Transcript
Connor Morley (00:00) hey, Connor. Hey, Nicole. Oh, how is your day? It’s going? I’m right there with.
Norma Mendo (00:11) You.
Connor Morley (00:19) I’ve been ready for Friday since Monday. Yeah, seriously. All right. Let me, let them in.
Connor Morley (00:38) Oh, I am tired.
Norma Mendo (00:43) There you go. And now you can’t see me, oh.
Connor Morley (00:48) Hey, Norma, we can hear you…
Connor Morley (01:38) Can you hear us now?
Norma Mendo (01:39) I don’t know. I hate zoom.
Connor Morley (01:47) No worries. I think from our perspective, we’ve… received all the information that we need from you. We clarified on the group enrollments. Again, it sounds like you just have a single group enrollment for mercycare right?
Norma Mendo (02:12) Correct. Yeah, the only one that everybody else goes individually and then linked to the group as a tax id.
Connor Morley (02:19) Okay. No problem. So we should be okay there. And then I think.
Norma Mendo (02:32) I wanted to see if there was a way you can show me. So a lot of the providers I’m trying to get into their caqh and their Ada, then going to caqh and updating all the information properly for them. And I want to make sure that will, does it link or does it verify everything at the end of the day? So then I, you know, like to link all the information directly there for them or should like?
Connor Morley (03:01) So there’s a, yeah. So there’s a couple things we can do like the bulk import. The integration that we have with caqh is not a live or dynamic integration. We can do a couple of things. We can run it every month or so typically or… you have, or if you’re just going with a single provider into their Ada and caqh profile. And they say, okay, now, I want to pull that into medallion. You have the ability to go down to like the data imports, link their profile or relink their profile. If we have one where we already have a caqh number. So, I’m just going to switch to eligible actually. So, yeah, for example, all of these, if I go into Bryce slack… I can scroll all the way down, go to data imports and let’s say you just updated their caqh profile and you want to pull it in, you can relink the caqh profile. We’ll set that up. And then just, you don’t have to import everything if it’s just like you’ve made a few tweaks, you can review and add which information you’d like.
Norma Mendo (04:21) Oh, I see. Got it. Okay. Yeah, a lot of them have been updating like for example, there’s one by the name of dr Matthews. We just added all her information this morning, linked… everything updated her. Yeah, there’s where’s she go. I think it’s just, is it Matthews that way? Just put, yeah, there’s no, that’s not her. Put on mat. Let me see where she’s at just mat. Her name. Is… there you go, Jackie. Oh, okay. And now she, I went into the Ada and went to their caqh and she had everything in there already and there was an error. So, I think… it’s because it’s the Ada and not their caqh because it’s her email… and I don’t see anywhere where we can add the Ada for you. Does it really matter?
Connor Morley (05:24) We, I don’t believe we have an integration with Ada. But I mean, linking the caqh profile wouldn’t we don’t require an email to link. Okay. Caqh profile. So I don’t know if that’s okay?
Norma Mendo (05:42) Because then I should not, should I not write the information in the caqh profile then? Because that might just.
Norma Mendo (05:55) I don’t know how you want me to not have, I mean, most of them have a caqh and, but should they be writing the information in the login and password in that caqh external information?
Connor Morley (06:12) Yeah, they can, they’ll need to input that in order to go through like payer, enrollment, revalidation, okay? For the integration on their data to load for caqh. We only need caqh id and social security. I’ll take a look on why all of these failed… those.
Norma Mendo (06:40) Are all DDS dmds dental? It looks like. Oh,
Connor Morley (06:45) so they wouldn’t have caqhs, they?
Norma Mendo (06:47) Do have a caqh. But again, I think we would have to go into their Ada and make sure it’s updated. Maybe that’s why?
Connor Morley (06:56) Got it. So they haven’t been attesting to their caqh.
Norma Mendo (07:00) So, I will go, how do I get into that? Let’s look at all the failed ones. Oh there there. Okay, I can look at that. It looks like it’s almost most of the you.
Connor Morley (07:10) Actually don’t have the access to this, but I do, and I can send you a copy of this.
