Transcript
Naomi Denson (00:00) hey, Nick.
Nic Schisler (00:04) Hi, sorry, I thought I was on mute for some reason, but I’m not.
Naomi Denson (00:07) You’re not, it’s okay.
Nic Schisler (00:11) How’s it going?
Naomi Denson (00:13) How’s it going? Let’s see. I don’t know.
Nic Schisler (00:16) Don’t I know it.
Naomi Denson (00:19) Christy’s here. Can you refresh me before I let her in their facility assessment for payers, their facility credentialing, yes, that’s like an immediate need, like we’re running with everything I.
Nic Schisler (00:34) Think right now, it sounded to me like when we came out of the internal call, let’s handle credentialing because there was a good, I shouldn’t say handful like a couple 100 providers that needed to be credentialed and I think we needed to still kind of feel out the facility piece because I think they were under the impression that we would be handling some type of an outreach which we, I think currently don’t and so, I think we needed to vet that out and it might be worth us probably coming back together internally. Like me, you and merit to.
Naomi Denson (01:11) Talk about that. Yeah, I’ve got a thread going about it. Great. Okay. In the channel. And because I was like, I don’t know if I should be asking them for like facility data or anything like that. So I just, I won’t bring it up right now, okay?
Nic Schisler (01:23) Sounds good.
Naomi Denson (01:26) Okay. Looks like Christy’s here twice?
Naomi Denson (01:35) Hello? Hi. How are you doing well?
Christy Garrett (01:38) How are.
Naomi Denson (01:39) you? Good? I’m.
Christy Garrett (01:41) glad you can hear me. I’ve been having computer issues.
Naomi Denson (01:44) Yeah, it looks like you’re joining twice?
Christy Garrett (01:47) Pardon me it.
Naomi Denson (01:48) Looks like you’re joining twice there’s another Christy that’s spinning trying to join. Oh, wow. I was.
Christy Garrett (01:55) Extra excited about the meeting then.
Naomi Denson (02:01) All right. Is larisse coming today? She?
Christy Garrett (02:03) Is on pto? So she will not be joining us.
Naomi Denson (02:06) Okay, perfect. All right. Well, then this will be just… quick updates. I did get the caqh pdqs invitation for medallia to set up their user account and the credentials from caqh. So that is enabled.
Naomi Denson (02:29) I’m going to add you and larisse as admin users and credentialing administrators to the platform. So keep an eye out for your invitation to get logged in and see the platform… and then wanted to just touch base back. We had talked in the last time we met about like apis and technical needs that you guys might have wanted to just touch base and see if you guys had a technical contact that you connected with, if you had any additional questions that we can loop Nico in on from our end. And.
Christy Garrett (03:05) I apologize. I’ve been letting larisse take the lead on this. So what is the technical need if.
Naomi Denson (03:13) you want any like apis like as far as, so there’s an API available that you would need a technical contact on your end to own building that we could provide a public API key to help… guide that, but it allows you to make your credentialing requests through the API… load in the recredentialing requests for the providers, and then log the credentialing votes without having to go into the platform and manually upload a template to generate those requests for credentialing?
Christy Garrett (04:02) Say that one, say that one I’m so sorry, say that?
Naomi Denson (04:04) One more time, there is an API available that some of our payr customers will use to generate the actual credentialing requests. Alternatively without the API, it would be filling out a template and then uploading it each time you need credentialing requests. So the API is usually preferred. So I didn’t know if larisse had taken that back and had any questions about it, but we can definitely connect with her via email to revisit that. Nico? I don’t know. Have you been in contact with anybody for access for this group about the apis or anything yet?
Niko Byron (04:43) I have not, but happy to support any way that’s necessary. Okay?
Christy Garrett (04:48) Can you send that to me so that since she’s out and I can see who internally would take the lead on that?
Naomi Denson (04:56) Yeah. The API documentation and the outlines for everything Nico, do you have that? Can you send it to me? And I can just include it in my follow up?
Niko Byron (05:04) Yeah. Well, do we want to give access? Like I don’t think we’ve set up API keys and stuff as well?
Naomi Denson (05:09) We haven’t and I still need to build a sandbox for them. I built their original, their main account, but I’ll set up the sandbox and then let you know and you can build the API key and then you guys can review that and investigate it on your end. Christy, let us know where we land on that. Yeah.
Niko Byron (05:26) I’ll send you the link to the docs right now, Naomi. And then, yeah, once I hear back, I can send those ids once we get everything set up on our end.
Naomi Denson (05:36) Okay, perfect. And then larise did share all of the policies and procedures with us and some legacy credentialing packets. So those are in review with our credentialing manager. So once she reviews those, if they have any feedback or questions for you while they’re building the sops for your organization, we’ll… let you know and we’ll communicate on that. And then the delegation agreement, I am just waiting on one final confirmation from our credentialing director on something in there. And then I’m going to send that larise had indicated to send that to you via DocuSign.
