Yeah, because it looks like it termed. So we don’t think it’s being done. And then with Krista ruboski not being flagged for us, it evidences that it’s not being done. And then combined with Bridget’s response that it’s not being done.
Merritt Miller (20:05) Yeah. I think support was just a little confused by, that terminology, but it’s all hooked up and it’s all running as expected. I just want to look into some of this and Kyle and I can give you like the dates of some of those emails for those issues that went out a little bit more description of like what ncqa says about mpdb and how we approach it. And then I can get what this enrollment status means as we’re passing this over, but everything is still hooked up correctly on our side. Okay? And then,
Meaghan Bowman (20:39) are we concerned at all that these state disclosure answers are in progress? This work history gap is in progress. This malpractice is in progress for a lot of our providers, but other providers, it’s all filled out because I’m pretty sure that’s an ncqa like work history gaps is an ncqa thing to be monitored.
Merritt Miller (21:03) It’s not to be monitored. It’s just during initial credentialing events. So, if we did not, it just, we’ve changed the way this page looks. So, you have completed credentialing packets, from us and it’s possible that this just wasn’t configured before those were done, but you should have a packet or unless this is one that’s in the request queue for our team to work. This is how we work and complete these verifications, but… it’s not like indicative of monitoring or anything. Okay?
Meaghan Bowman (21:31) But for us to have approved a roster for our governance agenda on February… this is fine.
Merritt Miller (21:41) This.
Meaghan Bowman (21:42) is reported the way we want it to be for a medallion? Yeah.
Merritt Miller (21:46) You wouldn’t use any of this, for reporting to them, you would take the cred packet through committee when we complete that. So.
Meaghan Bowman (21:54) We do need a cred packet then for this provider, if.
Merritt Miller (21:57) we have not credentialed her for you before? Yes, you would want to request a credentialing request for us to give you that packet, how?
Meaghan Bowman (22:05) Do I see if she’s been credentialed before?
Merritt Miller (22:08) Let’s see. So if you type her name back in the providers tab, this is how I look, Kyle might have a different way that he directs people. I.
Meaghan Bowman (22:18) Was gonna go completely different way with that merit?
Merritt Miller (22:19) All right. Well, good. There’s multiple ways. And then if you scroll over recred, scheduled, yep. So it looks like we have already done a credentialing packet for Danielle. Okay?
Meaghan Bowman (22:32) So, for ncqa for that credentialing packet, for all of her new stuff to be done, it has to be done within 180 days, right? Of the.
Merritt Miller (22:44) re of the credentialing request. So she’s not due again until her recred request in 30 whenever, 36 months from that, the decision date was, okay?
Meaghan Bowman (22:54) And I feel like that’s part of our language discrepancy as well because when you say credential, we don’t use medallion for pay your credentialing. And so, since we only had that one meeting in 20 25 for delegated credentialing and the roster wasn’t even approved or ratified in any meeting notes, we had another governance agenda in February. That… was our governance. I’m.
Merritt Miller (23:21) not sure if I’m as up to speed on that. I’m mostly on the delegated credentialing front. But if there’s anything we can do to help you all get some data, just let me know. But, yeah, this is mostly related to like delegated credentialing okay?
Meaghan Bowman (23:35) So, this… cred pack is medallion saying like, yes, we credentialed her on whatever date. Let’s just say, I don’t even know. It doesn’t even say when that cred packet was done… yeah.
Merritt Miller (23:56) If you go to, so if you type her name under credentialing, and then the close request, it will give you the packet, the details, all those dates that’s just like one quick way. I like to see like where the request is in the life cycle.
Meaghan Bowman (24:09) Okay. So that would be the date that you credentialed her medallion. We didn’t add her to our roster for over 180 days. Is that not an ncqa metric? I’m.
Merritt Miller (24:26) not sure about adding to your roster to give to the payer and the timeliness of that. But if you need us to run another credentialing request, you can just throw the request in and we can do it.
Audra Ficken (24:37) Okay. How?
Meaghan Bowman (24:40) Much does a cred packet cost?
Merritt Miller (24:45) Kyle, I’m going to pass that over to you. It depends on what’s in your contract for a cred request?
Kyle Rice (24:51) For the delegated, I believe it is a unit price of 1,000 per.
Merritt Miller (24:57) No, no, that’s not right? No, that’s not right. We can get your account manager to give you that Megan.
Audra Ficken (25:04) Let me.
Kyle Rice (25:04) Pull that from Salesforce for you guys. I can get the unit cost for you. Must be something off here with the consumption here.
