Transcript
Connor Morley (00:00) hey, everyone. We’re going to be going through some training today. It should be fun, but I’m going to let in Renee and Kenzie. Okay, awesome.
Connor Morley (00:20) Hey, everyone.
Connor Morley (00:31) How are you doing?
Rasencio (00:36) Sorry, I was talking on mute. I’m doing good. Thanks. How are you?
Connor Morley (00:41) Doing good. We’ll go through the training today. I want to get through the platform overview and I want to get through some of the additional requests that you’ll be making. I think credentialing, we can try to get to it today. I do want to show you kind of like what it looks like, but I’ll have to go into a different like demo environment that’s not necessarily your environment just because we don’t have any examples that I can show you in your environment, but we should be all set there.
Rasencio (01:22) Okay, great. All.
Connor Morley (01:24) Right. And then just give me one second really quickly, and then I’ll jump right in.
Rasencio (01:29) All right.
Connor Morley (01:42) All right. Sorry about that. I saw my dog chewing a hat and did not want that to get destroyed. Okay? Really quickly. I’m going to log in right now. Let me know if you can see my screen. Yes. Okay. So we are on the provider directory tab. This is essentially kind of where your default will be for the vast majority of medallion. Just looking at all the different providers that you can see in the platform. I am logged in as you all. So you’ll be able to kind of really see what you’ll be able to see. I do want to call out that there will be some missing information while we’re continuing to load some of the groups, the practices and some of the enrollment data. But from a high level view, you’ll be able to see on the provider directory, all the providers. And then if you hover over here on this kind of pie chart with all the red, you’ll be able to see for each provider profile, what information is missing at the high level. And then you can also go in and you can filter by, you know, what providers are 100 percent complete 90 to 99. You can multi select these different filters to kind of get a better sense of what providers need to complete their profiles and what providers are all set there. The other piece of information and I’ll show this a little bit later once we go into the analytics view… is we do have a report that you can pull in to be able to look at the providers at a whole level. And exactly it’s essentially an excel that you can export to view all the providers and all the documents that each provider is missing on like an excel export template. And with that in mind, whenever you’re going through medallion and you see over in this right hand corner, this download providers report or this download button. If you click download, this will send a CSV file directly to your email that’s associated with your medallion account. So you’ll be able to pull all the information either on the provider’s profile, the group information, licensing information, payer information, what have you? And in addition to that right next to it, you’ll be able to see this bookmarks bar. So if you made like certain groups or certain filters that you wanted to bookmark, you can add a bookmark in here, title it, and then you’ll be able to go back and use that bookmark just for the module that you’re in. So if you’re in providers and you make a provider’s bookmark, you’d only be able to use it in providers. Versus if you went into payers or licenses to make some updates there. It would just show up or make a bookmark in there. It would just show up in those areas. Okay? Does that make sense so far?
Rasencio (04:50) So far? So good.
Connor Morley (04:52) Okay. All right. Connor. Real.
Kviser (04:55) Quick, is the analytics going to be sort of the dashboard driven thing? The space that you’ll be talking about?
Connor Morley (05:04) Yeah. So the analytics, yes. Yes, we have like a couple different I’ll show you what I’m talking about. There are like multiple different quote unquote dashboards that you can see if you’re looking at like specific payer information, like payer requests, you can go to the payers tab, and that essentially has a dashboard. If you’re looking at the credentialing tab that’ll have a dashboard, things like that. So, and the analytics will have more of if I just show that really quickly, it’ll have more kind of like high level information, turnaround times in progress, requests overall in this kind of dashboard view. But if you go in here as well and you go to enrollment requests, you’ll be able to see a little more drilled down information on like all of the payers that are in progress and, or have been requested that are processing, have applications submitted and that we’re waiting for things like that?
Rasencio (06:02) That looks great. Thanks.
Connor Morley (06:04) Yep. No problem. One thing as well as admins. So you all have admin access. If you wanted to invite either a provider or a credentialing specialist into medallion, you could click on this invite provider button right here and then it’ll pull up the roles that can be added into medallion. So we can add in providers from here, admins, admin, provider, dual role auditor is essentially a read only access team manager. I don’t think you need any team manager roles because that’s specifically if you create like a team within medallion of providers based off like your groups or your practices, a team manager would only be able to see that specific team and they would only be able to make requests for like licenses, payers and credentialing for that team. Does that make sense? It?
