Transcript
Dreama Hembree (00:00) hi, good morning or good afternoon, depending on where you are.
Mintu Abraham (00:03) Morning still for me, California?
Dreama Hembree (00:06) I’m Dreama. I don’t think we’ve met.
Mintu Abraham (00:09) We have not, my name is mintu. I manage the practice fusion billing services team for the implementation side. It’s.
Dreama Hembree (00:18) great to meet you. I’m the engagement manager for veradigm with medallion. So I think we’re still waiting on max to join yep.
Mintu Abraham (00:44) There he is.
Dreama Hembree (01:01) Hi, max.
Max McGlothin (01:03) Hello dreamer. How.
Dreama Hembree (01:05) are you today?
Max McGlothin (01:07) I’m doing well. How are you?
Dreama Hembree (01:08) Doing well. Thank you.
Max McGlothin (01:12) I invited a couple of people to this call today specifically about the ultimate community care account, but also mintu… and if Nick’s able to join just so that they can, you know, perhaps give a little bit of insights into some other areas that they may need help with. And we’ll just see. I don’t see anybody else joining at the moment. So I would say we could probably get started.
Dreama Hembree (01:53) Okay. I did already meet mintu. So we will go ahead. I’ll share my screen with the agenda and we’ll jump into it. All right? Let me know if you cannot see that.
Dreama Hembree (02:10) So, of course, I have ultimate on the agenda. I know that there is an issue with their medicare surrogacy. I was working last week with the medicare team on the surrogacy issue. It looks like I think her name is Julie at the practice. She kept indicating that the surrogacy was through her individual mpi which we already have surrogacy through. So we’re needing it for the group level. So I think either she’s my suspicion is that she’s not connected to the group in the medicare Ani portal as like the authorized official, and that’s why she cannot see our request. Everything that I can see on my end, the mpi is relatively new. It was established in November. The incorporation details and stuff. Makes me think that the group level is brand new and has never been enrolled. So that’s why I’m thinking she’s not connected to the group as an ao, or, you know, an authorized delegate for the account. Do we know otherwise, max, or have we investigated it with them?
Max McGlothin (03:27) I was looking yesterday, I was unavailable to be on the call. Two conflicting calls I was on yesterday. So mintu did meet with the client. What the concerns were is that they had submitted surrogacy?
Max McGlothin (03:53) Requests and that they thought they were approved. I saw that they’re I’m trying to go back into the tasks right now and figure.
Dreama Hembree (04:00) Out, which, so I know Alicia was sent out for surrogacy, one of the providers and so that was separate. And then the request came in at the group level. First, there was no providers attached to it. So I think that caused an initial delay is that there wasn’t a request for enrollment at the provider level, just the group and so that perhaps delayed the processing of it. So once we got Alicia’s request in there, then it was tasked out for surrogacy for Alicia to enroll. And then at the group level for surrogacy. So that’s when Julie came back and said it’s under her individual mpi and not the group’s mpi. So that’s I think where the disconnect is here.
Max McGlothin (04:54) Okay. Mintu, is there any other… I’m trying to go? I’m looking at these tasks the.
Dreama Hembree (05:05) Tasks that I looked at this morning were all connected to one of the managed medicaid plans and not anything outstanding for any of the other enrollments outside of surrogacy. Of course.
Max McGlothin (05:19) Okay. So the original note… is that if the, or the original request was submitted for Juliette… is what you’re saying and that was linked to her individual mpi, then it was discovered that there was an mpi that was an additional mpi that was used.
Max McGlothin (05:52) Company. Okay. So according to the note here on the twentieth, please add an mpi to the company request. The company does not have its own account. It has to be attached to Juliette’s mpi. I called medicare and this is the information they gave me. Can you please resend the request with her mpi attached, right?
Dreama Hembree (06:14) So that’s what makes me believe that obviously ultimate care as a group mpi, all of that exists but it has not been enrolled with medicare. And so, in order to establish the roles within the group, the ao, all of that good stuff, we have to do that through medicare’s Ani portal. And so that’s where you go in and you say, hey, I’m the authorized signer for the group. I’m you know, I own the group, etc, medicare attaches that person to the group. So then she can see the group in her portal. And so when we do eventually submit an application through payco, she would go in and sign off. Etc. So we’ve submitted the surrogacy request for ultimate, the group. She cannot see it. So that’s why I’m thinking she hasn’t established that relationship in the portal as the owner or the authorized official. Does that make sense?