Meaghan Bowman (25:11) I’m glad I asked because I mean, as far as I’m concerned, like from the language that I’m seeing like, yes, you need to do the credentialing within 180 days of adding them to the roster to be presented to delegated credentialing committee.
Merritt Miller (25:29) Well, it looks like this already went through your committee based on the approved outcome here. No, so.
Audra Ficken (25:36) This would have been, so Meaghan, this would have been back in 20 25. They did a bunch of async approvals that’s what these are.
Meaghan Bowman (25:45) But they weren’t ratified, and.
Audra Ficken (25:47) that’s why they’re listed in the, they’re listed in async minutes… or like they’re right? But they were at that time. So they’re not going to reappear for recred for us like we would have had to manually request that… you know, like that’s a part that I think that we missed.
Audra Ficken (26:14) Because they would have went through as like a clean file.
Meaghan Bowman (26:18) So,
Audra Ficken (26:21) if we wanted to get… them back through delegated committee, I think that’s something that we would have had to manually request. How often does the system merit? How often does medallion push them through recred automatically? Is it every three years?
Merritt Miller (26:39) Yep. Yeah. The ncqa cycle every 36 months?
Audra Ficken (26:43) Okay. Yeah. So if they were marked as clean Meaghan, which automatically approved, they wouldn’t come back through for another three years.
Meaghan Bowman (26:53) Well, and I get that, but… I guess we’ll have to look at our old minutes because my understanding was like only three providers made it through the actual credentialing committee. And some of them aren’t even here anymore.
Audra Ficken (27:10) I’d have to go back and look, I don’t I mean, it’s hard to say like what exactly they reviewed, but there were clean files mentioned.
Merritt Miller (27:23) That’s that’s pretty common just so you know, a lot of our customers don’t take clean files to committee. They just have a policy that states they can vote on them in that manner and then delegate someone to do that and mark it in the system. But if there’s any go ahead, yeah.
Meaghan Bowman (27:38) No. I was going to say we do that too, but we have, our medical officers sign off on them asynchronously.
Merritt Miller (27:48) Well, yeah, if there’s, a standard you all are concerned about or want to pass it to Kyle and I to take a look, please just let us know how we can help. But, from our perspective like these were clean, these were files that were approved by you all. And then like Audra said, we’ll go into our recred cycle unless you request a new addition, a new initial credentialing event.
Kyle Rice (28:09) And then, Megan, I just pulled, the list price for each credentialing, I believe it’s 110 per each credentialing instance. Yeah.
Meaghan Bowman (28:18) 110 dollars or 1,000. Oh, okay.
Kyle Rice (28:21) 110?
Meaghan Bowman (28:22) Yeah, I was going to say that sounds a lot better than a 1,000.
Kyle Rice (28:25) Yes, it does. I apologize there. No, no, no.
Meaghan Bowman (28:28) You’re good. I was like that one’s going to be tough for them to swallow. But, okay. So, possibly, we need to do a recred on the providers who don’t have all of this done. I.
Merritt Miller (28:47) would say it’s up to you. You would need to do if we do anything off cycle, it would be an initial credential request. So we would just get them on a new recred cycle and redo it all. Again, this verification page is probably old. So, it just depends on what you all had configured back then. And I’m not sure why it’s saying that, but it gets, when you put in a cred request, this kind of refreshes the way it’s supposed to look for our team to work at. It’s. Been a while since we’ve done some cred for you all? So it’s possible that’s why it looks this way.
Audra Ficken (29:16) Is there a way we can test that with Chris urboski? Because I don’t want to send… 50 providers back through, yeah, cred and just have them not like, I want to see what this would look like should Chris urboski run through a recred, because I have a feeling… I just don’t want to create a bunch of work where there is none. I.
Merritt Miller (29:40) Actually, when I was meeting with you guys, had the team run a file was like,
Meaghan Bowman (29:46) a Francis Shetty?
Merritt Miller (29:47) Yeah. What our new packet looks like. So that should be able to give you what they, because you really don’t need to use this verification section. You should be using the packet that goes through in the ready section. This is again just kind of like troubleshooting mpdb and taking a look at what the team did, but you wouldn’t want to use this for anything other than just like taking a glance. The cred packet has all the information you guys need.
Audra Ficken (30:11) Okay. Click on credentialing and see if it can because you?
Meaghan Bowman (30:16) Just did Rebecca’s for us so we can see what a clean file looks like. And this one has all of that on. It has her malpractice, has her state disclosure, has the work history?
Audra Ficken (30:37) Yes, I’d be interested if we ran Christy hrabowski, again through our cred, if that would populate just fine. Well.
