Transcript
Niccole Russell (00:00) Nancy, how are you? Good morning.
Nancy Rodriguez (00:04) I can’t hear you. Can you hear me?
Niccole Russell (00:07) Yes.
Nancy Rodriguez (00:08) Can you hear me?
Niccole Russell (00:10) I can.
Nancy Rodriguez (00:11) Okay. So, chendel, I saw him just a few minutes ago and I reminded him of the meeting.
Niccole Russell (00:17) Okay. We’ll give it just a couple of minutes.
Nancy Rodriguez (00:20) Yeah, let’s give him a couple of minutes. Let me just go. It’s just next door. So let me sure. Yeah.
Niccole Russell (00:27) Go ahead. Let me just.
Niccole Russell (00:55) Hey, chendel. Hey, what’s going on… going well? How are you? Good to see you. Do you know if Jasmine’s coming to this meeting? I haven’t seen her since, okay… Nancy, do you know if Jasmine’s coming or should we go ahead and get started?
Nancy Rodriguez (01:19) We should get started. She knew about the meeting. So, okay, all.
Niccole Russell (01:24) Right. Well, I’m going to share a few things and then we can kind of jump into it if you have any questions as well.
Nancy Rodriguez (01:30) Yeah, I have a few.
Niccole Russell (01:31) Questions. Okay. Let me go ahead and share my screen here. So these are just some notes that I’ve put together. So I just wanted to bring attention. I try to do this with every client just so you kind of know what’s out there. I’m sure you do. But just to bring it to everyone’s attention. So for tasks, we have overall 19, 12 of those are for the provider.
Niccole Russell (01:55) Seven of those are for the admin, and then I also check any bort certs that are expiring within 30 days. You did not have any at this point in time. So we’re good there. And then under the payor enrollment request for requested, we do have 27 for processing. We have 163 and then 58 need client attention. And then, and I can also kind of show you, I think I showed before, but if not providers, where I find this information. So outstanding tasks, we have 10 provider profiles that need action. We have 10 of those. And then I also look at provider profiles from zero to 84 percent. Because as we know, it doesn’t go through intake until it’s at reach at least 85 percent. And they’ve signed their agreement. So there are two that are still in between zero and 84 percent. And then providers that have not signed into medallion at this time, there’s only one. So just wanted to bring those up so we can make sure that we keep track of that information. So I’ll stop sharing here.
Nancy Rodriguez (03:20) Okay. When did you actually did this? Probably yesterday, right?
Niccole Russell (03:25) I did it this morning.
Nancy Rodriguez (03:27) Oh, okay. Because right now, the total task is different. So it’s a totally different number, but that doesn’t matter.
Niccole Russell (03:37) Yeah. I just did it a couple of hours ago. Oh.
Nancy Rodriguez (03:40) Okay. That’s probably because we came in at a different time zone because I came in at like nine o’clock and I did a bunch of them.
Niccole Russell (03:51) So,
Nancy Rodriguez (03:51) but that’s okay. But my concern is about this… provider for files two and provider not signed into medania. I would like to know who are these two people? Okay? Because I noticed that this still has one of them about the city and the state and we talked about that already, right? I want to see who they are, let.
Niccole Russell (04:19) Me, get to your account here. Hang on just a second. Oh, I was there. Okay. All right. So what I do to find this information is I go under providers, okay? And then there is a drop down right here. It’s a small one. So let… me look, you wanted to know the two percent, the two that are, yes. Okay. So what I do is I will click all of these up to 85 percent. It will show 85 percent, but I take those out because once it’s reached 85, we’re good. So it’s really just zero to 84 percent. But the two, no… hang on. I must have some. Oh, this is not you. I’m sorry?
Niccole Russell (05:14) I thought it was, I knew it was not. So I go over here to providers, and then I click this and I will click all of these. I hit. Okay. And then these are the two that are not quite at 85 percent and you can hover over and see, I think 85 percent shows yellow. So any of the red, I go ahead and add in. And then at yellow, I look to see if it’s at 85 percent.
Nancy Rodriguez (05:47) It looks like those. I’m glad that we’re talking about this because maybe that has something to do with it. I don’t know, but let me tell you one thing. Give me one second.