Max McGlothin (07:16) Yeah. It makes sense to me. I don’t think it makes sense to her.
Dreama Hembree (07:19) Right. So I can set up a call if you think it will help with her to kind of look at her screens on her end because I can’t obviously see her portal account. But what I suspect is that she’s not connected to the group as the authorized official, and that’s why she can’t see it. So, we, there has to be an authorized official for the group. So we can a, get surrogacy, submit the application and then they have to go in and sign off, right?
Max McGlothin (07:47) Correct. Yeah. So if she’s not registered as the ao, right? She would not receive it, but there has to be somebody registered as the ao.
Dreama Hembree (07:56) Right? Not necessarily if a group isn’t enrolled and they just haven’t gotten that far. Okay? Because she said she called, I read her notes. She said she called medicare and they said it’s under her mpi. Well, she has her own account obviously. So I can do some, I can set up a call if that will help, but I think that’s where the disconnect is for the medicare.
Max McGlothin (08:20) Okay. Just so you’re aware we did want to have this conversation still just based on our communication yesterday because again… I know I outlined a couple of issues… that they have brought up. I don’t necessarily think it’s is a… as nuanced as I stated it was. But the, you know, what we’re running into is communication issues, right? I think it’s it has a lot more to do with their understanding or not understanding and not just, at ultimate, not just from their perspective. I think it’s you know, we talked about this last week as well. Is that just these clients are not getting, they, the self service model is frustrating to them, I think, yeah, but.
Dreama Hembree (09:21) At the.
Max McGlothin (09:22) same time, we get complaints of having too many phone calls, not from that, not necessarily from like, these specific clients. But mintu can attest that we get complaints quite frequently about the number of meetings and touch bases and, communication channels, that take place across the board. And, but in, you know, then they start requesting, meetings and, being able to have hand holding sessions for this stuff. Again, I understand like even our agreement is, this is a self service model. There will be limited, communication resources available outside of the portal itself. But I do think this one would potentially need, to have, some of that additional hand holding. It sounds like, however, we did receive notice to, from them to basically stop processes from, or for medallion to stop processes for medicare and medicaid, requests at this point. We were just basically told to please let medallion know to hold off on credentialing us with medicare and medicaid right now.
Dreama Hembree (10:43) They’re just medicare and medicaid.
Max McGlothin (10:45) That’s what the notification said. So I mean, I can, obviously, I’m gonna send that to you in a,
Mintu Abraham (10:52) Written communication.
Max McGlothin (10:54) But, that was, I’ll do a follow up after my email yesterday, mintu, is there anything additional… outside of that?
Mintu Abraham (11:07) Yeah, I think she just seemed overall, just frustrated with the process, I guess, just not understanding what’s pending for her to do. Yeah. So, she kept mentioning like there’s tasks that are, and I’m not as familiar with medallion. So I do apologize. I’m just wetting my feet on it. So I may be stating things incorrectly. So, if that is true, please do correct me. But she’s she was saying that there’s tasks that she’s already addressed that are still in a ready status. I think it was.
Dreama Hembree (11:39) So, the, and I don’t know what she doesn’t know, but max, I think you’re more familiar with this, where the tasks live. There’s this little green,
Max McGlothin (11:50) Mark.
Dreama Hembree (11:51) To the side, I don’t know, I’ll drag this over. So you can see it. It’s here. It’s right here. So, once you have, she has addressed it. If you do not click this, it won’t go back to our bucket. That says, hey, I’m done with this, please review it’ll. Just stay out there. So, she has to click mark task complete, and then it moves back into this bucket that says it’s for our review at that point. Does that make sense?
Mintu Abraham (12:20) So, these are, and she may not be doing that, yeah.