Norma Mendo (07:15) Okay. Yeah. So I can go into that and see what’s triggering it. Yeah. But overall, it seems to be working well. We’re able to, you know… get… all that on that end. I know Rachel has been working on the group information, just… seeing if there’s anything else missing on your end, but it looks like it’s running well. It’s… easy to manage. I would.
Connor Morley (07:50) say like what I’m missing right now is the group profile and practice information. We’re missing a lot of information on the group, and we’re going to need this to do payer enrollment.
Norma Mendo (08:05) Okay. So go into the group information and try to fill everything in there. Okay? And.
Connor Morley (08:10) Then I also need that credentialing… document. Okay?
Norma Mendo (08:14) Oh, the policies and things like that. Yep. Did you need me to upload in there? Their psvs that, but they’re old. So does it really matter?
Connor Morley (08:32) They’re old, like,
Norma Mendo (08:34) their primary sourcing that we did initially when they first started, no?
Connor Morley (08:39) Okay. No… we should be okay. Okay. All.
Norma Mendo (08:46) Right. And then, yes. So the policies that we haven’t looked at, so you can have an idea of what our policies are, especially because there, it says we opt out of medicare through all of our dental providers. Yep. Okay. And I did do a, I did a report today with CMS and GS. There were like seven teams that they’re that Arizona did not complete a opt out. So, I’m filling those out before you start getting them. Okay. Perfect. And then, yeah. So we’re just trying to get these doctors. We’re giving them a set of one more week to kind of get them going here.
Connor Morley (09:31) Yep. I was just going to look at how many have signed up?
Norma Mendo (09:34) Yeah, just.
Connor Morley (09:35) It’s like we’re a little low where?
Norma Mendo (09:37) Are we, you’re going to scare me? You’re going to scare me here?
Connor Morley (09:41) I thought.
Norma Mendo (09:42) I was doing, we were doing well, but maybe not, you know, I.
Connor Morley (09:46) Mean, I think I was just looking at some of them who have just been added. If I’m looking at the list, it looks like. I think we’re actually doing a lot better in terms of the date joined. Yeah, I think we’re doing pretty good on the date joined. How many providers have logged in? Okay? Oh, yeah. All right. So, I.
Norma Mendo (10:16) think, I mean, we’re continuing to do what we can on this end and then going by one to give them some assistance on the external information… and then also the home address. They believe that permanent address is their office, so that we had to reach out to them and say, no, it’s your home address and your home phone number. And they’re like, why do they need that? Yeah. So, yeah. And then also, this also gives me an opportunity to look at that home address connected to my medicaid product, because that’s going to be important for you guys. Yep, as well as the npi and see what has not been updated from their previous employers. Yeah. So all of that has been just a circle of friends for me. So it’s like I see the light now, but what’s really nice. And I was telling Rachel that it’s really nice to kind of get a connection to where we should always be at. So it’s a good thing. Yeah.
Connor Morley (11:17) It’s nice to be able to see everything in here. One additional piece that I just want to kind of confirm is making sure that we have all of your… all of the possible payers that you could choose listed out and have them mapped to something within medallion. So, I’m going to share another spreadsheet.
Norma Mendo (11:43) Payers, and I’m just going to break it down here. Payers. You do mean payers? Not product to the payers?
Connor Morley (11:52) Yes, just the payers. Like just the payers, like you would not put in all the.
Norma Mendo (11:58) Different health plans here. I’ll give you an example, blue cross blue shield, ppo is a payer, blue cross, blue shield is the payer. Yep.
Connor Morley (12:05) It would just be the blue cross blue shield.
Norma Mendo (12:08) Payer. Okay, perfect. Yeah. Illinois, Arizona. Yeah, I get it.
Connor Morley (12:13) Yep. It would just be Illinois, Arizona. And then we would want to map that to what it is in medallion and then understand, it sounds like for the vast majority of these, the group enrollment is going to be a no, the only one that might be a yes, would be mercycare. Right? Yes.
Norma Mendo (12:32) And I’m still hesitant on optum, but I’m trying to reach out to the optum lady for unitedhealthcare because they dropped us out. They dropped us from one optum with our MDS dos hospitalist providers. So that’s why I’m saying no to nothing else, but I don’t know how they are grouping us with the speech and everybody else, which are allies. But I will confirm this within the next couple of days. I am off three days next week, well deserved.