Chendel Hooks (06:08) So, I’m looking at Sonia.
Nancy Rodriguez (06:11) Okay. So basically, Sonia… Gaffney, and Albie, they are the two that are actually going to be managing their own cqh profile. So they’re always going to come up. Is that the case? Is that what you’re missing?
Niccole Russell (06:35) Nope. Why are.
Nancy Rodriguez (06:37) they missing? Because they did everything except the caqh?
Niccole Russell (06:41) No, they did not. So there’s basic information which that should be optional. That should be optional, right? Okay. Yes. But there are external accounts, right?
Nancy Rodriguez (06:54) That’s the caqh, they’re not going to give us that information, they’re going to manage their own.
Niccole Russell (06:58) Okay. Well, they haven’t signed their agreements either. So once they sign their agreements, maybe that will boost them up, we can take a look and see.
Nancy Rodriguez (07:07) Okay. So that’s the station, you mean? Right?
Niccole Russell (07:11) Yeah. So that’s under the agreements tab for us to work on their behalf.
Nancy Rodriguez (07:16) Oh, okay.
Niccole Russell (07:17) For enrollments or, anything that we need to do medallion wise, they need to sign this agreement. Can we?
Nancy Rodriguez (07:22) Just go into her file. I just want to see it. Can we check, okay?
Nancy Rodriguez (07:32) All right. And then that is, but they did, okay, where the agreement, right? They open it, right? Yeah, open it and.
Niccole Russell (07:41) Then this external account, they may be able to add it and put in a.
Niccole Russell (07:50) Okay.
Nancy Rodriguez (07:58) Yeah. Let’s just say there’s no space to let them know.
Niccole Russell (08:04) Let’s just see if this will complete it out. I’m not sure. Okay. So that completed it out. So we’re good there.
Nancy Rodriguez (08:13) Oh, okay. So we do the same thing with, yeah.
Niccole Russell (08:17) Now, see this bumped it up to 93 percent when it’s completed. However, if the agreement has been, has not been signed.
Nancy Rodriguez (08:24) Can you open it? Open it? I just want to see, yeah.
Niccole Russell (08:27) And this has to be done by the provider.
Nancy Rodriguez (08:29) Yes, I am that. Okay. Yeah, no problem. Okay. I will follow up with both of them. Okay?
Niccole Russell (08:36) So that’s for Sonia, let’s take a look at Alvi here and see it’s. Probably what’s missing there. So there, and this provider needs to complete the disclosure questions and the agreement and then you said they’re going to manage their own caqh here? Yes. Okay. Yes, I’ll do na, here as well.
Niccole Russell (09:08) They will still need to add Pecos information for us to do anything. Oh, is this optional?
Nancy Rodriguez (09:13) It says optional it?
Niccole Russell (09:16) Is optional. But if you put a request in for medicare, we are going to prompt for this information. So, just to let you know, you don’t have to do it now. But if you put in a request for us to either send a provider to your group or do a new enrollment for a provider for medicare, yes, we do at that point, then at that point, you have to ask out to the provider and ask the provider to complete that?
Nancy Rodriguez (09:42) Well, what I’m getting from your team is that they send them an email and they’re asking for them to give them access to medicare that’s the way that we are working right now with your team, but no one had come back to us and ask us for that mpps account number. Yeah.
Niccole Russell (10:03) If they’ll task out if they need this information.
Nancy Rodriguez (10:06) So that makes sense and none.
Niccole Russell (10:09) Of this has been completed. So, I’m not sure… basic information that’s probably the first.
Nancy Rodriguez (10:16) Oh, there he goes the missing fields again.
Niccole Russell (10:20) So, I don’t know, I’m wondering if let’s see if this provider has a PE task out there. They don’t have any. They don’t have any tasks. So it should be optional. I’m… not seeing why.
Nancy Rodriguez (10:43) He says that one is blocked… because of that.
Niccole Russell (10:59) So, it’s saying medicare is blocked because of that. I.
Nancy Rodriguez (11:02) Know. So they need to remove that.
Niccole Russell (11:06) I’ll get, I’ll look back into this again. Yeah. Can we?
Nancy Rodriguez (11:11) Check.