Dreama Hembree (12:22) Right. So, these are the ones that are still pending for her to look at, all tasks. So they break it down provider admin whatever, but all of them live here. So four are ready for her. So once they’re addressed, she’s got to click that. Otherwise, we won’t know that she’s completed it.
Mintu Abraham (12:40) Okay. So I can let her know that if she’s not doing, that she needs to be doing that. Yeah. Okay, perfect. And then the other thing that she said is, oh, sorry, max, go ahead, I.
Max McGlothin (12:51) Know Nick has gone over that a couple of times with them, but, they might.
Dreama Hembree (12:55) Have forgot. Yeah, oftentimes they need a little bit of a reminder, yeah. Well, and,
Max McGlothin (12:59) where we run into mintu just so you’re aware, like where we do run into a couple of like issues is when they’re in review. So, like in this case, Dreama, there’s three that’s in review on here. And… they’re marked as complete.
Dreama Hembree (13:20) But,
Max McGlothin (13:20) they haven’t moved over. So, like what she’s concerned about with these three that’s in review is, where do they stand? She has no idea. One of them doesn’t have any information on it, from Dreama, January. So I just, I don’t know what needs to be done moving forward from. Yeah, I.
Dreama Hembree (13:41) have those on my list to ask the team about just to make sure that those are completed. And there’s nothing else required on there. So I have that as one of my takeaways for them to get those moved over to the completed bucket. So I will, okay, I’ll get that addressed. And.
Mintu Abraham (13:57) Then the other part that she wanted to know is like, what is it that she needs to still be doing? Is there anything that’s pending? Like from her standpoint that she needs to complete? Because she said she’s ready to do whatever it is. She just needs to be told what it is. Okay. So, it didn’t seem like she had a good idea of like what’s still in her to do list, I think.
Dreama Hembree (14:18) The only one that I saw last night when I was looking through there is we, it looks like we’re still needing, availability access for them. And then there, I think the enrollment request, for, one of the medicare or the medicaid advantage plans was pending something, but I’ll send a follow up email max, outlining exactly what she needs to do on her end. So, it’s clear. And then, if we’re putting the medicare and medicaid on hold, that might affect some of those tasks too. So, I need to go in there and look at which ones are tied to which ones.
Max McGlothin (14:57) Well, and, I think it’s I think she’s telling her to put it on hold because she’s frustrated. We, so one of the things is, we had a call with them yesterday, and we had, you know, several people on, from our team on there, but ultimately, the questions revolved to medallion, and we didn’t have anybody from medallion on that call. And so, that just created, I think a little bit more frustration because all, you know, from our perspective, we can’t we,
Dreama Hembree (15:30) give her the information that she’s needing. Yeah.
Max McGlothin (15:32) Yeah, I mean, it’s like we’re able, to isolate down into what her concerns are, but we just can’t fix the concerns while we’re on the phone. And I think that’s what she wanted. She wanted to have that call to fix the concerns while on the phone. And so, I think if we can remediate that, either give her, a task list, let her know, that you’ve been made aware to, you know, not proceed right now with medicare and medicaid, but you’re you know, willing to work with her on the next steps. For those. I think that might be what she’s looking for.
Dreama Hembree (16:07) Okay. Yeah, to re.
Max McGlothin (16:09) And, and that would, you know, potentially restart the medicare medicaid, or be able to restart that? Do you?
Dreama Hembree (16:16) Want me to put the medicaid on hold because that one, is literally about to go out the door, so.
Max McGlothin (16:22) Yes, we need to because she has made a written request. We need to not proceed until she tells us to proceed.
Dreama Hembree (16:29) Okay. I will, I,
Max McGlothin (16:30) don’t know what she’s doing on her side, so. Okay. But I would, again, I would send a follow up. I would see if you could, if we can schedule a call with her, just, to say, hey, we’d like to give, you know, additional assistance, on this, we understand that medicare and medicaid has been asked to be, put on hold at the moment. But perhaps we can, you know, work, on it together to get it reinitiated. Yeah. So.
Dreama Hembree (17:07) The medicare obviously won’t go anywhere because we don’t have any surrogacy for the group. So, that one is going to sit there until we get the surrogacy, and I just placed the medicaid on hold.
