Transcript
Connor Morley (00:00) hey, Connor. Hey guys.
Sheldon Kennedy (00:03) How are you?
Connor Morley (00:04) Doing good? We waiting on?
Sheldon Kennedy (00:08) Anyone?
Connor Morley (00:08) Else?
Connor Morley (00:18) One of the updates for par analysis, I’ll send out some notes later, but one thing that I am gonna need from you all is we have a list of the payers that you asked for, and we’re doing like a mapping process to make sure that they have the correct names in the, in medallion. Do you have a list of the lines of businesses that you’re looking for the, for… these? Or is it just we’re looking for all of them?
Jijo.Mattamana (01:00) Let me pull up the file that I sent you real quick. Connor, let me just refresh.
Connor Morley (01:07) I tried to look through that. I didn’t see them in there.
Jijo.Mattamana (01:11) I might have rolled it up to a higher. Well, let me see if I have like data.
Connor Morley (01:28) Maybe I just didn’t look in the right spot?
Connor Morley (01:36) But I’ll… send this spreadsheet out in the notes. But one thing I want to check with you all. Does this include all… of the payers… that… you’re looking for? All of these payers… that are here? We’ll map them to a, what they would be called in medallion. They look off the top of my just eyeballing them. They look like they would be included but I don’t know Vanessa, we have to run them through like a mapping tool to make sure.
Vanessa Persha (02:21) Yeah, that’s correct. I see a couple of them that may be similar matches to our standard payer name in medallion, but a few, we may need clarification on especially where there’s acronyms used and things like that.
Sheldon Kennedy (02:36) If you need the clarification on those, just reach out to me. I can get it for you.
Vanessa Persha (02:47) Connor, if we have a shared file we can use for the payer mapping. Like once you do your first pass at trying to map it once the new em takes over and she has that like we can work live out of that and she can just tag Sheldon and any payers where she has questions.
Connor Morley (03:07) Okay. I see. Yeah, jijo, is this the data where we could see some, yeah.
Jijo.Mattamana (03:14) That’s the raw data. So it looks like when we did the analysis, we have it rolled up to like that payer consolidated. And then primary payer are like the line business that have been grasping for it?
Connor Morley (03:28) Yeah. We’re asking for like the line, yeah. So for like medicare, I’m assuming that’s just traditional medicare, right? But for blue cross blue shield, like would it be commercial aca, traditional managed and medicare advantage? Like that’s kind of the level of detail that we’re looking for? I’m.
Jijo.Mattamana (03:50) assuming so just doing a quick work like it seems like a lot of these are problems where you include all like I’m looking at. So like we’ve got bpo in there, we’ve got medicare advantage. We’ve got the shape of science.
Jijo.Mattamana (04:12) Yeah. So I guess you want like a more like a view of that first half that I sent you with that data or do?
Connor Morley (04:23) We just, I’d like you to fill it out on this list specifically because this is going to be our source of truth moving forward not only with what you’ve sent us so far, but what it will map to in medallion.
Jijo.Mattamana (04:38) All right. So, we needed to like select all of them. So, for like that, anthem, like are we able to select all of them?
Connor Morley (04:48) Yeah. You can select multiple. Cool. Okay. So, yeah, it’s for anthem, bluecross, blueshield, if you can select whichever one’s multiple. And then in addition to that, when we start making the requests for these, like what is your… enrollment? Do you have any special enrollment considerations? Do you, are these roster eligible? Do you have like roster templates for any of these? They’re not, they’re a different like nonstandard enrollment process? Are these all direct enrollments?
Sheldon Kennedy (05:32) I can confirm for you, Connor, but I don’t think any of them are roster enrollments.
Connor Morley (05:37) Okay. So none are roster. Are they all direct enrollments? Or do you go through the group? I.
Sheldon Kennedy (05:43) believe so, but let me confirm. I’ll check with Maria?
Connor Morley (05:47) Okay. I was.
Vanessa Persha (05:52) Just going to say to add on to the lines of business section. So traditional medicare and medicaid are reserved for just medicare medicaid. So if you are looking for the managed medicare or medicaid products under a commercial payer, you would use those managed lobs… there. Managed medicaid or medicare advantage? Okay?
Jijo.Mattamana (06:20) And Connor, how many players do you have?
Connor Morley (06:26) 68.
Jijo.Mattamana (06:42) Share that file with me? Yeah.
Connor Morley (06:56) Hang on. Let me just turn… on. You can get access. I got to change the file permissions one second. Okay. I just put in the chat, I’ll throw it in the notes as well. Let me know if you have access to that document.