Christy Garrett (06:13) Okay. So I.
Naomi Denson (06:14) will be sending that over as soon as I get my final confirmation on one piece of it. And then I’ll send that over but wanted to just check in. Not too much going on right now while we are reviewing these and building the policies and procedures. But do you have any idea on timeline of when you need to get started with… initial credentialing, when you plan to have a need for re, credentialing? If you’re using a current vendor or doing it internally up to what date are you going to cut that off?
Nic Schisler (06:49) I actually.
Christy Garrett (06:50) Was going to ask how quickly can we get this rolling? So.
Naomi Denson (06:54) It would all depend on if we need the API set up before we start doing this? And we’ll work through the testing and stuff with that. There is also a manual process. So right now, what I’m waiting on that is a key piece for go live API or not is those policies and procedures to go through review. And then to align on the requirements needed for the packet from… your end. So they’ve had them, I think she sent them to me last week. So let me check in with them on the status of those. And then I’ll reach out with any additional questions that we have. So we can try to nail that down. Okay? So you guys, what?
Christy Garrett (07:34) You need from me is a technical contact for API, and that’s it, correct?
Naomi Denson (07:40) Yes, for right now and then I’m going to send you our delegation agreement to review and sign for the delegation of credentialing to medallion. Okay?
Naomi Denson (08:01) Anything I’m missing… Nick, Nico that you can think of? Yeah, these.
Niko Byron (08:08) Nothing that I can think of right now. I think as we get the ball rolling, we’ll probably have some things come up, but, yeah, yeah.
Naomi Denson (08:14) So, I’m going to check in with them on the policies and procedures, so we can finalize those sops because they need those in place before you can actually start requesting. But if you can try to get an idea of volume of both recredentialing and initial credentialing for your providers that you would need. So that we can, you know, align with our teams internally and let them know, hey, they’re planning, they have this many that they’re either holding on or would like to get started with. Usually while we’re running through testing phases, we’ll start with like a smaller group of providers just to make sure all of, the connections with caqh and all of that are set up appropriately and that they’re working correctly, and then give you a chance to kind of review and audit a couple of initial files to make sure that everything is in there that you need. Okay? And.
Christy Garrett (09:08) Have you sent over? And I apologize if I’ve missed it, we’ve gone through several transitions over here on our end like… the instructions like step by step instructions for both the manual way to load and the aip way to put providers into the system.
Naomi Denson (09:37) I have not sent over instructions. We usually will go through that directly live in a training, but I can send over what the templates look like. That would be required for the manual upload. So you can see those. And then as well as the API documentation for your technical contacts or technical members to look over.
Christy Garrett (09:56) Yeah. If you could send instructions that would be helpful, I just want to make sure that… were clear on… how it’s going to flow.
Naomi Denson (10:12) Absolutely. Yeah. And I can put together just like a general outline of the different processes so you guys can decide which works best for you. Okay?
Christy Garrett (10:28) So, how far out are we, do you think like a week out?
Naomi Denson (10:35) We have a caqh pdqs set up and we have the npdb agent authorization set up. It’s really going to depend on the credentialing team. So hopefully they will have those reviewed and we can get back to you with any additional questions that they have. And then I would say at least without the API at least two weeks so that we have time for any additional configurations to happen from our epd team, if there’s additional requirements or verifications that we have to pull into the packets, but that would be like an… absolute, the absolute soonest.
Christy Garrett (11:15) Two weeks out.
Naomi Denson (11:17) Yeah, at a minimum depending on if we do decide to go the API route. Usually, there’s some testing involved in building that from your end, that can kind of drag things out, but we can always, I think Nico we can go live the manual way while they’re working on the API if they need to, as long as credentialing is ready for them.
Niko Byron (11:38) Yeah, definitely. Okay.
Christy Garrett (11:41) Awesome. Yep. So.
Naomi Denson (11:42) Once the policy procedures are reviewed, if there’s anything that’s outside of the standard in cqa requirement credentialing… file that requires our engineering team to do some special configurations on the back end. So they’re looking for things like that might jump out that we would need to configure to pull in as additional psds.
Christy Garrett (12:08) Okay. And it’s this you guys have been discussing like the three separate types, correct? Like the regular providers, the MDS dos in Arkansas, and the facility verification correct? She sent.
Naomi Denson (12:24) Over all of the credentialing policies and procedures. Let me see which ones that’s what they’re reviewing for the different types, so we can build the separate packets, how they need to be for the different profession types and providers. Let me see what she sent me.
Naomi Denson (13:01) There’s provider, credentialing, monitoring, and re, credentialing policy. Let me just show you these are all of the files that she sent over to me.
Naomi Denson (13:23) There’s a credentialing committee, provider credentialing. So, these separate processes, provider direct contracting?
Naomi Denson (13:36) Is that what you’re referring to? The different, the different processes?