Rasencio (07:05) Does, and I think we would like to set up teams just for the simple fact of it gives our credentialing specialists an opportunity to, I guess just look at those analytics… based on their providers that they’re working on. Unless there’s a way, I mean, looking at this, it looks like there may be a way on each dashboard for them to just kind of define it based on their states. I think as we get into training, we may be able to decide what would fit our needs best.
Connor Morley (07:38) I think just to kind of put into perspective of what the teams would look like, one additional area that you can go to is this members tab. So if you go into the members tab, there are these, this is also an area where you can add in additional users to the platform, invite member and invite provider, have the same functionality. So you can invite whoever. But for the teams themselves, you have the ability as admins to define the team and you can either use these provider attributes. So do it by profession type group or practice that they’re associated with. So if you were to pick a group, we could pick in any of the groups that you have, and it would load in all the providers that are associated with that group. And then here’s where you would pick the team manager as well. If you have like a unique team that you’d like to create, you can turn off this provider attributes and then just individually pick providers. Does that make sense? It?
Rasencio (08:50) Does, yeah, that’s helpful.
Connor Morley (08:51) Okay, great. In addition to that, like if you are on this members tab here is where you could potentially archive a provider if they’ve been termed or if they for some reason are no longer with your organization. So you would go to the members tab and you would click on essentially this deactivate member button and that would archive them. So you would still be able to run reports on them, but you would not be able to go into their provider profile and change any of their information. I think I might be getting a little ahead here, but that’s essentially a way to archive any of your termed providers.
Rasencio (09:38) Okay, great.
Connor Morley (09:40) Okay. I’m going to go back to the providers tab really quickly and just show you the provider profile itself. So if you click on their name, it’ll take you to the provider profile and essentially here’s where you can see all of the information that’s missing. So with basic info, if I’m scrolling down, I can see specifically that we’re just missing a primary phone number here. It’ll call out if there is something that’s required and is missing on this page just for the basic info. The only thing that’s missing is primary phone number. But if I were to go into like professional info, there might be a little more information that’s missing like care delivery setting, and that’s about actually it. One thing in addition for those providers who are no longer with your group, here is an important field that I’ve seen most customers enter, which is the termination date they’d usually enter that before deactivating the provider, just so you can run a report later on to see the exact term date. Okay? In addition to that, as admins, you have the ability to update all of this information for your providers except for the agreement section which they will have to log into and fill out themselves. You don’t have access to complete this. Okay? I.
Rasencio (11:18) Have a quick question if there’s something in there that is required but it’s not relevant to our providers, our practice, how we do our credentialing, like they know, sometimes hospital privileges, admitting privileges, our providers are not required to have them if it’s something like that and you guys require it, but we don’t is there a way to bypass that in the system there?
Connor Morley (11:41) Is we do have the ability to say, turn that requirement off? I think it just, it depends on exactly what it is like if it’s something that hey, like we will not need for pay enrollment or credentialing. And we know that, and we agree with you, we can turn that off as a whole. If it’s something within credentialing that you say like, hey, for this specific provider, we need to waive this in order to because they just don’t have it or it’s not needed or you’re not asking for it that’s something that we could talk about a little more where we might need to kind of put that in the notes or create a support ticket just to acknowledge that this has been waived. Okay. One second.
Connor Morley (12:39) Sorry about that. It is almost… five o’clock and my dog’s going a little crazy right now. So, this is like all of the provider information that you’ll need to enter. In addition to this, if you are adding in a new provider, you’ve entered in their email address, invited them into the platform. What you can do for linking caqh as admins, you have the ability to connect to caqh and they’ll be prompted to connect their caqh profile, right? When they log in, what you want to do in order to kind of speed that up. Is if you scroll all the way to the bottom of the profile section and you go to this, go to data imports, it’ll show you this caqh profile piece right here. And with this, typically what it says, if a provider’s caqh profile is not linked, it will say link your caqh profile. If they do link their caqh profile. And let’s say there’s some missing information or they’ve updated after they’ve linked it, you can go back in. If you hit review and add data to look through and select what information you’d like to review. So you can import everything. You can select all, or you can go step by step in their kind of caqh profile and pull in what information is important or what information you’d like?
