Transcript
Vanessa Persha (00:00) hi, Deanna. Good afternoon.
Deanna Purchiaroni (00:04) Hello. How are you?
Vanessa Persha (00:06) Good. How are you?
Deanna Purchiaroni (00:09) I’m good. Let’s go ahead and jump into this.
Vanessa Persha (00:22) Can you see my screen?
Deanna Purchiaroni (00:25) Yes. Okay.
Vanessa Persha (00:27) Perfect. We’ll start down at the bottom here. So, I did add one item here for us to review for cortica healthcare, the California medicaid group demographic update. The ops team flagged this to me because the application requires signature and per the notes, they said they emailed it to you on three nine for signature. So, I just wanted to confirm that you received it and to see if you’ve been able to sign that and get that back over to us.
Deanna Purchiaroni (01:05) Yeah. I think last week you had mentioned this, but I didn’t get an email from them. Interesting. Do you know who the email would have been from?
Vanessa Persha (01:17) Let me go. Take a look.
Deanna Purchiaroni (01:41) And it would have been an email, not like a admin task, correct?
Vanessa Persha (01:45) Yeah. I think they created a task requesting for the application to be signed. And then they said they also sent the email. It likely came from the medallion E box, the cortica at medallion. Com or something like that. Let me look at the task and see if they included a link.
Deanna Purchiaroni (02:10) To it in there. Yeah, I don’t have any emails from that email or just like any from medallion on that date?
Vanessa Persha (02:24) Oh, yeah. And they didn’t even like actually create a task. Okay? Let me respond really quickly in our internal channel here, just so I can let them know… one second.
Vanessa Persha (04:05) Have them resend it and I’ll have them forward it to me as well. And then I’ll forward it directly to you just in case there’s any issues with the email going out.
Deanna Purchiaroni (04:18) Okay. Also, I believe Sarah might be in the waiting room.
Vanessa Persha (04:22) Oh, she sure is. Just let her in. Thanks. Ahem.
Vanessa Persha (04:44) Okay. All right. And then Marlee chang’s Connecticut RN license renewal. So I flagged that one to our licensing team and they were saying that her RN license is part of the compact license. So it didn’t need renewal. Does that sound accurate to you? And I’m only asking because when I see it in the platform, it doesn’t show that it’s compact like that. She has that as part of her compact license sure, but just wanted to confirm with you.
Deanna Purchiaroni (05:20) I mean, I’m not as 100 percent confident and on the licensing side of things, but that doesn’t seem accurate. I was under the assumption that license would also need to be renewed. And I did reach out to the provider, and she also was under the impression that medallion would be working on this but it didn’t look like it was requested… but she also thinks that it needs to be renewed.
Deanna Purchiaroni (05:48) Okay? And I did see that her auto renewal is on, but it wasn’t requesting. So I manually hit request, but I’m still not seeing it pop up under the request tab.
Vanessa Persha (06:04) So it did, what they were saying is they could see that it auto renew was on and that it triggered a request to renew, but then it was closed out because they said it was part of the compact licensure. So it wasn’t renewed because of the, for that reason. But I’m going to take it back to them. I do see now it’s sitting in her requested like it’s sitting as a request?
Deanna Purchiaroni (06:28) Right. Yeah. I see that. Now, I think I just requested it again this morning.
Vanessa Persha (06:32) Okay. Yep. So I will circle back with them and just triple check that it is indeed part of the compact license and share your feedback as well.
Deanna Purchiaroni (06:43) Okay. Could that be marked as like top high priority? Because that license expires in like seven days?
Vanessa Persha (06:50) Yep. I did, when I flagged it to them initially, I said like this needs to be resolved ASAP? So I have a thread going on with it as soon as we’re done here. I’ll follow up again.
Deanna Purchiaroni (07:01) Okay. Thank you.
Vanessa Persha (07:03) No problem. The Fallon caqh emails. So for the one that you had shared with me, which was for who was that? Let me go back and look.