Connor Morley (13:01) Yes, absolutely.
Norma Mendo (13:04) But I’ll be back on Thursday for our meeting. So it’s okay.
Connor Morley (13:08) Okay. All right. No problem. Okay?
Norma Mendo (13:13) Well, talk to Rachel about the group profile, your policies that have to get to you practice information, payers that you need not products, just the payers and where is that going to be? Can you just show me real quick where you want that at?
Connor Morley (13:27) For the payer information, it’s going to be in this spreadsheet I’m going to send out to you.
Norma Mendo (13:33) Okay. Good.
Connor Morley (13:34) So, it’s essentially just looking at like the payer name, what state and we’ll map it to state payer name, and medallion. So it’s.
Niccole Russell (13:44) slightly.
Connor Morley (13:44) different. Medicare actually will turn into I think medicare… Illinois or medicare.
Norma Mendo (13:53) Arizona.
Connor Morley (13:54) Within medallion. So some of them are very minimal. Some of them might not be. But if you could just list out your payers, the lines of business, and then it sounds like the group enrollment is going to be no, for the vast majority of them, we would like to know if you do have rosters for any of these, and I don’t think you’ll have non standard enrollment for any of these as well?
Norma Mendo (14:18) Non standard enrollment. Give me your essentially.
Connor Morley (14:23) You reach out to this credentialing or payer enrollment contact specifically because they are dedicated to you.
Norma Mendo (14:33) Oh, no.
Connor Morley (14:35) Yeah. Maybe Nicole, do you have another example? I don’t know if that’s a good one or not.
Niccole Russell (14:39) Yeah. So just something that’s unique to your practice. It’s not a standard enrollment process across the board that’s the information that we would need.
Norma Mendo (14:51) Okay. Yeah.
Niccole Russell (14:52) And any rosters that you have, I do want to add, we do need to know where to submit those, where to follow up if you have any contacts and then if they require a prerequisite such as medicaid or medicare for enrollment to be completed, okay? All.
Norma Mendo (15:09) Right. Yes. Here. Let me just, Rachel had an emergency. She apologizes for not attending the meeting. No worries. Let me just connect somehow with her to let her know that I am in here. I think I can not connect. Okay. Yes. Okay. I will work on that. That’s an easy… fix on that. Okay. I think that was it. Let me just close this real quick here. I’m trying to connect with Rachel here on the.
Connor Morley (15:49) Think so. All right. We’ll get you up and moving pretty soon. We’re just going to need some of those provider profiles, group profiles and location and practice locations finished.
Norma Mendo (16:02) The group profiles, you mean?
Connor Morley (16:05) Right. Yeah. The group profile. Yeah, the group profile is the practice location information, and then the provider profiles in order to get payers going.
Norma Mendo (16:18) And isn’t that the spreadsheet that Rachel originally sent out to identify? Yeah… we have.
Connor Morley (16:31) All of the existing enrollments and we’re working on loading those. But in order to place new requests, we are going to need your group profile information, completed, your practice location information completed in medallion and their profiles up to at least, 85 percent complete and the addendums or the agreements signed in order to start putting the applications together. And we can’t submit an application until their profiles are at 100 percent complete.
Norma Mendo (16:58) Got it. Yes. I think we were aware of that. Okay. All right. Well, then that makes more sense. Okay. All right. I will talk to her. I know it’s been a little crazy over there, but yeah, I’ll talk to her and then we’ll get that going for you. If we have any questions we’ll kind of reach out.
RachelsiPhone (17:14) So, hi, this is Rachel. I just joined the call. I’m sorry, I had an emergency.
Norma Mendo (17:20) Are you? Okay? No worries. Yeah.
RachelsiPhone (17:22) I’m fine. It’s just, yeah, it was just anyway, is there any, sorry? You’re probably at the end of the call, but is there anything that you need from me or any instructions for?
Connor Morley (17:34) Me, those cred policies?