Niccole Russell (11:12) but there are other fields, so, professional history as well. Just while we’re looking at it… what is it? So there are nine enrollments blocked here?
Nancy Rodriguez (11:24) Well, why?
Niccole Russell (11:30) We can see the enrollments that are blocked. Let’s see what?
Niccole Russell (11:38) So, professional history missing required education, field institution. So these are the things that are missing. So if you go to the overview, this kind of lays it all out.
Nancy Rodriguez (11:49) Yeah, but it’s 86 on the professional history. So it should be fine. It’s just the disclosure and the agreement, but we’re.
Niccole Russell (11:56) at 83 percent. So we’re.
Nancy Rodriguez (11:58) not going to want this.
Niccole Russell (11:58) Provider until it’s 85, the agreements have been signed which have not been signed. It’s going to?
Nancy Rodriguez (12:03) Go on. Yeah. And.
Niccole Russell (12:05) then on top of that, if the payer requires information which they do require educational history, that would need to be completed before we started enrollment as well.
Nancy Rodriguez (12:16) Can you check that again? The missing required education? No, no, right there. Yeah, go into that. I want to see exactly what’s in it. Open it because I thought everything was in there. The school is there? So what exactly are you missing?
Niccole Russell (12:36) So, please enter your undergraduate and graduate education here. This is a graduate education.
Nancy Rodriguez (12:43) That’s what you need.
Niccole Russell (12:45) Undergraduate as well. It’s.
Nancy Rodriguez (12:47) not necessary for each of us. They never requested that, but let’s see what your team is going to tell us.
Niccole Russell (12:57) So, these are the things that are missing. And until we get these.
Nancy Rodriguez (13:01) Yes, I’m going to follow.
Niccole Russell (13:02) up. And then if the payer requires this, then they will leave a task out there for that as well.
Nancy Rodriguez (13:08) Yeah, no problem. Now. Can we look at this person also has managing her own caqh, Michelle Landry?
Nancy Rodriguez (13:22) And I know she currently has two tasks open.
Nancy Rodriguez (13:33) And let’s go into the caqh.
Niccole Russell (13:35) All right. So, I followed.
Nancy Rodriguez (13:38) up with her this morning on those two, but we need to put the N a, about the caqh on her profile.
Niccole Russell (13:45) She’s doing her own, yes, yes, because.
Nancy Rodriguez (13:49) I thought that once you uncheck the box, your team already knows that they are doing their own caqh. Oh, she did put something in there, okay?
Niccole Russell (13:59) She did, but.
Nancy Rodriguez (14:01) I know she’s managing her own. So I don’t know. All right. And then you said that one employee is missing enrollment because I thought that chendel and I, we did all of them, right? Chendel?
Niccole Russell (14:15) Yeah, one that has not signed in. So, right here, profile not signed in? Yeah. Who is that? So, if you go back, that was.
Nancy Rodriguez (14:25) One of my questions for you today to figure out who’s missing?
Niccole Russell (14:31) So, if you go back here and then scroll all the way over here to the right to date joined. So, this lets you know when they joined medallion platform. Okay? And I hit these little… buttons for ascending it’ll, do January. So then I hit it again and it will bring up.
Niccole Russell (14:57) Usually it was at the top. I don’t know why it didn’t but it comes up right there. So it’s Albie. Oh, I.
Nancy Rodriguez (15:04) thought we did her.
Niccole Russell (15:07) You may have invited her. She did not join, so we can look to see.
Nancy Rodriguez (15:12) Because yeah, I thought we, so.
Chendel Hooks (15:15) She still needs to have hair almost done for her.
Nancy Rodriguez (15:18) I thought we did all of them. Remember, I know she’s still Albie is the one that needs the disclosure and attestation.
Niccole Russell (15:32) So, if we get a member.
Nancy Rodriguez (15:33) Because I know she’s there, we did every single person.
Niccole Russell (15:38) Actually, you should be able to see. Let me see here. Let’s do this. So, if you’re looking at Albie.
Nancy Rodriguez (15:54) You see pay a request?
Niccole Russell (15:58) Okay. So, it did not let’s go here to members.
Chendel Hooks (16:02) Yeah, it looks like I’m seeing stuff for her.