Vanessa Persha (07:42) Oh, Margaret, Regan. Yeah. So we didn’t actually even submit a request for her. Like we just show that as an existing enrollment in the platform. So I was kind of curious like what even triggered for them to reach out about this? Let me see. The caqh team responded and said our caqh is updated with the correct group npi and tax ids… but again, they don’t there’s no like enrollment request affiliated with this. So they’re they don’t really know what, like does something need to go back to the customer or, to the payer or?
Deanna Purchiaroni (08:30) Yeah. I’m not fully understanding what the email is like. I don’t know, and I sent you this provider randomly, but we get this email for basically every single provider. Like we always have a bunch of these emails coming in. So, I don’t know if this was just one that like cortica submitted, but there’s other ones that medallion has submitted. Yeah, it seems like the like group information on all providers caqh profiles doesn’t match what they have on file. So I wonder if.
Vanessa Persha (09:01) this is like an error.
Deanna Purchiaroni (09:02) Something on like the contract side of like that they don’t have our correct info because I don’t know what else it would be.
Vanessa Persha (09:21) Do you want to work with Sarah on this one offline and see what you guys can find?
Deanna Purchiaroni (09:29) Yeah. And I can like log into the caqh and look into it more. Okay? I just wasn’t sure if you had like seen this before or knew, but I can look into it.
Vanessa Persha (09:42) Yeah, nope. I have not seen this before. Okay. And then Carrie mazansky, her optum Massachusetts line, I went into the platform and updated her existing enrollment to the correct group information and addresses.
Deanna Purchiaroni (10:04) Oh, perfect. Thank you. So, she’s fully enrolled with the correct group now?
Vanessa Persha (10:12) Yes. Yeah. So, the enrollment was completed for SCD, but I don’t know why her existing enrollment showed cat. So I just went into the cat, existing enrollment and corrected the group information.
Deanna Purchiaroni (10:27) Okay. And she is now linked to cortica Aba therapies.
Vanessa Persha (10:33) The only request we have for her was to link her to SCD?
Vanessa Persha (10:41) You’re talking about optima Massachusetts that’s not right? I.
Deanna Purchiaroni (10:45) Think this is what I recently messaged you about Sarah. I think all of these were submitted by Paige… and I was going to do like a big cleanup because I think all of them were requested under… spring tide, but it should be under C a T.
Vanessa Persha (11:10) Yeah. So the only two requests that we’ve processed for her were… for spring tide child development.
Deanna Purchiaroni (11:21) Okay. So I’ll have to go in and re, request all those for all providers to be linked to. We can do it on the portal. I think it is very easy. Okay?
Vanessa Persha (11:39) All right. And then your Coi renewal question. So your cois, are they, do you have like one group Coi? And then it has an addendum attached with all of your providers or is there individual Coi face sheets for every provider?
Deanna Purchiaroni (11:58) Individual? Yeah.
Vanessa Persha (11:59) So, that one will have to be a manual update into each provider… profile and then caqh management. Once we have the Coi face sheets, you can send a request to support. Well, actually, we’ll talk about support in a second, but that’s the typical process is you would send a request to support and ask for the cois to be updated for all of your providers in caqh. And then support will go in and trigger a request for the caqh management team. Okay? So.
Deanna Purchiaroni (12:35) We are expected to upload to medallion, but then medallion will upload to caqh.
Vanessa Persha (12:40) Correct. Yep. Do?
Deanna Purchiaroni (12:42) You know, if there’s like a time frame of when, how long that would take, because I know that is a lot of providers that they would have to log in for?
Vanessa Persha (12:49) Yeah, I’m not entirely sure, but I can run, I’ll look at the volume of providers you guys have in the platform and just run it by our lead over there and see how long it would take them to do.
Deanna Purchiaroni (13:02) Okay.
Vanessa Persha (13:31) Oh, let me just make a note here.
Vanessa Persha (13:43) All right. And then the gainwell application denials. So, I know gainwell processes apps for several payers. Can you forward me the last few emails that you had sent over to the help at medallion email? So we can take a look at those. And then I’m curious if your internal servers are blocking your emails, going to these two email addresses since it’s happening with the help and the support email and it’s not affecting any other customers. Would you mind reaching out to your internal it department just to make sure they’re not blocking those outgoing emails?