Christy Garrett (13:40) Well, so there there are three separate providers… or types that will be going through medallion. There’s the providers that are MDS dos in Arkansas that have to be credentialed via ccbs. Okay. And then we were going to put them into the system so that we could eliminate the meeting because… they can vote within the system. The credentialing committee can vote within the system. So like I’m not even sure that the credentialing committee policy is like that would need to be rewritten based on moving to medallion, right? Because we’re no longer going to be meeting if.
Naomi Denson (14:23) they can.
Christy Garrett (14:25) Vote within the medallion system, correct?
Naomi Denson (14:29) Technically, to be in cqa compliant, and like if there were audits, you still have to have a meeting for any, like depending on what the policies say or any additional reviews… that might happen if there’s any flags or anything outside of your requirements that would call for a review. But definitely, you can ask our credentialing team about that.
Naomi Denson (15:05) Because you can vote in the platform, but typically for audits, they still want that formal meeting with the meeting minutes where they show they were reviewed, unless every single committee member was going to have access to medallion. And then everyone would be required to review the files and then vote on them from the platform.
Christy Garrett (15:27) That’s what I understood is that.
Naomi Denson (15:28) like that we would.
Christy Garrett (15:29) get the committee members… access and that they can vote in the system, which would then eliminate the input comments in the system. So that if they.
Christy Garrett (15:48) Like if everybody’s on the same page then?
Naomi Denson (15:50) I don’t.
Christy Garrett (15:52) understand the purpose of a meeting, but that, I mean, maybe I’m misunderstanding yeah.
Naomi Denson (15:58) So, other customers they will like they have when a credentialing file is processed, they’ll have a clean status or a needs attention status. And a lot of times their policies will say that the credentialing manager or administrator or medical director can go in and review the files directly in medallion and then vote and close that out. And then if they need attention, most of the time, they have to go through the full formal review in a credentialing committee meeting. And then they can designate an administrator to come in and vote in medallion to close it out. But… if you just want, I’ll have to clarify what’s compliant with our credentialing leadership to make sure that is… not going to cause any issues down the road if you’re just only reviewing in there. And then you, maybe if you had an audit or something and the editor wanted to see your meeting minutes, you would say we don’t have any. So I don’t know what that could potentially lead to or if that is even a thing.
Christy Garrett (17:02) Okay. Yeah. Let me know what they say on that because that’s.
Naomi Denson (17:10) a lot of our, a lot of our credentialing customers, they navigate this in different ways and it all depends on what’s written in your credentialing policies on what processes you need to follow, for the voting and the review of the files. So you, may be very correct there and that it just needs to be rewritten to indicate that, but I don’t know if a formal committee meeting will still be required or not. But I’ll get some clarification for you. Okay?
Naomi Denson (17:44) But yeah, let me check in with them on the review of these. I didn’t see in the files that were sent here. Are there separate facility credentialing policies and procedures that would be in some of these or are these just for individual providers?
Christy Garrett (18:04) Those might be just the individual providers. I know we have a draft policy of the facility. Let me see if I can find it quickly.
Naomi Denson (18:15) Yeah, you could share those with me too, because I didn’t see them in here and that was something… that I was curious about as well.
Christy Garrett (18:25) Okay. So, let me see if I have your email. I know I do.
Christy Garrett (18:39) My email. Yeah, I was just going to shoot it over to you via email. It’s.
Naomi Denson (18:43) yeah, just Naomi at medallion co. Yep, you popped up and then I can add that to the folder for the team to make sure that they’re reviewing that as well.
Christy Garrett (18:57) It is in draft form right now.
Naomi Denson (19:01) I’ll let them know that it’s not quite finalized, but that way they can at least get eyes on it and.
Naomi Denson (19:10) Start processing forward.
Naomi Denson (19:19) Okay. Yeah. Let me get some clarity for you on the committee voting, and what needs to happen there with the processes. And then once they have that finalized, I’ll share over, the templates and the processes for the manual request creations. And… if we’re going to be voting live in platform, then probably not too worried about the API for the voting process since it’s not going to come over as a single decision. But well, we can talk more about that after I send over, the template and the API documentation and see which way we want to go. Okay. If anything else comes up or I get any updates on my end, I will follow up with you, but I’ll also send a initial regular follow up from the call today.
Christy Garrett (20:07) Okay. Sounds good. So just the technical contact, the delegation agreement, and volume and you’re going to send instructions and we should be up and rolling in two weeks.
Naomi Denson (20:16) We can shoot for that, but I can’t guarantee if there are, you know, back and forth on the credentialing setup, but, we should be able to, I would think so if it’s just the manual template upload, and then standard voting processes, I can build the committees and get everything ready for you. Okay? All right.
Christy Garrett (20:35) Sounds good.
Naomi Denson (20:36) All right. Thank you so much. Thanks. Have a great day. Thank you.