Transcript
Brittany Dees (00:00) how are you this morning, Amy trucking?
Amy Barfield (00:03) Through emails from stetlana… she said she’s on a plane and she’s doing her favorite. I was like lucky you.
Brittany Dees (00:16) So I’ll be quick. I just have a quick thing and Latoya, unless you have something for juvie. I, you know, stetlana’s not joining. So I don’t think you guys need to you and juvie. I don’t think you guys need to stay on this meeting.
Amy Barfield (00:31) Okay. Yeah.
Brittany Dees (00:33) Okay. I’m going to share my screen. So, Amy, we’ve been working on this list right here and I can send it to you. It’s a term providers list. None of this matters besides what’s right here. And essentially, we’ve kind of gone through all of our term providers from January 20 25 until just recently to February 20 26. And we’ve identified… every single enrollment that is still open. That essentially just needs to be closed and what just needs to stay open because of pending Ar. And so I wanted to kind of go over with you how you would like for me, what would be the best way or the most efficient way to kind of send this over to you? And, and then like let you know, like, hey, like for instance, Natoya is still active. She has no ongoing enrollments. OK, that’s probably not a good one. Let’s see. OK. So like this one, Amy craft is a term provider. We can stop managed care services and well care, you know?
Amy Barfield (01:58) What would be helpful is to go through this list if the provider has no Ar… yep to just deactivate them. Yes.
Brittany Dees (02:08) So we’ve already been doing that. So, this is my list right here. Yeah. So this is what’s left over. So there’s and there’s a reason so we can’t completely deactivate a provider, you know, if they’re still in enrollment? Yeah.
Amy Barfield (02:26) Okay. So no ongoing enrollment if I look, so I just need it to be very specific on what the pay that.
Brittany Dees (02:34) You want me to do? Yeah. So I can definitely do that. So what I can do is kind of make a copy of this list and only have like provider’s name and notes and then only in the notes put what we want you to stop. And that’s it, yeah, that would be great. Okay?
Amy Barfield (02:56) Okay. And then I can just limit that to support, okay, to me and I will.
Brittany Dees (03:08) You cut out. I’m sorry, I can’t hear you. Sorry, it’s okay. Yeah, I’ll have our team adopt those. Okay? This report instead of you sending it. Okay, perfect. Yep. I will do that then, and… that’s and then one last thing I received an email yesterday, let me go to my emails. So I don’t want me to let you know for.
Juvy Patal (03:39) Sandra.
Brittany Dees (03:41) Stojakovic S, her last name is spelled ST o J a K o V. IC… I’ve received an email from blue cross blue shield of Illinois for their medicare advantage, ppo plan that she was accepted. I’ve sent it over to medallion and everything already. I already sent it over to support it’s. Just in medallion. It’s still blue cross blue shield of Illinois. Yes.
Amy Barfield (04:15) Effective.
Brittany Dees (04:18) date 12 eight, 20 25.
Brittany Dees (04:25) I think Svetlana already sent over to request for retro. Yep. So retro was already requested.
Juvy Patal (04:35) But.
Brittany Dees (04:36) just in medallion, it’s still showing us pair processing. I’m not sure if that’s one of those.
Brittany Dees (04:49) I’m not sure. It just got sent yesterday. Yeah. Okay.
Brittany Dees (04:59) And then one… more, Kevin Levine, LEVINE… he was accepted into blue cross blue shield of Tennessee. So, and it looks like they have, you know, blue care, blue network, P, blue network S, blue care plus and Tennessee care select, and those were all completed as well.
Brittany Dees (05:30) And I think… let’s see and I think retro was already requested. Okay? So retro was not requested yet, but Solana did request that. So, and I sent that over as well to medallion. Oh, Keith Levine. Yes. Sorry. I just said Levine? Huh.
Lori Durkin (06:22) I can’t hear her at all. Is it just me? Amy, we can’t I can’t hear one word.
Brittany Dees (06:27) Is that any better? It’s not just you. I can’t hear her either. It’s you this team does.
Amy Barfield (06:31) Not like me. Yeah.
Brittany Dees (06:33) You, it’s like you cut in and out sometimes it’s just like your microphone just goes off.
Amy Barfield (06:39) Let me go off camera. Sometimes. Is that any better?
Lori Durkin (06:44) A little bit. It’s super faint, but,
Amy Barfield (06:47) The speaker was working. Okay? I’ll try to speak up a little bit.
Lori Durkin (06:55) Sorry, it’s like talking to my grandfather, you know? And then they yell everything.
Amy Barfield (07:02) I’ve.
Brittany Dees (07:02) noticed that I was like getting closer to my laptop.
Amy Barfield (07:06) I know you’re all right?
Brittany Dees (07:10) That’s all I had, Amy, just those, a couple of things. So, thank you so much. You said?
Amy Barfield (07:16) There was a retro request. I don’t see one?