Deanna Purchiaroni (14:28) Yes. Okay.
Vanessa Persha (14:30) And let me know what you find out because like I said, we’ve been investigating internally and they can’t see any reason why we wouldn’t be receiving them and no issues with other customers?
Deanna Purchiaroni (14:43) Okay. So, you confirmed that like medallion’s just not receiving emails and forwarding. Okay?
Vanessa Persha (14:49) Yep. I sent her over examples the ones that you had sent me and she’s like, yeah, these are not hitting our intake box at all?
Deanna Purchiaroni (14:57) Okay. I’ll reach out to it and if it is blocked and we get it unblocked. Should I just re forward all of those to support? Yes. Yep. And would I use the support or the help?
Vanessa Persha (15:10) Go ahead and use help? I think you’ll get faster responses from the help.
Deanna Purchiaroni (15:14) Okay. Does help… also? Like, is it the same type of process where they send you like a, we received this like a typical ticketing. Okay. Yep. Yeah.
Vanessa Persha (15:27) Eventually all of our customers will be transitioned to that help box. They’re still configuring it on the back end for, to like go out for everyone. But, she went ahead and got you guys set up so we can process your support tickets through that email. Okay?
Vanessa Persha (15:48) Brenda rodriguez with health net.
Deanna Purchiaroni (15:56) I think this is where on her… application, it wasn’t necessarily listed as like a behavioral analyst, yep.
Vanessa Persha (16:06) Let me go look because I, they responded to my inquiry. And then I just, I was like, this response doesn’t sound like it’s responding to the question I asked. So let me go see if she’s responded back. Not yet. She said she’s looking into it. She gave me a response to like a North Carolina medicaid question I had from before. I was like, no, no different issue. Okay? So yeah, I’ll try to get an answer for you today. I know she said she was going to call the payer directly to confirm.
Deanna Purchiaroni (16:40) Okay.
Vanessa Persha (16:42) Your support issues. We just talked about that, North Carolina training tasks. So, I did update the North Carolina medicaid tab with all of your enrollment requests for North Carolina medicaid and put their current status in here. Have you had a chance yet, Deanna, to confirm with providers who have completed their training and to mark those tasks as complete?
Deanna Purchiaroni (17:10) I have a list of like four providers who confirmed, I have not reached out to everybody though?
Vanessa Persha (17:18) Okay. So if they don’t complete the training within that window of time, North Carolina medicaid does charge another fee. I think it’s like another 100 dollars to submit the application. So if we can get that confirmation from them sooner rather than later, it will prevent us having to resubmit the app and then charging the additional fee.
Deanna Purchiaroni (17:45) Okay. I will reach out to these providers. And then I did have one provider, dr, Rashika shmala, who’s on this list, he reached out. He’s line nine. I think that is okay. He reached out to me this morning saying that he… got a bizarre request to watch a training video. Blah, blah, I told him that he needed to do it for medicaid enrollment, but I don’t see that he has a task in medallion. So, I think there are still providers who don’t have tasks.
Sarah Aloisi (18:24) Do doctors need to do it? I thought it was just bcbas?
Vanessa Persha (18:30) No, I think it’s all providers. Let me go look.
Vanessa Persha (18:39) Yeah, that’s all of your providers. Okay? And then let me go back into.
Vanessa Persha (19:12) You are correct. They made a note that they tasked him to complete it but didn’t actually create the task.
Vanessa Persha (19:44) Okay. I will ask them to review this list again for all the ones that show they need to need the training and make sure the tasks are all there. Let me just make sure. Oh, yeah, it still would have shown there if he had completed it. So, I’m not seeing that one was ever created. Okay? I will follow up on that one.
Deanna Purchiaroni (20:11) Okay. And then, Sarah, do you think that I should just like send out a mass email to all these providers saying that it is legit and they do need to complete it?
Sarah Aloisi (20:19) Yeah, that would be great.