Kviser (14:13) Will we have a… particular specialist assigned to our groups? Or for example, if we receive a notification from the payer or if there’s activity that needs to be done, is there an assigned specialist?
Connor Morley (14:32) So, I think what you’re referring to is more on the lines of like a demographic update? Is that right? Is that what the question is?
Kviser (14:43) Demographic updates? Yes. Like for example, in Texas, when the license gets renewed, is that going to be automatically done through the system? Because you’re already having the renewed license? Is it like a one stop shop? Yeah?
Connor Morley (14:58) Great questions. So for licenses, we can set auto renew to on for all your licenses or we can set them to. You would choose specifically what licenses you want to auto renew just in case there are some licenses that a provider may have that aren’t really relevant to your business. And then on the payer side of things, what we’ve seen in general for these like revalidations is that for the most part, it’s a pretty silent process for the commercial payers. So we don’t automatically select a revalidation, but we do have a way for you to enter in a revalidation or a demographic update in the system. So if I go to the payers tab, let me show you what I’m saying. So on the payers tab, if we look at here’s where you’ll be able to make requests, and here’s, where you’ll be able to do like a revalidation or demographic update. If you get a letter from a payer, that, hey, this provider needs to be revalidated, you can go into the requests up here. And rather than hit like a new brand new payer, enrollment, you can request a revalidation, you would say for medallion, you wanna choose the provider, Denise wood, the enrollment for let’s say, I’ll choose medicare for this example. And then if you’ve received a notice about the revalidation, you can hit yes and you can upload a copy of that. And then you can go ahead and submit this request. One of the key pieces here is also going to be you’re going to want to make sure that this request owner is listed as medallion so that we know to work that and do that revalidation on your behalf. And then once that’s been submitted and requested, then our team will put together that application and you will be assigned a specialist for that to go through and kind of put together the application?
Niccole Russell (17:01) That’s great. Thank you. Yep.
Connor Morley (17:04) In addition to that, so not only with you can do like brand new payer enrollments, you can also do demographic updates. Single demographic update is essentially just updating a single enrollment. So you’d pick the provider and you would pick the enrollment, and then you would pick what needs to be updated, whether it’s practice location, lines of business. This doesn’t really apply to medicare or the provider name or anything else. And then if you were to do a bulk demographic update, you would pick let’s say the provider and… you would update and you would choose what’s been changing and that would be requested for all the payers associated with that provider.
Connor Morley (17:54) Okay. Does that make sense? It?
Rasencio (17:57) Does I have a quick question? So what would the process look like? So in Texas specifically, when a provider renews their license, there is no communication between the medical board of Texas and Texas medicaid. All of those updates. When a provider has a new license or a revalidated license, we have to make those updates manually. What would that look like to request it in medallion?
Connor Morley (18:24) So, let me see if I understand this correctly. So for medicare… within the state of Texas, you know, the new license doesn’t get, they don’t the licensing board and the medicare board don’t communicate with each other, right? So we would just confirm within the licenses that their existing license has been renewed and all of that information lives within medallion. So if you are requesting a revalidation with medicare, we can go back and we can look at, hey, what’s the status of their Texas license? And I do want to ask maybe Niccole if you can clarify, I think with medicare and medicaid, we, they do require revalidations. So.
Niccole Russell (19:16) Yeah, it’s actually she’s asking something different. So for medicaid, you have to track when a provider’s license is going to expire because you have to send that proactively… Renee, I have only been here a few months and I have not seen that. So let me reach out to our PE team and see how they handle that. And then I’ll get back with you.
Rasencio (19:42) Okay, great. Thank you, Niccole. You’re welcome.
Connor Morley (19:48) Okay. We’ll take that back. And then if at any point in the process, you guys have questions or run into an issue like what you can do within medallion, we do have a support center where here’s where you would be able to go in and you’d be able to ask a question or this is where this ask a question kind of turns into like, hey, I need a support. I need to submit a ticket and we will track that ticket within this general support center so that you can go back and view the progress made on that ticket.
Niccole Russell (20:26) And just to highlight here, this is what you would be using to like follow up on lines or do inquiries within the system. However if you receive a participating letter, you can send it to the support or you can send it to me. But a lot of your day to day questions, inquiries will go to support. So you can send over that participation form, and then we can update the line if it’s something that we are currently working for you. Great.