Brittany Dees (07:18) No, no. I think Svetlana requested for a retro to be put in, but there has not been a retro requested yet.
Amy Barfield (07:28) She did not. I don’t see one that’s been in.
Brittany Dees (07:30) Okay. So we all will just probably need to request retro. I don’t know the date yet. Juby, did, do you happen to receive a request from Svetlana yesterday for a retro request for Keith Levine?
Juvy Patal (07:48) No, I did not receive any, but I can see that, the earliest date of service for Keith Levine?
Brittany Dees (07:57) It’s.
Juvy Patal (08:00) it’s 20 26 I,
Lori Durkin (08:06) can, I can?
Amy Barfield (08:07) Add the demo update for the request. Okay? I appreciate that. Thank you so much, juby.
La Toya Pough (08:14) Okay. I have those. I’ll.
Amy Barfield (08:16) look for that retro request and then push it, get processed through so our team can pick it up. Okay, great. Is there anything else? Not for me? I?
Lori Durkin (08:28) Do have something Louisiana medicaid, I know is like a whole thing. I, okay. Let’s start with Theoria. So I put notes all on the like payer enrollment line for Theoria. But what I found out is that Theoria has two provider numbers, group, provider numbers with Louisiana medicaid. One was just recently issued from like the stuff you and Svetlana were doing with the mailing labels and all the things. Yes. So that notice was just mailed out on March seventeenth… on, that particular provider number. I’m lagging too. I’m going to go off camera. That particular provider number is just for traditional medicaid, like fee for service, traditional medicaid. There was a provider number issued back in 20 25, early 20 25 separate provider number. That is for the managed care plans. Only. Not sure how that happened but that.
Amy Barfield (09:53) Managed.
Lori Durkin (09:54) care provider number deactivated back in July of 25. I’m the administrator on that particular account. So, I went in and revalidated it. And like did the things that had to be done to get it reactivated. The newest one that just got issued was backdated with a like backdate. I don’t know it’s.
Amy Barfield (10:21) like February of 20 25. Yeah.
Lori Durkin (10:24) Yeah, cool. So my question is there’s like, I mean, I was on the phone with these people and had to watch a webinar to know how to go in there and like enroll on the provider, I’m sorry on the provider portal because apparently our managed care provider id was deactivated because we didn’t log into the portal and do this provider enrollment piece on there. So, what she told me is there’s like a super time sensitive thing on this letter that was mailed to us on March seventeenth. I don’t know where it went. I’m assuming to our lockbox like the cred hold or I’m sorry, the cred lockbox or whatever, but there is a super time sensitive thing on there that we have to get into that portal and complete the steps to register or it will be deactivated as well. Where?
Amy Barfield (11:17) Would it have come from Lori?
Lori Durkin (11:20) Louisiana medicaid? Okay?
La Toya Pough (11:23) Gainwell?
Lori Durkin (11:24) Possibly, I think they are also known as gainwell. Yeah.
Amy Barfield (11:27) They use gainwell. Okay. G a.
Lori Durkin (11:31) INEG a IN, well, okay. I’m.
La Toya Pough (11:37) going to go.
Amy Barfield (11:37) Have a look for it.
Lori Durkin (11:39) So, I’m not the admin on that, and if I remember correctly, you got to go through quite the process. I had to get something notarized. I think I had to go get fingerprinted. I mean, it was like this whole thing for me to get access, but I didn’t realize there was two different provider numbers for Theoria. Yeah, I didn’t either, yeah. So I noted all that, put everything on the payor line there. But yesterday, when we were on our call, I was kind of like googling it to find out if that’s always the case. And what I found was, no, not really. So I just want to make sure that like complex cares are good because Louisiana medicaid’s been a nightmare. They’re just hard to work with. I don’t know if maybe Theoria’s original application went in some kind of way that issued this MC. I don’t know how we got to the spot Theoria’s in, but just something to like maybe look into on the complex care side to make sure that our one provider number for Louisiana medicaid covers both, or do we need to somehow get both? I don’t know, Laurie.
La Toya Pough (12:43) With my experience with Louisiana medicaid, sometimes you can’t they will provide two separate numbers for fee for service versus all other payers. So you might run into that. If the application somehow is not processed at the same time, they won’t generate two separate numbers. I mean, they won’t generate one number. It’ll sometimes be two separate numbers depending on how the application is being processed. Gotcha. So.
Lori Durkin (13:15) I think, is there?
Amy Barfield (13:16) A possibility to have one number? That is… that encompasses both? My?
Lori Durkin (13:25) Understanding is yes, but like Latoya said, it sounds like it’s gotta be like simultaneously or they’re gonna issue two?
Amy Barfield (13:33) Okay. I’ll try to find out how complex care is set up, yeah.
Lori Durkin (13:38) Yeah, because what happened was Theoria is.
Amy Barfield (13:40) Set up correctly?