Sheldon Kennedy (07:22) And,
Vanessa Persha (07:23) Sheldon, when it comes to filling out like the non standard enrollment process section, that would really be reserved for calling out anything outside of like going to the payer’s website and doing a typical enrollment through their website or through their portal that’s where we would want to know what your specific instructions are like. If you submit applications directly to a contact at the payer, instead of submitting through an online web portal, we would need that information. And then of course, who you submit to the cadence that you submit to those just thinking of any unique scenarios we would want to be following on our end.
Sheldon Kennedy (08:05) Got it. And where would that go again? So.
Vanessa Persha (08:09) That’s going to be in the non standard enrollment process. So if it’s again like a specific person you’re sending it to you would change column J to say yes. And then in column K, if there’s a document, a particular document that you utilize, you would paste a link for it there. And then in column L, you would outline any of your actual processes.
Sheldon Kennedy (08:42) Got it. Okay.
Vanessa Persha (08:58) And then, I’m so sorry, Connor, I just wanted to ask really quickly when you submit your enrollments today. Are you utilizing your group npis on your applications or do your locations have practice specific npis you’re submitting for?
Sheldon Kennedy (09:15) I think it’s practice specific on some.
Vanessa Persha (09:19) The actual npi itself or?
Sheldon Kennedy (09:25) It is, let me pull one really quick.
Connor Morley (09:36) Are you pulling it?
Vanessa Persha (09:42) And I’m just looking, I’m… looking at your data, your practice location data too, just to see if we have.
Sheldon Kennedy (09:54) Yeah, by practice.
Vanessa Persha (09:56) It’s by practice. Npi. Yeah, yep.
Suzyb’s IPhone (10:07) I believe the only exception to that is for Eevee. But Sheldon, I think you’re going to have to confirm that they have some interesting setup.
Sheldon Kennedy (10:17) Yeah, no, you’re correct?
Vanessa Persha (10:22) Okay. So if there are payers that are specific, excuse me. Sorry, one second, if it’s specific to either certain payers that wouldn’t follow that process or if there are specific locations that don’t follow that process, we would need that called out in the instructions.
Sheldon Kennedy (10:42) On the, yeah, we can do that. Yep. Okay. We’ll pretty much just take our like we’re essentially creating like an sop, yes. Yeah. Okay.
Connor Morley (11:00) Okay. And then Sheldon, any… word or any update on the progress for filling out some of these practice and group profile information because we are going to need that as well to submit payer enrollment requests.
Sheldon Kennedy (11:22) So teams, they’re working on it now, we’re looking at four to five weeks, okay? But if we can get it done sooner, we definitely will, but that’s like looking like the timeline right now, okay?
Connor Morley (11:36) And the providers are all in the system. It does look like they are going through and your team is going through and making updates. Yeah.
Sheldon Kennedy (11:44) They did let me know that there’s a few missing. So I’ll be sending that over to you. I just, I need a list. I don’t want to piece it. I want to just give you one list with everything. So they’re validating some of that today and I should have that for you in the next week or, sorry, in the next day or so, and then we can add in those providers and then some need to come out or we can just deactivate them. I think we can do that on our side, right?
Connor Morley (12:10) Yeah. If you need to deactivate a provider, you can go to members and then search the member… and you can go over here and deactivate the member. The one thing I’ll call out is that if you do go in and deactivate a member, you can’t update their profile. So if you need to add in a termination date or some additional information to look back at before you deactivate a provider, you’re just going to have to do that before you deactivate a provider in the provider profile.
Sheldon Kennedy (12:42) Got it. GJ. Does it make sense to just delete them out completely so that we can save a seat? Or how do we want to handle that?
Connor Morley (12:50) If you deactivate a provider, it doesn’t count towards seats. Okay? It’s only active users count towards seats. So you can still archive their information within.
Sheldon Kennedy (13:04) Medtrainer. Okay. So then, yeah, we’re looking at that. We’re going to start with providers, then move over to the clinic profiles from there, clinic and facility. I’m sorry, clinic and the facility profiles to get those completed as well. So we’re looking at about four to five weeks, put just some time in April?
Jijo.Mattamana (13:34) Okay. So I guess hunter just to like just fill down like what are the main, like the main key things that would, you know, accomplish before or like before, you know?
Connor Morley (13:47) Sorry, what was that like?
Jijo.Mattamana (13:49) What are the main, I guess, what are the main key buckets of activities that need to happen before we’re fully implementing outside of the prior analysis?