Connor Morley (21:05) Okay. Thanks, Niccole. And in addition to this, when we are working requests, so when you make a request, what we need in order to complete that request, is that the provider profile, usually, in order to start working on the request, putting out the application, the provider profile itself has to be at about 85 percent complete, as well as the agreements have to be signed. And specifically, when we’re working on say, like payer enrollment requests, what’s also going to be important is making sure that the group profile information and the practice location information is complete. So for example, there’s going to be some missing information on this group profile that we’re going to need you to fill out. If we go and click into the group profile information, you’ll be able to see like what are the lines of businesses, date of incorporation, what financial info we need, and all of the other information you can hold off on any of the practice locations and providers, because we’ll be loading that in as a part of the PPG or the provider profile, group matrix data that we load.
Connor Morley (22:23) Does that make sense?
Rasencio (22:25) It does.
Connor Morley (22:26) Okay. All right. I did also want to go through some of the report builder as well. So you have the ability to run a report and pick information essentially from the providers field deactivated or the providers directory, deactivated providers license requests, and any of the requests that you have, you’ll be able to pull in full name. Anything that’s on the provider profile. You can pull in. The best practice is to pull in at least full name npi, just two identifying pieces. And then if you needed to pull in like date of birth, you could pull that in as well. And we’ll show you the first 10. We’ll show you a preview of the first 10. If you need to export it, it’ll send that excel file directly to your email. And then if you need to create a report that runs on a recurring basis, you can click save report type in what that report’s called.
Connor Morley (23:30) It can either be available or sent to all the admins or just you. And then if you just want to have it run automatically on a monthly basis, weekly or quarterly, you can set that and determine when the first date that you want it to get sent would be. So if you want it to be sent monthly, you would set it for the first of the month and set the report cadence to monthly.
Rasencio (23:56) I have a quick question regarding this. So one of the documents that we require our… providers to have is this collaborative agreement with either the supervising physician or the medical director. It is something that we send out just because we get those signatures via DocuSign. So we send it out and then we would want to upload it into medallion as, you know, as a document, but certainly necessary for credentialing on our end. A lot of our payers require them as part of the credentialing process. Because our providers do not hold deas. We do not require them to hold deas. Is there a way for us to, I… guess specify in a report that we would like one pulled for the provider, the npi and like their collaborative agreement renewal date?
Connor Morley (24:52) How often do you renew that collaboration date?
Rasencio (24:57) Annually?
Connor Morley (24:58) Annually, And it is required for credentialing. So what I’m thinking of two different options that we can go with, one of which is essentially within the provider profile, we can have that information listed in the documents. And then if you were to create or upload a new document in here, you can specify an expiration date, and we can search by that within the report builder. I don’t know if you could pull that, but the documents and their expiration date do and will pull into this overview tab which I was going to get to next. And there’s an expirables date that you would be able to pull in based off of some of the documents. The tricky part is we’d have to search by document and then specify the name. So if you were to say the name is like collaborative agreement, or if we, as long as the naming for what you label that document is consistent, we can put the, if you search by agreement, you can have the expiration dates pull in and you can download that on like a monthly basis or a yearly basis. If that’s what’s needed. Hey.
Niccole Russell (26:26) Connor isn’t there a place in the provider’s profile that feeds over to that supervising physician because that’s what that would be.
Connor Morley (26:35) Oh, yes there is. So there is like a provider supervision information, so we could essentially go to like a provider supervision.
Connor Morley (26:54) And we can enter in their supervising information. Okay. That one, I haven’t particularly seen all that often though, so I might have to get back with you on the details of how to set that up and see if we can do a data import for that.
Niccole Russell (27:13) Then under professional info, by chance, I can’t remember… I.
Rasencio (27:21) know in caqh, when we have to enter it in caqh, it’s usually in the locations area in that all of that, those three tabs for additional information for each location, it’s somewhere in there. And the reason I ask it would solely be for our purposes for our… compliance officer usually likes to get monthly updates on our collaborative agreements. And since they’re all signed at different times, we would need to run a report monthly just to send over and show, hey, we’re on top of it, we don’t have any that are up for renewal or, you know, these are the ones that are in process. And so it’s just trying to see if there was an easy way to pull something that I could just export, send over to her. And let that be that. That way I don’t have to keep track of it manually anymore.
Connor Morley (28:10) Yeah. I think it is something that we can definitely store. I’m just trying Niccole, maybe you and I can talk offline on the best way to do.