Vanessa Persha (20:22) Okay. Thank.
Sarah Aloisi (20:23) You.
Vanessa Persha (20:25) and Vanessa?
Deanna Purchiaroni (20:26) This is everybody on this list here. All these providers are ones that need to complete. There’s. No one missing.
Vanessa Persha (20:32) Correct. Yep. These are all of your current requests in the medallion platform. Okay?
Deanna Purchiaroni (20:37) I’m going to, if it’s okay with you, just create two more columns and just like do send email so I can track it. And then I’ll maybe do one that’s like training complete and I can write an answer now. Okay?
Vanessa Persha (20:51) Perfect. And then there are a handful of providers in here that have missing information that needs to be attached. I think it has some have to do with like a Dea in the platform that’s not a North Carolina Dea. It’s a couple odd and end things. So, if you want to take a look at those when you have a chance for the ones that say task for missing info… okay?
Vanessa Persha (21:21) And then Sarah, for those ones that we confirmed are enrolled as individual providers, are you guys, okay if we go ahead and mark those lines complete? Now? Yes. Okay. Perfect. I will get that done today. And we did confirm with NC tracs because I had shared that another customer told me NC tracs will send out enrollments for the managed medicaid plans once the provider is enrolled, which I thought was kind of fishy sounding, we talked to NC tracs and confirmed they do not send out those enrollments automatically.
Vanessa Persha (21:59) So you’ll still need to request individual pesrs for any managed medicaid plan that you want us to enroll your providers in?
Vanessa Persha (22:14) Any other questions on North Carolina medicaid before we move on?
Deanna Purchiaroni (22:21) I do not. Okay. Awesome.
Vanessa Persha (22:23) Ever, north, Arizona, there were those three lines where the payer continues to say the Arizona location is not par. I talked to the team about it again this morning and said like you just, you need to push because the practice location that is attached to these providers are attached to other providers that have been completed. So, they’re going to make a phone call to the payer today. And then… Arizona… medicaid. We talked about this morning. I did flag… mark violetti again and said like we just, we need to get the app out. It is still within our standard processing time to get the app submitted. But I just shared, you know, like I’d like for there to be enough time for the QC process to go through and make sure that the application is completed appropriately before we hit the end of that like window of processing time. So, they’re going to get that done today. So.
Sarah Aloisi (23:27) He’s already enrolled with North Carolina medicaid under his previous job, and I think he just needs to switch the tax id. Is your team aware of that?
Vanessa Persha (23:36) For this is for Arizona medicaid?
Sarah Aloisi (23:39) Sorry, if I said North Carolina, I still meant Arizona.
Vanessa Persha (23:42) Okay. Let me go look and see what’s on his notes.
Vanessa Persha (24:05) I’m not seeing notes here, but let me take a note and flag that for them.
Sarah Aloisi (24:21) Do I need to do? I need to do this one? I really don’t want it to get messed up.
Sarah Aloisi (24:31) It’s been a long time.
Vanessa Persha (24:36) I think it’s been about eight days since his request has come in.
Sarah Aloisi (24:47) Which is a long time in terms of lost revenue. And if they’re going to submit a full application when it’s not needed? That makes me nervous.
Sarah Aloisi (25:06) And I also noticed that, the renen, do you remember her name, Deanna, renen something or other that you told us for?
Vanessa Persha (25:16) Several.
Sarah Aloisi (25:17) weeks was worked on and it was just not typed into the system. I noticed that wasn’t true and the domain access was just submitted a couple of days ago. Yeah.
Vanessa Persha (25:29) I did flag that to the team lead for that agent. And I said, look like this is a problem. We were told for weeks that this was done. You told me?
Sarah Aloisi (25:40) That you flagged it for the agent? Yeah, nobody looked at it for three weeks to, yeah.
Vanessa Persha (25:48) So, again, like I said, I’ve I shared that information with her. They shared and had a conversation with the agent.
Sarah Aloisi (25:58) I mean, so what are we doing to make sure that doesn’t happen with mark violetti. So.