Max McGlothin (17:20) So,
Dreama Hembree (17:20) do you want to send me some available times, max for, kind of a touch base with her? Or what would you like to do?
Max McGlothin (17:34) No, I mean, you could, send her a follow up, that it had been, or send her any, communication that had been escalated to you. That, you would like to set up, a call with her. If we need, we can pull in Nick, or mintu as well. I’m if she’s able, to meet tomorrow, I’m actually, I’m just out of the office tomorrow. So, I, just, if she’s willing to meet tomorrow, I just wouldn’t be able to be available. So I don’t want to, but I don’t want to be the one that holds this up either. So, okay. I would again, just see if we can get her, on the phone and walk her through whatever she needs to walk through, and give her, you know, her next steps, that are needed. Okay? I’m just making.
Dreama Hembree (18:24) this a note from here. So this medicaid doesn’t go.
Dreama Hembree (18:41) Okay. And that’s her email address that mintu, you just dropped in the chat? Okay? Got it. I was just going to go and look for that, but got it. Okay. I wasn’t sure if I was sending it to Julie or the office manager who it was. Okay. All right. I will look at the schedule and get something set up. So, for matriarch medical, I have that next on the list, max, I did a whole account review on that one. I’ll send this to you in our follow up.
Max McGlothin (19:09) Basically.
Dreama Hembree (19:10) I flagged cigna, medicare and anthem to the team that needs to be escalated at the payer level. So the rest of them look like they’re processing accurately. I didn’t see anything that stood out to me that needed immediate intervention other than the lidos. I guess this one here, the notes in there indicate that the recruiter reached out directly to Amy and sent a recruiting letter for her to review and she is not followed up directly with them on that.
Dreama Hembree (19:46) So I needed to know is she still wanting to pursue that enrollment or is she doing that one on her own because she has not responded back to the provider rep?
Max McGlothin (20:02) Which payers is this for? This is for?
Dreama Hembree (20:04) Matriarch for the lidos, qtc health service. Yeah.
Max McGlothin (20:12) Have not been… made aware.
Max McGlothin (20:24) Let me see if I have any… I’m assuming that they want to… push forward. I know mintu, we had conversations regarding this client previously, but, this payer wasn’t a part of it. No, I think specifically,
Mintu Abraham (20:51) No, I think the one that we were asking about previously was, I think it was USA managed care organization was the one that came across as completed but it’s technically not a payer is what payer path said. Yeah… that they can enroll with.
Max McGlothin (21:12) Yeah, it’s called USA managed care organization.
Dreama Hembree (21:14) Okay. What, what was the, does it, do I need to look at that one for? Yeah.
Max McGlothin (21:21) Because, it came over as a payer that had been credentialed, but our clearinghouse is indicating that, they don’t have, any notification like any, Anything tying that payer to anything that they can do. So they don’t know if it’s if there’s a different name or like payer ids. Okay? Yeah. Like they don’t have a payer id to tie it to. Okay?
Dreama Hembree (21:50) Let me look at that one and I’ll get you some additional information if I can find it on that one. Okay? Got that written down as a takeaway. So I’ll send you this for matriarch. And then I guess my only follow up would be, the lead host as she’s wanting the letter from, the provider rep or the email from the provider rep was basically because we were checking status. He basically was like, we sent her a letter in November, a recruiting letter. I’ve been in direct communication with her and she’s not responded back to us. So it was like they had things on hold on their end until they heard from her directly that she wanted to.
Max McGlothin (22:30) Proceed. So.
Dreama Hembree (22:31) I guess we need some clarification on that.
Dreama Hembree (22:38) The only other things I had were the termed instances. Max. I did a handful of those. I have one left that’s not supposed to be termed until four one. So I’m holding that one, but I needed to ask you about the API keys. Do you want me to revoke those or do you want me to leave those intact?
Max McGlothin (22:59) If they’re deactivated or if they’re terminated, then we can revoke those because we’re not going to be doing anything with them. Okay? Moving forward with the API stuff. One of the questions I do have and I did see that the deactivated accounts are now going into the deactivated section, but under our veradigm account there.
Dreama Hembree (23:21) Are a.