Niccole Russell (28:19) that. Yeah, I need to look at that because I’m not real sure where that’s stored. However when it is stored under the providers, we just click on that providers tab again. Yeah.
Rasencio (28:31) And there’s going to be some providers who have multiple collaborative agreements whether it’s because like in the state of New York, we have different medical directors for different locations. So they may have two or three collaborative agreements or we have multiple groups in that state. And so there’s a collaborative agreement or they’re licensed in multiple states.
Rasencio (28:50) So they just have collaborative agreements with all of those states. So there’s quite a few providers who would have a number of collaborative agreements to keep track of.
Niccole Russell (29:00) Okay. Yeah. I’m not sure about multiple, but I do know like if you’re under the provider supervision tab, then you can download that over to the right. There’s a drop down. You can do it there. And then under the report builder, you can, I believe you can run a provider report there and add the supervising physician in.
Rasencio (29:22) Okay. Maybe something we figure out while we’re in there to see what works for us. And if not, then I can just keep track of it manually the way I’ve been doing… because again, it’s they’re only done once a year, but so there’s only a handful of them that have to be renewed each.
Connor Morley (29:39) Month. Okay. That sounds good. We’ll take that offline to just see what can be done. And then in addition, what I wanted to kind of go through is when you’re placing these like requests for licensing payers for credentialing, you, we may need additional information or we may need the providers to do something like for licensing for like fingerprinting for example.
Connor Morley (30:11) So if there’s anything like that, typically what we do is we will assign either a provider task directly to the provider. They’ll get an email notification and an alert within medallion, and you’ll be able to view all of those tasks in this overview tab. So you’ll be able to filter by either provider tasks or admin tasks. Specifically admin tasks could be something having to do more along the lines of like group enrollment, or if we reach out to a provider that we need the provider to complete something like fingerprinting, we reach out to them three times. Our team also sets an admin task to alert you that we’re having trouble getting this provider to complete this task. And so there’ll be two tasks one for the provider, and then a final like admin task essentially to alert you that we are having difficulty with this provider and that’s our point of escalation.
Rasencio (31:11) Okay. Great love that. That actually brought up something. The only time I’ve ever come across fingerprinting with our providers is in Florida. Obviously, acca requires us to have our providers fingerprinted even just for medicaid purposes. This is something for that state that is done upon hire during that onboarding process. They send them out for fingerprinting. We have access to that information through the acca clearinghouse. Do you guys need to? I know that I think you guys were granted access to our npdb but is it something where medallion would need to get access to our groups in the acca clearinghouse as well. So.
Connor Morley (31:59) For acca specifically, I’m not sure. I know that for when we assign these fingerprinting tasks, in general, we do check a database to look for the fingerprinting. I don’t know if acca is included in that, but I might have to follow up on that. Okay? All right. And then, so here’s where you’ll be able to see like which providers as well are assigned. A task. Fingerprinting is an example. But there could be a handful of different tasks that get assigned. If there’s more information or if the provider profile is incomplete, it’s at 90 percent and we, they signed the agreement but we’re missing another piece of information that’s needed for payer enrollment that’s where we would kind of push and highlight that we’re missing information and need the provider to complete it. Yeah.
Rasencio (32:52) That’s great. I loved it. You just mentioned fingerprinting and it triggered in my head. I was like God, I don’t really need access to our acca clearinghouse. So I wanted to make sure I asked while it was in my head.
Connor Morley (33:03) I will follow up on that because I don’t like I’m just not familiar with that specific one, but I know we do have access to fingerprinting a fingerprinting database. Okay? All right. In addition, you can go to the licenses view, so you can view all of the existing licenses for your providers at a high level. You’ll be also able to see like their renewal information when their renewals are coming up. If there have been any automatic verifications, or if we need attention on any specific licenses, you can filter by an expiration date. If you’re looking for licenses that are expiring within the next month or within the next two months, you can filter by that. And then we can also confirm the last verified date for all the existing licenses. And similar to payers… you can add in any existing licenses that you need. Okay, great. I did because I think we have time. I did want to go through and show the credentialing kind of process. But I need to log out really quickly and log back in.
Rasencio (34:30) Okay. So.
Connor Morley (34:31) Give me a second because I need to use a different user.
Connor Morley (34:51) So one second while I get through that.