Merritt Miller (30:44) What are you guys trying to use this for? Why do you want to see some of the verifications get marked complete? Or what are you looking for? Well, it’s good practice.
Audra Ficken (30:54) I mean, I guess for me looking at something like we’re relying on medallion as a vendor for provider data management. So if we go to a verifications page and we see a bunch of stuff in progress that’s like kind.
Merritt Miller (31:08) Of concerning.
Audra Ficken (31:09) For us. So we want to be able to, we also pull medallion data into other systems. So if we have unclean data or data that’s out of date or anything like that, it can make things really confusing and messy. So like this looks wonderful to me. I love looking at this and seeing like clean sourced on whatever date, this is perfect. So it sounds like for like thinking back to another to Christopher basky, or another provider that was verified a long time ago. This… verification page is not live. It’s not a live page.
Merritt Miller (31:49) No, but the like on this packet or this practitioner. And specifically, if you would go back to the cred tab, Megan, I would encourage you guys to look at like the packet from the ready tab. If you scroll over, this has all the information and the point in time that we credentialed her, which will be the most relevant. If you hit the blue link that says credential. Yep, this will show all of that information and the checklist that’s in cqa compliant and all of that, that’s just kind of the source data that pushes into here once the team reviews and signs off on it. Okay?
Meaghan Bowman (32:24) So, correct me if I’m wrong because I think we were going over this in one of our emails, but you said specifically with the ongoing monitoring issue that we identified with sibenik, that this verification window here was the source of truth and that’s how you knew sibenik was still being run because it was the source of truth. But now it’s possibly not, no.
Merritt Miller (32:48) But this is just where I was troubleshooting it and where you would see an error message for the ongoing monitoring. So like for any of the ongoing monitoring verifications, which some of these are and some of these are not, this is where I go to see if there’s any kind of missing data with the npdb, it would show up here. It’s just kind of like a helpful investigation tool. But like the compliant credentialing packet is on the other tab that you would use and take to any meetings.
Meaghan Bowman (33:19) Okay. So this is what we want to take to the meetings, not the look back, not the other files that have been sent to us. Can I ask why these weren’t sent to us to take to our credentialing committee? I?
Merritt Miller (33:32) Just don’t I don’t think you guys have run any files through cred for a while. These, these were, all, these are what, this is, what is generated as part of our cred process. So you can like click each tab to get more detail. You can download it. And most of our customers like download them and then mark them up and take them to their committee meeting. So if you go to any completed credentialing file, you should be able to see these packets versus having to look back at the verification tab, these packets would be your source of truth for a credentialing request. And what happened at that point in time before it was voted on?
Audra Ficken (34:06) Yeah, Meaghan, we can sync on that. I am understanding of that piece. I’m looking back on 20 24 minutes and there was a lot of files approved asynchronously.
Audra Ficken (34:21) So they wouldn’t have shown up and are like… unless they’re automatic, unless they’re up for repread, they’re not going to show up for us.
Meaghan Bowman (34:31) Right. So then we’re not worried about the work history validation possibly not having been done for those other providers. Let’s look at a closed one from 20 24. It should.
Merritt Miller (34:46) Have been done. It just might have looked a little bit different. We’ve made a lot of changes to our cred packets, but all still compliant. It’s just started to look better over the years. Can.
Audra Ficken (34:57) you find Krista hrabowski’s, oh, yeah. I think you can start to the top maybe hopefully.
Meaghan Bowman (35:04) Can you, yeah, to.
Merritt Miller (35:06) The, the name, yeah, she.
Audra Ficken (35:08) Has… a closed one right there, yeah.
Merritt Miller (35:17) Nope. If you would have scrolled over, yeah, that would have it… that one.
Merritt Miller (35:38) It’s in the application and attestation. Again, we’ve made some changes to make this easier on you all reviewing it, but it would have been in there at this time.
Meaghan Bowman (35:56) Okay. So, and then this one has it.
Meaghan Bowman (36:02) So, is this just like a syncing thing?
Merritt Miller (36:08) Sorry, what do you mean? The mpdb yep. I would expect that to be in here. We completed credit this time. So we would pull the verification into the packet.
Meaghan Bowman (36:17) Okay. So why doesn’t this appear on the verifications?
Merritt Miller (36:24) It should be the same on the verification. So, if you go there.
Merritt Miller (36:36) Then you click it, y’all, resourced.
Meaghan Bowman (36:39) It on the seventeenth. So now, we’re not going to see.