Connor Morley (13:57) So, we need the provider profiles. I would say about 90 percent of them need to be complete. And then I need these group profiles to be at 100 percent complete these practice location profiles to be at 100 percent complete. And also these facility profiles to be 100 percent complete because I need the information on the ascs too in order to do facility enrollments.
Connor Morley (14:32) And I know that. So we spoke with Sheldon’s team last week and walked them through how to complete and fill out all this information.
Jijo.Mattamana (14:46) I’ll find some time here. Say that.
Jijo.Mattamana (14:55) One.
Sheldon Kennedy (14:56) More time, Tj, we’re losing you?
Jijo.Mattamana (14:57) Sorry, I’ll find some time again, Wednesday. We can talk to you. Okay?
Sheldon Kennedy (15:06) Yeah, I’ve got providers groups, practice and facilities.
Connor Morley (15:10) Cool. And then we need that information that Vanessa was talking about in order to make new enrollment requests. So, if you have any special instructions for us on how to go about enrolling the providers or the facilities with that list of payers, we’ll… need to know that.
Sheldon Kennedy (15:39) And then Connor, what if we don’t what happens then?
Connor Morley (15:44) Vanessa, if they don’t know, we just follow the general sops that we have for that payer, right?
Vanessa Persha (15:51) Correct. Yep. We have standard payer processes that we utilize. So, if you’re not sure we can utilize our internal directory for submissions and then we can tweak things as we go. If you guys start to see things out of the norm.
Sheldon Kennedy (16:06) Okay. So, is the thought like maybe we have a faster path than your standard sop?
Vanessa Persha (16:13) Correct. Yes, if you have any, you know, processes that ensure completion that would help us get those approved faster for sure. Got it. And I did want to call out really quickly. Sheldon. I was just looking at the PPG tab of your data import that we used, and it looks like all of your practices actually their npis roll up to the group npi. So I’m not seeing as of right now, any practices that have a different npi is?
Sheldon Kennedy (16:47) That in medallion?
Vanessa Persha (16:49) This is in the spreadsheet for your data that we imported. Oh, yeah.
Connor Morley (16:53) But we did load all of those into medallion?
Sheldon Kennedy (17:01) Got it. Yeah, I might have had them mixed up. Thank you for that. Okay?
Connor Morley (17:13) like we need to like… Sheldon when you say that you had them mixed up. Do we need to reload this data?
Sheldon Kennedy (17:26) No, the data’s fine. It was, it’s my mental error, not you guys’.
Vanessa Persha (17:38) okay. So then our process would be that all of your enrollment requests that you submit, we’ll submit utilizing your group npis, and then we’ll just include the actual practice addresses that are included in your requests that’s.
Sheldon Kennedy (17:52) right.
Vanessa Persha (17:54) Okay.
Sheldon Kennedy (17:58) Yeah. Sorry for the confusion there.
Connor Morley (18:02) Okay. And in… addition to that, I think I saw a message from Amy that we are adding 210 providers for… housing the ase housed providers. Yeah. Is that correct?
Jijo.Mattamana (18:28) So, I have a list of the engines… and let me, I’ll send that to, I guess need it in the same format as we had provided for the other providers. And it was like, yeah, that’s like saying like, you know, all that information or sensitive risk or privilege in mind for anyone?
Connor Morley (18:55) I think Gigi, sorry, Gigi, I’m having a tough time hearing you, but, yeah, for those ase housing providers, we need essentially the same information. If you don’t have caqh… we can load that in without caqh, but we’ll need them filled out in this ase housing providers tab of the import template. And then we’re going to need to know which ases… that they’re associated with. So we need essentially in this existing appointments tab, we’re going to need those providers, their mpi email, and then where you see entity name in this existing appointments tab, that would be the name of the facility. So, if it’s ambulatory surgery center or eye surgery center of north California, that’s where the entity name would go. Okay? Yeah.
Jijo.Mattamana (20:04) We should have all of that Sheldon. I’ll send the most updated file to you and Maribel, and I assume Maribel can probably complete all of this very quickly.
Sheldon Kennedy (20:15) Yeah.
Connor Morley (20:19) Okay. So that’s all the information for the asc housing housed providers that we would need to load so that you could see which ones are coming up for, and what’s going to be helpful as well as the expiration date, so that you can see which ones are coming up for needing either re, credentialing. Okay?
Connor Morley (20:54) All right.
Jijo.Mattamana (21:03) Sorry?
Sheldon Kennedy (21:05) Go ahead Dj.
Jijo.Mattamana (21:08) Question Connor, when I was looking at the payer scoping file that you shared with me, I think there are some players in there that are not considered part of.