Niccole Russell (35:02) And while he’s doing that, Renee, I did find under the provider profile, there’s a professional history. Actually. Let me show you why he’s doing that.
Niccole Russell (35:19) So, if you’re under providers, you can click on any provider there and you get to their profile under professional history. There’s where you would enter the supervisor.
Rasencio (35:34) Great. Is there a way, when would you mind clicking on add supervision? Is there a way to specify which state because again, we have, okay, great. So.
Niccole Russell (35:44) You make it add multiple, if you hit save, you make it add another one. I am not sure, I haven’t seen but.
Rasencio (35:52) Okay. But yeah, on here, it allows us to put in the supervising physicians, licensed state and everything like that.
Niccole Russell (35:59) Oh, yes, yes. Hopefully.
Rasencio (36:01) There will be a way like it’ll just show what state we’ll see as we get into it, but there’s some way to, yeah.
Niccole Russell (36:09) Yeah. And then when you enter it here, that’s when it shows under this tab and you can export it right here. And then also, I believe it’s providers. Okay? I guess it’s not going to show there. So you would be able to export it off of that tab there. Okay? And then if you wanted to filter by expiration, anything like that?
Rasencio (36:36) All right, great. Thank you, Niccole. Yeah, you’re.
Niccole Russell (36:38) welcome.
Connor Morley (36:40) Okay. I did want to show you this demo environment. It’s with credentialing. It’s not exactly how yours will look. There will be a few call outs that I’ll just mention… right off the bat just because this credentialing tab will actually be called privileging because you have tjc credentialing but everything else up here will look the same in terms of requests, ready committee, closed, things like that. So you’ll be able to see all of the credentialing requests in progress. That these are going to be requests that our team is essentially putting together the credentialing packet for. And then you’ll be able to pull up the credentialing file and look at the PSV report as well. If there’s anything that’s marked with a yellow that essentially says this needs attention. This is where we have something flagged. And then if we actually pulled up a credentialing file, you’ll be able to see… a summary of what’s been completed versus what’s incomplete, what’s clean, where there’s an issue from a high level. And then you’ll also be able to dig in to the different kind of summaries. So if you wanted to look at say licenses, medicare opt out, npdb, ofac, oag, things like that, this is where you would do a deep dive and this credentialing packet will be customized for your organization. So once this has been moved to a ready status, here is where you’d be able to see, okay, the PSV report pulled in no issues. You have the credentialing file. You’d be able to download this and bring it to your board for review. And then in addition to that, once it’s in this ready status here’s, where you would send it then to a credentialing committee. And we can talk about exactly what that committee looks like. I think with your org, I believe we talked about Renee you and Kenzie being like the committee members and you taking the completed packets to your board for review and they would vote there. And then you would be the sign off in medallion under.
Kviser (39:14) The actions, if we were to send it back for corrections or additional review, it would go directly to an assigned credentialing specialist, correct the one who submitted it.
Connor Morley (39:27) So essentially… if you sent it to needs review, that would be send it to a credentialing committee, it wouldn’t actually send it back into requests. So let’s say, for example, there are flags on this… here is where we would have to essentially determine what do we want to do with this? You would be able to, you could still go back in and we could update the provider profile, or we could ask for additional information or we could put in a note that says we’ve reviewed this. It is not a deterrent from moving on to the committee.
Connor Morley (40:12) Does that make sense? Do you?
Kviser (40:14) Mind saying it in a different way or maybe I could say it in a different way too. So when the credentialing specialist onboards a new provider, and that provider is ready for the final, I guess committee review, which is our ivf form, the credentialing specialist would send it through your process, correct? And then I’m saying if Renee finds a fallout or if there’s just a flag outside of those application requirements that you did the click down on, can we bounce it back to the actual credentialing specialist to fix?
Connor Morley (40:50) Do you have an example of what that like flag outside? I mean, their internal credentialing specialist? Yes.
Kviser (41:00) Our internal credentialing specialist, because they would be the one sending this to the committee in hindsight Renee.
Connor Morley (41:08) Gotcha. So we… pull all of this credentialing information from the provider profile, right? Everything that’s pulled in here for the verifications we have, we pull in from the profile. So if it’s something that is like missing on the profile or needs additional information on the profile. What we would recommend that you do would be to essentially kind of correct that. And you, there… are a couple different… ways we can do this, one of which is to assign a task to one of your org admins that says fix this provider profile, so that it’ll pull in correctly to the credentialing file?