Niccole Russell (16:06) I’ll be.
Niccole Russell (16:12) So, you invited February 20 first? She still has not or they have not accepted. Yeah.
Nancy Rodriguez (16:18) I know that you told me, but I thought that chendel and I, we are over in all the insurances.
Niccole Russell (16:25) You may have put request lines in, but they won’t be able to see.
Nancy Rodriguez (16:28) If we did it.
Chendel Hooks (16:30) I think we did. I’m looking at it now, I see the request in the system.
Nancy Rodriguez (16:37) Okay. So.
Chendel Hooks (16:39) She just, so they won’t move forward, until she joins.
Niccole Russell (16:43) Correct. Okay. Yeah, the only way to move forward is 85 percent completion plus the agreement and disclosures being signed.
Niccole Russell (16:52) And then on top of that, if they need additional information to work any sort of payer, then they’ll task out for that information.
Nancy Rodriguez (16:58) Okay. And,
Niccole Russell (17:00) while I’m in here, I can go ahead and resend her invite. Okay? So she at least gets it at the top of her email.
Chendel Hooks (17:10) Oh, that’s great.
Nancy Rodriguez (17:12) We gotta do Sonia too. Sonia didn’t do it. Did you do, Sonia? I.
Niccole Russell (17:22) think Sonia was in there?
Nancy Rodriguez (17:24) No. Let’s send her there. I think she.
Niccole Russell (17:28) has not signed her agreements, but she has signed into medallion. I believe. Yeah, she accepted the invite. She just didn’t go in and do her agreement. Okay?
Nancy Rodriguez (17:39) Yeah. All right.
Niccole Russell (17:41) Okay. And then I’m going back to providers just so you can see. So this is where I’m pulling the latter half of all of this information. So click this little funnel here. And so the first thing we looked at was zero to 85 percent. And then if you scroll down a little bit profile action required, if you click that, it shows you the names and then how’s outstanding task, it’ll show you the names there. Okay? So I’ll leave that for you. We’ve only got about 10 more minutes and then I have to hop to another call.
Nancy Rodriguez (18:13) Okay. So then let me go ask my questions quickly. Sure. So Lupita received an email from Caroline behavioral health stating… that the notice that she needs to attach the W9 form that there was an issue. So I send it to your support team and have not received a response. So I just want to double check. So, what is the typical turnaround time for support responses? And will providers be using this kind? Will we be getting this kind of documentation? Or is it a medallion? Because W9 is a facility? And remember, we had the issue about the, that it was not the actual address? So we changed that, but your team is not, they’re not checking again. So well, they can’t they didn’t see the task before. So they.
Niccole Russell (19:17) didn’t know that task had already been, that was a task out to you. So.
Nancy Rodriguez (19:21) They weren’t aware of that. So how can I send a task to your team for them to follow up? Because if you look at here, Lupita is, I can’t send them a message. I send them via support team and they haven’t replied. So, how do I, is that the only way to talk to your team?
Niccole Russell (19:44) Through support? Yes, unless it’s me?
Nancy Rodriguez (19:47) And what is that turnaround time? What would you be expecting? I’m not.
Niccole Russell (19:53) Sure if I have been given that, but I can find out if not, let me, oh.
Nancy Rodriguez (19:58) Okay. So let me go to the next one. So you will find that and you put it on your note… now.
Niccole Russell (20:05) You can always follow up on a ticket because you can see all of your tickets as well. So you can always follow up as well, but I will find out the turnaround time.
Nancy Rodriguez (20:13) But I want to find out if, you know, if I don’t want to keep following up that’s why I want to know what is the turnaround time? Now, there’s also another, this is a task. Okay? Medallion sent me an incorrect medicaid… facility applications. I have provided example of the two church tree along with a blank medicaid application for reference to you. They are completing the incorrect medicaid application. They’re asking me to have Maria sign it, that’s the wrong application to add the facilities. I send them that I follow up with your team on March and have not received a response. So we wanted to know when do we expect a response from your team regarding this issue? Because this, you know, medicaid, like I mentioned to you is our number one payer. And five days have been so far and they completed that incorrect medicaid application. Okay? So if you can please follow up with them, I really appreciate it. And then my last question… I remember talking to Naomi during our calls and under the, providers, supervisors are still blank. Are you still having a glitch in the system? And when is that going to be fixed?