Max McGlothin (23:23) couple of like ultimate care, community health is like, there’s multiple accounts and like,
Dreama Hembree (23:31) there’s two of them. Yeah. I saw that when I was in there, I don’t know how a duplicate got. I think that was, that happened before my time, but I can go in there and deactivate one. But I saw your email that there was possibly a space or something that was throwing off the naming convention. So I have that on my list to look at. Okay, back.
Mintu Abraham (23:54) To matriarch, I think the other payer that the parapat team said is not a payer that they think it’s different. It’s trycareforyou. They weren’t seeing that come across, they think it’s trycareforlife is what they said.
Dreama Hembree (24:10) So, trycareforyou yeah. So if we,
Mintu Abraham (24:13) can get a payer id for that one as well.
Dreama Hembree (24:18) I’ll look at that one and.
Mintu Abraham (24:21) the other thing that they said with that is that the client’s preference for all payers enrollment is group npi, whereas the trycare has been set up with individual npi.
Max McGlothin (24:36) Okay. Well, that might.
Dreama Hembree (24:37) Be at the payer level where they don’t do a group enrollment, right? Okay. Yeah. Well, not only.
Max McGlothin (24:44) That, but I only see for a new provider enrollment. I don’t see a group enrollment request for.
Dreama Hembree (24:52) That payer that could be the case too. Yeah. So.
Max McGlothin (24:55) Mintu, these providers like these provider offices, they’re the ones that have to initiate if they want group or provider enrollment. I do see under trycare east that there is a group enrollment and a provider enrollment. I don’t know what the difference is in.
Mintu Abraham (25:11) Trycare for you.
Max McGlothin (25:12) Versus trycare east because both of them show… like both of them show humana’s military locations, but I do only show the provider enrollment… for that trycare for you.
Dreama Hembree (25:29) Yeah.
Dreama Hembree (25:37) So off the top of my head, I don’t think you enroll directly for trycare for you. I think that is like automatic if you have like the medicare part a B, but let me just check on that and I’ll do some investigation. But yeah, the request if the request comes in at the provider level and not the group level, that’s how we will enroll it according to how they’ve initiated it in the platform. Okay? So it goes.
Mintu Abraham (26:07) Back to like the clients needing to know how they want to credential themselves and put setting that up themselves.
Dreama Hembree (26:13) Right. Yeah. There’s the, when they hit that request button there’s you know, it’ll say new payer enrollment, single demographic, update, bulk, demographic update, whatever it is. And so then they tell us if it’s at the group level, and if it’s at the group, who are the providers, what are the locations etc? So it could be that they there’s some miscommunication in terms of how they’re entering it into the system.
Mintu Abraham (26:44) I will keep that in mind. But yeah, if we can get the payer ids for the USA, managed care and the tricare for you, I think that’ll help the payer Pat team, yes?
Dreama Hembree (26:52) I will look at that one. And then other than that, I just had that southern kidney specialist. I just needed to confirm you said they were not doing anything with medallion. Would they be added under veradigm? Or this is a completely separate entity could?
Max McGlothin (27:10) Be a completely separate entity. I’m not going down the path of pulling them into our current because they’re not a practice fusion client. So I don’t really have a… pricing model for that yet or even a scope for them. So we’re trying to, they are a revenue cycle or a veradigm customer. But they’re just, they’re wanting credentialing services, but we don’t on that side of the line of the business. We don’t offer credentialing services right now. So I don’t have anything to offer them. So I figured I’d just hand it off to medallion. Okay? Yep.
Dreama Hembree (27:48) I have Jack on that email, so he will take it from here. Okay? All right. Anything else that we did not cover?
Mintu Abraham (28:01) Nope. Yep. That’s.
Dreama Hembree (28:02) it, I appreciate you both being here today and calling that stuff out. I have some takeaways and I’ll, get that out to you by end of day, if not by tomorrow. Tomorrow’s. Like my down day where I kind of like catch up. Sure sounds good. All right. Thank you so much. It was great meeting you, mintu, you as well. Thank you. Have a great day. Thank y.
Max McGlothin (28:22) ‘all appreciate it.
Dreama Hembree (28:23) Bye.