Lori Durkin (13:42) So on the managed care like Theoria right now has both provider numbers, the managed care provider number is in process right now of like revalidation… for lack of better words, more like reactivation. Yeah. But there’s this whole thing on the portal that you have to go through before you finish the enrollment. And that’s basically like portal enrollment, but that portal enrollment, you gotta have everything. I had to have Svetlana’s middle initial, her social security number. You’re probably gonna need that for green Miles Greenberg. You had to have like all the info which I know you guys have, but it’s like a whole additional step… and I could like if your team needs the screenshots or anything for that. I mean, I was on the phone with them for like an hour and a half and finally got to some lady that was super helpful if your team needs any help with that. I’m happy to like log in and send a screenshot. But literally until you complete that, you can’t do anything on the portal. It’s like a provider enrollment, portal thing, you know?
Amy Barfield (14:51) Well, Lori, I was gonna say, can you give me a screenshot? And then I’ll put something together for our team to… Lori?
Brittany Dees (15:02) I just slacked you what we received from Louisiana gangwell. 318, we received it. It looks like it was like a notice informing our enrollment of Louisiana medicaid program. So I’m not sure if that’s what perfect.
Lori Durkin (15:22) Yeah. So there’s a couple of things we need to do on here. I’m just scanning it right now, but… we got to do era… electronic remittance advices. And then she said somewhere on the bottom, Hold on… shoot this over to Amy too. But Amy, I know that you have to get onto this site and finish something. Hold up. I’m about to just let me take you there because it is like a whole flipping thing. And then I’ll just shoot your screenshot.
Brittany Dees (15:59) And Amy, this, what I’m about to send you right now was also already sent to medallion on March twentieth. Okay?
Lori Durkin (16:07) She just told me it was like super time sensitive and I guess I’m just learning all this with Louisiana. Yeah. But we might want to make sure that we don’t need two… providers, yes, or at least one encompasses.
Amy Barfield (16:27) Both. Yeah.
Lori Durkin (16:33) Exactly. Nope. That’s not, so see right away. It showed me when I went in there with Theoria’s enrollment that it required revalidation. Okay. But that’s not where we need to be. Oh… I went to so many different things and literally, she was like, you have to watch this webinar to know… what to do because she said we get so many emails about it. I.
Brittany Dees (17:03) Just emailed it to you, Amy. Thank you.
Lori Durkin (17:07) So, like I said, I’m only the administrator on Theoria’s… mco one. So if there’s somebody you want me to add, why am I not logging in?
Lori Durkin (17:26) Is there somebody from medallion I should add as a user?
Amy Barfield (17:32) Yeah. Let me, do you have Kelsey’s information?
Lori Durkin (17:36) I will need her middle initial and her, I don’t know. Let me, I’ll show you what I need. I’ll get you some screenshots here real quick. So when you get in here, you literally can’t see claims or nothing. And until you get into this, my application and go into provider enrollment portal application?
Lori Durkin (18:01) And she said that’s the reason this particular one got deactivated. So let me pop in here real quick. I can’t see the whole application, but it’s quite the process. So like right now it’s in process, but it’s quite the thing. Yeah, I see that. So that is super. And I’m not seeing it on the bottom of this letter, but she told me it is like she goes, it is super time sensitive. So, okay, user quick.
Lori Durkin (18:42) See, Ramina is the only one right now that has access to this particular one. So let me take a screen. Okay? So all I really need is her middle initial telephone number, fax number. I’ll shoot you an email on this, but, okay. And then if she could add us on the other ones, that would be awesome. Okay. But I’m assuming, I mean, I’m assuming here’s the thing… is there an administrator on that account? Because like I said, I had to get a form notarized to even get into this one. Theoria’s, mco, provider number was issued without an admin. So I had to go in and request to be an admin. And it was quite the process. So if we have to do that, that’s fine. But we just need to know if.
Amy Barfield (19:31) I would imagine that one is not set up. So I would go through that process because you want to be admin of all your portals anyway, so.
Lori Durkin (19:42) Got it. And that is like through a whole separate system that’s I forget who that is, but I’ll backtrack this is like awful what they make you go through like it doesn’t have to be this hard. It really should not have to be this hard. I’m asking my medicaid.
Amy Barfield (19:59) Who is the admin or is?
Lori Durkin (20:01) One? Okay. I just want to make sure like we have a lot of sight on it because if this rolls back, Svetlana is going to probably lose it you.
Amy Barfield (20:11) Know, yeah, for sure. Cool.
Lori Durkin (20:16) Cool. All right. I’ll get you some screenshots and like I said, I summarized it on Theoria’s payer line just so you kind of like know what I know at this point, but I’ll shoot you a quick answer. Okay? Thank you.
Lori Durkin (20:31) I think that’s all I have.
Lori Durkin (20:42) I’m good too. Thank you everyone. Thanks all. Have a good day. Take care.
Amy Barfield (20:46) Bye, bye bye.