Niccole Russell (21:47) Providers supervisors are still blank.
Nancy Rodriguez (21:50) Yeah. So if you’re going to providers, right? Directory, and then provider supervision, this is again, even Naomi said there’s a glitch in the system. So I’m just following.
Niccole Russell (22:03) up.
Nancy Rodriguez (22:03) Okay.
Niccole Russell (22:04) Yeah, I’ll follow back up. I think she put a ticket in. So I’ll follow up with her to see if she received a response or for her to follow up on that ticket.
Nancy Rodriguez (22:11) My last question? Okay. We have an MP, nosa, Sena. Okay. She currently has a non… part… medicaid number. Okay? And basically, I want to tell your team that they need to it’s medicaid. Oprah, she has been in medicaid, Oprah. So three 220 24. The provider is non billable. So, but you need medallion needs to change the provider to fee of service. So they need to complete an enrollment change form, not an actual whole enrollment because she’s already in medicaid. So they need to.
Niccole Russell (23:07) Have her medicaid information in medallion?
Nancy Rodriguez (23:10) I don’t know where to put that information in, but I wanted to send chendel… and I, we tried to add like you mentioned in your email that we needed to add another line of business, right? We tried that, but that is not an access. It doesn’t give us an option for that because she is, unless we add her as that, but she’s not billable. We can add her that she does have a medicaid number. We.
Niccole Russell (23:49) do not reach out to providers to payers if they’re non billable.
Nancy Rodriguez (23:55) Okay. So we need to, we need medallion to, I just don’t want medallion to do double work.
Niccole Russell (24:04) So, let me let.
Nancy Rodriguez (24:06) Me understand. Medallion needs to complete an?
Niccole Russell (24:07) Enrollment. And this is for medicaid. This is for medicaid. So she should.
Nancy Rodriguez (24:11) Be getting billed? No?
Niccole Russell (24:14) No, no. Or is she rendering and offering she?
Nancy Rodriguez (24:16) Has a medicaid Oprah, as of three to 20 24? Okay, provider is non billable. Provider cannot bill or be affiliated in order for this provider to be changed for fee for service, medallion needs to complete an enrollment change form.
Niccole Russell (24:39) Okay. So you’re wanting to change her to a billable provider, understood?
Nancy Rodriguez (24:43) Correct. What is the process with medallion?
Niccole Russell (24:46) So, medallion, that would be an enrollment or is she linked to opendoor? No?
Nancy Rodriguez (24:54) No, not yet.
Niccole Russell (24:55) Okay. So that would be a demographic update, but since there’s no line in medallion and she’s already been enrolled, I will need to check on that because the, only, to my knowledge, again, I’ve only been here since December. To my knowledge, the way the medallion works is for you to do a demographic update. You have to have that original line of participating, right? That makes sense. Let me make sure in my head, it makes sense because how do I know? I’m doing a demographic if I don’t have the par information for that provider, right? But let me make sure with medallion enrollment team that that’s how it needs to be done. And if so, then how do we get that information into the system? Yes?
Niccole Russell (25:50) Because that, I’m not sure of. Okay. I’m not sure of that. Yeah. All right.
Nancy Rodriguez (25:55) That’s all I have. Do you have anything else? Chendel? Because I.
Chendel Hooks (25:58) know we’re running out of time. No, no. I was just going to follow up on those cases on the providers that we did, you know, the pay enrollments for back on the sixteenth. So they should be going out on Monday, but I do see, I see it looks like they’re a lot of them are in processing. So it looks like it’s moving along. So it looks like they’re all already… going forward. So, I think we’re I think we’re good… Niccole, in the beginning, you said there was 52, I guess… things that the providers had to do in your agenda.
Niccole Russell (26:37) So on the payr tab, there are 58. So let me share really quick. And then I have to jump to another call in a couple minutes, but let me show you this real quick. So if you go, let my screen populate, can you see that? Yep. So if you go to payr’s right here and you go to enrollment requests, yep, there are 50. Well now 57. So one dropped off, I think there were 58. Yeah. So there are, if you click on this box, it will show you all of the ones that require attention. If you hit this drop down button. Yeah. Okay. I see, please approve your request for medicare users. So we’re needing surrogacy for us to work this.