Vanessa Persha (26:05) Your Arizona. Well… we’re we have started a tracker internally. I have a dashboard essentially that monitors week over week movement on your applications for your priority payers. And so that’s how I will monitor those things internally and then share that feedback with the PE ops team. When I’m seeing things that aren’t moving.
Sarah Aloisi (26:31) And.
Vanessa Persha (26:32) that.
Sarah Aloisi (26:32) dashboard, was, is… it brand new? Yeah. So.
Vanessa Persha (26:38) I’ve just, I’ve created it. I had, I was using it for another customer and I just created it for all of my customers so I can keep track of like higher priority payers and make sure that we’re staying aligned. But yes, it is brand new for you guys.
Sarah Aloisi (26:56) Because I can’t I mean, I can’t keep doing this escalating things three times and have nothing happen.
Vanessa Persha (27:01) No, I, yeah, it’s so much.
Sarah Aloisi (27:03) Money that we are losing because of this. It can’t I mean, can you admit, to figuring out mark violetti?
Vanessa Persha (27:15) Yeah, yeah. Absolutely. I have him called out like as a specific line item on my agenda with our team. Because like I said, I noticed that he hadn’t had any movement since his intake was completed, and really just stressed like we need to get the apps prepared and sent to QC like well before our window of time frame?
Sarah Aloisi (27:38) Are you going to ensure that they’re telling you the truth? If somebody is like telling you, they’re doing stuff that they’re not doing? I think probably we need to confirm instead of taking their word, yeah.
Vanessa Persha (27:52) No, absolutely. I’ve shared that feedback. Like I said with that team that like there needs to be a level of accountability here. Like, I cannot just commit that things are being done without proof that they’re actually being done. So that is something that we’re working through as part of like performance monitoring internally?
Vanessa Persha (28:15) But I agree 100 percent Sarah, and I totally understand your frustration there. These lines should not be sitting like this. I.
Sarah Aloisi (28:23) Mean, it’s not really. I mean, it’s not frustration, it’s money. The money is just going out the door.
Vanessa Persha (28:28) Yeah. Just out of curiosity for mark, when did he start working with you all? Oh, he started Monday.
Deanna Purchiaroni (28:38) Yes, I believe so.
Vanessa Persha (28:39) Okay. Is there a reason why you guys wait so long to submit the enrollment requests? Like why it’s so close to his start date? I mean.
Deanna Purchiaroni (28:54) It really just depends on when the providers sign the offer letter. Sometimes we’re notified three months before their start date. Sometimes it’s two weeks?
Vanessa Persha (29:01) Okay. And I’m only asking just because like a typical turnaround time for an enrollment can be anywhere from 90 to 120 days. So this is really cutting it close. Like, you know, even… if we processed everything the day you submitted it, there’s no way this provider is going to be par by the.
Sarah Aloisi (29:26) Effectiveness, this is the time to talk about corticas… processes before it gets to medallion.
Vanessa Persha (29:38) Okay. I mean, I’m not assigning blame here, Sarah, I’m just simply stating like this is going to cause revenue issues regardless, like we will do everything on our part to get these submitted timely.
Sarah Aloisi (29:51) Okay. Thanks for the advice it’s.
Vanessa Persha (29:52) not advice. I’m it’s I’m asking questions to try to understand.
Vanessa Persha (30:06) You know, to be honest, Sarah, I think I’m going to cut this call short. I don’t really appreciate the combative nature that has to come to these calls. Like I’m trying to be helpful here. I’m trying to be your partner to ensure that everything that you guys need done is being done timely. I think we can talk about.
Sarah Aloisi (30:25) The things on the medallions, not the things on the cortica side. I.
Vanessa Persha (30:30) Appreciate that sentiment, but it can’t just be one sided. There is a level of involvement and engagement that we need from cortica in order to be successful and for this partnership to be successful. And at this point, I don’t feel like this conversation is heading in that direction. So, I will let you all review the updated items on the tracker. If you guys have any additional questions, feel free to send them over to me in an email. But thank you.