Kviser (41:59) So, our internal committee review isn’t based off of the application that’s done in medallion. I think Renee, can you help provide a little context into the ivf form review?
Rasencio (42:15) So, our ivfs would no longer be necessary just because the psvs that are provided by medallion would replace those ivf forms. Okay?
Kviser (42:27) So that’s going to be a process that we phase out, then the ivf?
Connor Morley (42:31) Okay.
Rasencio (42:33) Yeah. And so my understanding is that all of the credentialing requirements were tjc accredited. So all of those requirements would need to be met and everything verified on the medallion credentialing specialist end before they even submit it to us for committee review. So if there were a flag, if something were to come up on an mpdb report or, you know, oig or any other thing where there’s a flag, it would before the credentialing is even completed and sent to committee review, that’s when we would get that notification that, hey, you guys might need to take a look at this. There’s something else going on. We need an extra review from our end from our credentialing specialist end. Is that correct? Connor and Niccole?
Kviser (43:21) Yes. Okay.
Connor Morley (43:23) Yes. Yeah. So we would not submit something to the committee until this is ready. That being said, there might be some flags in here that could pop up and they just need your attention. And those needs attention would then be, you’d have to follow that internal process depending on what the flag of that issue is, if it’s a correction, if it’s like an automatic deferral or a deny for the review. I guess it just depends on what the flag would be. Does that make sense… to me that’s.
Rasencio (44:08) something we’re just going to have to see as we get in with our individual providers. If something pops up, we’ll probably have to handle it more on a case by case basis. There may be just a number of things that could flag that would, I guess trigger a different response in how we handle that. So it may just be something that we need to look at as we go through it.
Connor Morley (44:33) Right. And typically… this is not the only training that we could go through. I can definitely do a credentialing deep dive with you where we kind of iron out exactly what that’ll look like just… so that we understand that workflow. But this is from a high level, you know, this is kind of the process for credentialing. Once everything’s been put together the application or the credentialing packets here, it’s ready that’s the alert to, for you all to send it then to the committee for review. And within the committee, the approver or the committee member that you send it to, they will either approve or reject, that request or that credentialing packet and provider. Okay? Yeah, I.
Rasencio (45:28) Think we’d definitely be interested in the deep dive. Once we have the entire team, all the credentialing specialists, that way, they can see how that works. And if they’ve ever, you know, if they come across any specific instances with their providers that they can bring up as an example. Yeah, I think that would be good perfect.
Connor Morley (45:51) And then in addition, so the committee can approve it or reject it once that’s been approved or reject, it would move into a closed status and you would be able to kind of see and filter by the outcome. So if there are any rejections, you can take note of that in, the closed as well as we will have the reappointments or re credentials scheduled automatically to occur that we usually start putting together the packets about three months before the credentialing deadline. Great. Okay. I do like to leave a little time towards the end to see if there are any other questions this?
Rasencio (46:40) Won’t.
Connor Morley (46:41) Be the only training we go through. But does all of that make sense right now? Were there any questions on anything that I brought up any of the processes?
Rasencio (46:58) I don’t have any right now. I’m sure as we get further into it, there may be some, and certainly, when we loop in the team so that they can get some training on it, they may have additional ones. But for right now, I don’t have any. Do you, Kenzie, no… not at this time. Thank you. Okay, great.
Connor Morley (47:25) I think Renee, we can start to have that credentialing deep dive for next week and invite the rest of the credentialing specialists, does that sound good? Yeah.
Rasencio (47:37) That sounds great. I’ll go ahead and shoot you an email with their email addresses. That way they can be pulled into the invite. Perfect. All right.
Connor Morley (47:51) Well, I think that’s all I had for today. Hopefully, this was helpful. And if you have any questions, let me know. I can send you a recording of this as well. So if you know, any questions come on, come up later on, please feel free, to reach back out to me. Yeah.
Rasencio (48:11) That would be great. I would love to have a copy of the recording. That way we can just kind of keep it in our folder for… reference. Yeah, no problem. Thank you. All right. Well, thank you very much. I appreciate it.
Connor Morley (48:30) Yeah, thanks, everybody all.
Rasencio (48:33) Right. Have a good one. You too. Bye bye.