Merritt Miller (36:42) If you hit view history on the top right corner, you can see the one from 20 24 and what it looked like, but the system’s just going to tell you that you’re looking at an old copy that we pulled, right? But it should be the same unless there’s been new action since then.
Meaghan Bowman (37:07) Okay. So it does have it on here, but we just didn’t get any email alert. Yep. And.
Merritt Miller (37:14) that’s what Kyle and I are going to take a look at, because we would have a log of that being sent. So we’ll go take a look on the back end on our side to make sure it was sent.
Audra Ficken (37:24) Okay. Well.
Meaghan Bowman (37:25) Then, so for, I don’t know… guess, Audra, do you want to just meet on what we present to the committee? Because… like the full sanctions log won’t do it because that’s not how npdb runs. Apparently. So the full sanctions audit log isn’t our best thing to present to the committee. Do we want to present individual cred packets of each provider for approval?
Audra Ficken (37:59) Yeah, because they reviewed them last, we can talk after this call on them on it on what we’re going to do. Can we, so if we want to manually send providers back through for cred, how do we do that… for a credible? Yep.
Merritt Miller (38:20) So under request right there, you would work just request at the top, right? You would just request the provider you’re wanting to send back through. If you drop it down, it should kind of show you what that looks like. The top right request initial.
Audra Ficken (38:35) I’ll be able to do it for each one. I.
Merritt Miller (38:37) Think it lets you type in multiple names. So if you hit initial credentialing, it’s not going to do anything. But yep you would start searching and just pull up the ones that you want. Okay? And if this is more Kyle’s realm. So if this doesn’t work, we can, I think we might have to do something with the current scheduled recreds and then request additional ones. But we can figure that out if it is something you guys are interested in.
Meaghan Bowman (39:07) Okay. So if these… this would just be the initial. So we couldn’t do it for a lot of these because they already.
Audra Ficken (39:16) Have they already had an initial? Yeah?
Meaghan Bowman (39:19) We.
Merritt Miller (39:20) we can redo that. I would recommend if they’re it’s showing you that because they’re and they’re pulling correctly in the recred cycle whenever that becomes due. So that’s why that’s happening. But I would just recommend if you have a list, you can send it to Kyle and I, and we can figure it out. We would probably just need to close out the scheduled recred. You would run an initial. You would need to vote on it, and then that would get it in a new and correct cred cycle.
Audra Ficken (39:47) Yeah. Can you get us pricing for that? Because in all honesty, I don’t know how this credentialing committee was ran in 20 24 and 25. I don’t know. I wasn’t there. I don’t know if everything was done up to snuff. And now that it’s with us, I want to make sure it’s good… 99 percent of our providers except for Christopher ruboski, and maybe dr michif will come back with a sanction or will not come back with a sanction, they’ll all be clean. So I’m just curious what the pricing is to run an initial all over again for all of our providers, ideally, most of them will be clean, Megan. And then we can just be like here’s, the clean providers just ratify that. And then the only providers we have to go over are going to be Krista and maybe one or two others.
Meaghan Bowman (40:46) So,
Audra Ficken (40:46) then maybe that’s worth doing again if it’s not like, yeah.
Meaghan Bowman (40:50) Yeah. So.
Merritt Miller (40:55) Then this,
Meaghan Bowman (40:57) one’s ready.
Audra Ficken (41:00) So, yeah, we would review her if she’s not clean, if she’s clean, there’s no reason to put her through committee except just to say that she was a clean file and she’s good to go.
Meaghan Bowman (41:13) Okay. And then that’s how it comes in through the closed or the committee section. Yep. Or wait, what is this committee section? So?
Kyle Rice (41:22) That’s where you’d send it. I think there was three dropdowns for committees you had. I think I saw it was like clean needs review and whatnot, once you select the appropriate file there, it’ll go for committee to voting. And then whoever’s on the credit committee should get a notification that it’s ready for committee. And then they could put in, put their vote via the credentialing packet via the credential. Yeah. And.
Audra Ficken (41:43) We would do that in the meeting. Yeah, exactly. Yep. So we can, so if her file has nothing on it, which I don’t think it did… she can just be marked as clean.
Meaghan Bowman (41:55) And.
Audra Ficken (41:56) then we just give them an asynchronous list of all the providers that are clean.
Merritt Miller (42:07) We will, yep, Kyle and I can check in on pricing and those emails and a couple other things we discussed. I know we’re a little over, so we probably need to run the one thing we didn’t get to cover and I wanted to make sure you saw were my suggestions on some of your policies. Like we should put the language about how the continuous query goes in there. And I put a bunch of suggestions. So I don’t happy if you just want to start commenting on there, if you have questions on where I’m getting that from, or if there’s anything else I can help with, but I dropped in quite a few recommendations in there just to help.