Chendel Hooks (27:21) So these are the providers you need the provider to do?
Nancy Rodriguez (27:26) But I’m confused.
Niccole Russell (27:30) I’m sorry, what was that? Chendel?
Chendel Hooks (27:33) No, I was just asking, are these things the provider needs to do? Yes. Okay.
Nancy Rodriguez (27:38) Yeah. Okay. But I’m sorry, I’m confused because if you go into the overview on the provider task, there’s only 12. So I thought that whenever something is missing, they’re going to send a task to the provider.
Niccole Russell (27:56) They don’t necessarily send a task. So they could put a note on the line, they could, but.
Nancy Rodriguez (28:02) Then how is the provider going to know that something is missing?
Niccole Russell (28:06) They’re notified, they’re notified each time. So like this is an intake. Wow my screen is, so this is an intake. You can also click on it. Medallion lacks information provided to move on.
Nancy Rodriguez (28:21) Medallion needed. Provided, can you go back because I want to see what it is because I was not aware of this task.
Niccole Russell (28:28) This is just stating medallion.
Nancy Rodriguez (28:31) Lacks information needed from the provider. Okay? But what are they missing? It’s like you can’t put a note in there and not tell us what it is.
Niccole Russell (28:41) Well, if it’s.
Nancy Rodriguez (28:42) what is it? So?
Niccole Russell (28:44) If it’s intake that’s provider profile information, which they are alerted, let’s.
Nancy Rodriguez (28:50) check on Carson. I want to see what it is. We have one minute.
Niccole Russell (28:55) Carson, yeah. Oh, right here, no.
Nancy Rodriguez (28:58) Because it says needs attention, so.
Niccole Russell (29:01) Can you?
Nancy Rodriguez (29:01) Go back?
Niccole Russell (29:01) Right. Intake. So that’s a profile. The provider has been alerted that their profile is incomplete. So there’s no task out here for that for the provider and you can see client task and you can see medallion task. So we’re waiting to complete our task until the provider takes action on their profile, but.
Nancy Rodriguez (29:21) The provider are not receiving any tasks. So, how are they going to know they?
Niccole Russell (29:27) Receive updates on their profile. So, let’s see.
Nancy Rodriguez (29:31) So, what are they missing?
Chendel Hooks (29:33) Do they get an email there?
Nancy Rodriguez (29:35) It goes, they said bird city and county.
Niccole Russell (29:38) Yeah. Again, I’m going to look into that, so.
Nancy Rodriguez (29:41) Yeah. So I think all of those tasks are referenced to the basic city, bird city. Can you please follow up with that and put it out? I will, yes. Yeah, I think that because I was like that’s crazy because Jasmine and I, we’ve been like every single day reviewing the overview task. Yeah.
Niccole Russell (29:59) I can take a look at that. I’m not sure. I’ve been told a couple of times that it’s optional. I don’t see that it’s optional, but I can follow back up and I do know that a PE request can override that. But again, for like medicare group, yes. But for medicare for provider should not need that information.
Nancy Rodriguez (30:22) Okay, only for facility. And you actually sent me an email and confirmed only for, if you need board of directors and administration, you do need the city and the state.
Niccole Russell (30:33) Correct. Yes. If you’re doing any sort of ownership change, anything like that, then, yes, right.
Nancy Rodriguez (30:39) I agree with you 100 percent, right? Yeah, for providers, so.
Niccole Russell (30:43) If your provider should not need that for medicare?
Nancy Rodriguez (30:45) And follow up because all those 57 out of 12, correct? They subtract 12. Yeah, because providers have 12… 57 minus 12. Those all has to do with the city and the state.
Niccole Russell (30:58) They could, I can’t say for sure because I haven’t looked, but I could see that definitely because I see a lot of tasks out there. So I’ll follow up with that. Yeah.
Nancy Rodriguez (31:07) Thank you so much.
Niccole Russell (31:09) Well, thank you for your time and you all have a great day. Thanks a lot. Thank you. Bye bye.