Sheldon Kennedy (21:21) Our analysis.
Jijo.Mattamana (21:23) I think.
Connor Morley (21:29) In the payer scoping document?
Jijo.Mattamana (21:32) Yeah. Like there was one, I think in your file, it was called like the lash, okay?
Jijo.Mattamana (21:44) Yeah, like you have one listed as a lash relief. And then the file I sent it wasn’t listed as a top negative thing, but.
Connor Morley (22:02) What was the payer name?
Jijo.Mattamana (22:03) The lash, the lash group?
Vanessa Persha (22:08) I see that one in par analysis.
Jijo.Mattamana (22:13) Yeah. In the file, I sent it’s included in there, but it was flagged as something that was not top payer. So, not, I guess I just wanted to be sure. Is this like an all inclusive list of top payer and not top payer?
Connor Morley (22:27) Or, yeah, it’s an all inclusive list of top payer and not top payer? Oh, so would you still be requesting par… analysis with that? No?
Jijo.Mattamana (22:41) I mean, as long as we are, I was just pointing to be sure that the par analysis was done on the ones that we requested, and then this is just for your own mapping, right? That’s what I asked anyway.
Connor Morley (22:52) Right. Yeah. So for all of, these could be anyone that you could potentially do a request for top payer, not top payer, got it.
Jijo.Mattamana (23:09) Is there a way to add a dropdown for all? Instead of having to select each individual one? Because I assume for like maybe five percent of these, it’ll be all center slides.
Jijo.Mattamana (23:28) But if it’s not possible to stay as far as?
Connor Morley (23:33) I don’t think so just because we do pretty much only keep traditional medicare for medicare and medicaid for medicaid… if you.
Vanessa Persha (23:49) Select your first payer, like let’s say your anthem blue cross blue shield and you select commercial aca, managed medicaid and medicare advantage, you should be able to copy and paste that into all your commercial payers. If that helps G Joe.
Jijo.Mattamana (24:04) Perfect. Yeah.
Connor Morley (24:08) Thanks, problem. I’ll do that.
Connor Morley (24:24) Okay. All right. That’s all I had for today… and.
Sheldon Kennedy (24:40) I’m sorry, is there a way that I can get a report out of like an excel sheet out of medallion that tells me what’s… still pending as we walk through this? I just want to have a metric to where I’m like can make sure my team is holding true to uploading things… can I go in and pull a report that says like all docs, all missing documents versus all, like completed ones… or will I just have to go like one into the system?
Connor Morley (25:15) Yeah. So within, there is a way to do that within the analytics tab?
Connor Morley (25:29) At a high level, if… you want to look at it’s, some of it is tough to see for in terms of like some of the information, if they, if it’s not there because they just don’t have anything or if it’s not there because they’re missing it. But if you go all the way to the right should be in here. There is a like a missing documents or a missing information piece. Yeah, right here. So if you go to analytics and you go to provider summary, it’ll have like this list right here, provider profile, missing information. And that’ll contain what’s missing for each provider in terms of like documents on their profile. So it looks like. So just from these top providers, a lot of them are just missing what looks like signatures. But if you want to export this to like an excel document, you can just by going over here to this action button.
Vanessa Persha (26:39) Okay. You can also, for your group profiles and practice profiles, Sheldon from the groups tab, you can export your group profiles into a CSV and it will tell you the fields and you can filter to find the blanks for each field. Oh, good. That’ll tell you what’s missing. Yep.
Sheldon Kennedy (27:04) I’ll play around with that. Okay, run in anything. I’ll let you, I’ll send you guys a message.
Connor Morley (27:12) All right. Thanks Sheldon.
Sheldon Kennedy (27:14) Thank you. And.
Connor Morley (27:16) Then there’s also your provider onboarding tab too, which should be able to show you what providers have not signed up or not signed in and… some information on… some additional information on when they’ve joined or logged into medallion.
Connor Morley (27:37) So you can see when they’ve been first invited and how many have not joined.
Sheldon Kennedy (27:43) Still got quite a few. Yeah. Okay. Sounds good. All right. What do you guys do? Sorry, last question? What do you guys do in that case? So we’ve got providers that still haven’t joined. Is that an us thing? We need to send out another notification or do you guys send another push out with a link?
Connor Morley (28:10) We can send out another push, but at a… certain point, if they, we can keep sending out like emails. If like we just don’t hear back from any physicians, then we usually rely on the customer to reach out to that provider to log in. Got it. Okay. All right. Thanks, everybody. Thank.
Vanessa Persha (28:42) You. Thanks everyone. Bye bye bye.