Meaghan Bowman (42:41) Can I ask why factor ii is crossed out? Yeah.
Merritt Miller (42:45) No, we, this is like totally up to you. It’s just a best practice I’ve I recommend here. And to a lot of customers is there’s a huge lift of updating standard names because they change them almost every year. So we actually don’t reference standard names in all our policies. We just reference like the like if we’re talking about like the sanctions and exclusions, we just talk about that versus like making sure we’re like factor ii this. So that’s why I was just recommending to cross it off. It’s just a lot to keep up to date, but it’s totally your preference if you want to do that or not.
Audra Ficken (43:17) We do policy reviews annually. So these would get reviewed next year anyway. Yeah, I.
Merritt Miller (43:24) might recommend, which is how you guys are explaining the monitoring happens to do any kind of off cycle review of these. Because the way you’re explaining the 30 count, some of the monitoring of like every 30 days things are happening that’s not currently what’s happening. So it might be worth like if you’re going to take these files somewhere based on these policies, I think it’s a little mismatched, which is where I put some suggestions in there and wanted to kind of chat through that.
Meaghan Bowman (43:56) Can I ask what at least every 30 days versus the usual monthly check? Especially since medallion is currently well, maybe, I mean, I guess I don’t know now, it looks like Sam and oig verifications are happening more frequently per month, but I mean, correct me if I’m wrong. It looks like we’re getting Sam and oig at least twice a month, maybe three times. Yeah.
Merritt Miller (44:24) Those, those run continuously too. They’re very frequent checks but, I think I’m just giving you trying to improve the language based on the standard to get flexibility for mpdb because right now, there’s no mention that does not happen 30 days. It happens like you would want to make sure you have a policy that states 30 days after receipt of an issue. So that, that’s where I just was cleaning some of this up based on the updated standards. You don’t you don’t have to take any of my suggestions. It’s just what I would recommend.
Meaghan Bowman (44:53) Okay. I guess I hadn’t seen… the difference between the usual monthly checks versus the strict 30 calendar day cycle. Yeah.
Merritt Miller (45:09) It’s just not how mpdb works. So, I would just be cautious kind of describing it like that because, they would probably look for evidence of that. And that’s not how we’re running mpdb right now.
Audra Ficken (45:20) Do you have a copy of the ncqa standards that we can review? Because… we… I don’t think we have every single standard in full. I’m.
Merritt Miller (45:33) actually not allowed to share them out. I’m so sorry, they, when you download them, they make you sign a bunch of very serious things. So, I do not have a copy. I can share, but you can grab the standards from ncqa’s website or if you’re looking for like snippets of something like if you’re trying to validate something I shared, I’d be happy to share like snippets with you all like to, I think Kyle, I gave him the like mpdb one that notates how it’s 30 days after an alert versus every 30 days, okay?
Audra Ficken (46:00) Yeah, Meaghan, we’re just gonna have to purchase a copy.
Meaghan Bowman (46:04) Yeah, because what we could find online was strict 30 days and that’s why we put it in the policy. Yeah.
Merritt Miller (46:11) Yeah. If you guys don’t have a copy, I definitely recommend it. They’re they’re really helpful.
Audra Ficken (46:18) Alrighty. We’ll take a look at these comments and we appreciate you taking the time to review the policies and just… point out things that we might not have considered. So, I think just for action items from this call is reviewing the email logs and then pricing for the… cred packets. And then possibly we’ll circle back and see if we can put all of our providers back through the initial cred so that we can just sign, get them signed off with this more formalized committee that we’ve created compared to what exists before. I think this would be good next steps. Meaghan. Did you have any other next steps besides that?
Meaghan Bowman (47:01) No, I think I’m going to look through these against the policies just to make sure and review any comments. Perfect. Yeah, I’ll.
Kyle Rice (47:10) double, confirm the pricing for you guys. We’re reviewing the email logs. I know we’re slated to follow up. I believe Wednesday afternoon. So I’ll get the gap closed on the pricing and then we’ll get the look back for Christopher bowski, and Michael medchef. For I believe it was for the npdb period. We’ll get the gap closed there as well. I should have some additional information involved for you guys prior to then.
Audra Ficken (47:36) Okay, great.
Merritt Miller (47:37) Thank you guys. Have a good rest of your day. Thank you.
Kyle Rice (47:40) Thanks guys. Bye.