RachelsiPhone (17:38) Yes, I gave them, I talked to dr Doherty about them. We have a couple of policies right now. I can send them over to you, but we’re going to revamp them a little. So, I don’t know if you want to wait for me to revamp them, I can send you what we have in the system right now. I just don’t know if it’s going to.
Connor Morley (17:57) Can we wait until you revamp them? Yes, I guess if you change the primary source verifications and the committee information, that would change our sop?
RachelsiPhone (18:10) That’s what I figured. So, yeah, I met with her on Monday. She gave me the direction I need to go in. I just have to, I just have to get it done tomorrow. I have tomorrow. Hopefully, I have some blocked out time that I can work on it. So I’m hoping that I can give it to you by the beginning of next week?
Connor Morley (18:31) Okay, perfect. That sounds good. Okay?
RachelsiPhone (18:35) Is there anything about, do you have any feedback about the payr stuff that I gave you nope?
Connor Morley (18:41) It looked all good to us. We confirmed last week that mercycare was the only group enrollment. So we should be all set there. Okay? Yeah.
Norma Mendo (18:50) He talked about the group profile and the practice information that we can work on, you know, get it done by next week. So.
RachelsiPhone (18:57) Okay. And I have, I’m almost done with, oh, sorry. Someone’s trying to call me?
Norma Mendo (19:07) Oh, she went out. I’m still trying to play with my whole, you can’t even see me. It’s one of those weeks. It’s one of those weeks. Yeah. So I will go through it with her. You know, we have a catch up meeting tomorrow morning all morning and afternoon. I think we can get some stuff for you done.
Connor Morley (19:27) Sounds good.
Norma Mendo (19:28) Oh, you’re a speaker, Rachel? Sorry?
RachelsiPhone (19:32) Someone tried to call me and I thought I hung up on them and instead I hung up on you guys. It’s a day at.
Norma Mendo (19:40) Least they can see you, not me. I don’t know my video’s all off anyway.
RachelsiPhone (19:46) Well, we had an update on Monday and it has thrown everyone’s computers out of whack, I don’t know how to explain it, but everything is out of whack, my camera doesn’t work. One minute. I can’t get to them, my network drives, the next, it’s been a week.
Connor Morley (20:00) Oh, no, well.
RachelsiPhone (20:02) I.
Connor Morley (20:03) hope Friday’s at least a little bit better for you guys otherwise.
RachelsiPhone (20:07) It will be, yeah, of course, on the I’m almost done with getting the people who need still have… pay your contract like pay your contracts that we need to get in place or pay your credentialing, I don’t know what to call it in your vocabulary, pay your.
Norma Mendo (20:30) Insurance. I think that, he wanted, well.
RachelsiPhone (20:34) Just the people that still need to be added to our contracts. That’s what I’m trying to say. I have a spreadsheet of them. I can’t remember the name of it.
Norma Mendo (20:43) Oh, the new providers that have not been added, but he, the enrollment?
Connor Morley (20:48) Requests?
Norma Mendo (20:50) Yes, yes.
Connor Morley (20:52) Enrollment requests. Yeah, once you have that completed, we can start loading those into medallion so that they, you don’t actually have to request anything in medallion. We can just load them right in.
RachelsiPhone (21:02) Okay. All right. And what… was I going to say about that… shoot? Oh, I think I caught just the tail end of when you were talking about getting all of the profiles completed to green? And.
Norma Mendo (21:20) What.
RachelsiPhone (21:21) exactly do we need? Like, do we need every provider to be green before stuff can happen or no?
Connor Morley (21:28) It’s not every provider, but if you place a request for a provider, we need that provider?
RachelsiPhone (21:33) To be green? Okay, that makes sense. Yeah. Okay. Because I think that’s how we would have had to handle it anyway. Like we couldn’t start the credentialing process until they gave us everything, right? Yep. So.
Connor Morley (21:46) It’s not just the providers though, it’s going to be the providers. And then it’s also going to be this group information. So, if you go to the groups we’re going to need like the information on the midwestern university tax id number, as well as all the practice locations. So, things like hours of operations.
RachelsiPhone (22:07) Oh, okay. Yeah.
Connor Morley (22:09) So, we’re going to need all of these to be green as well?
RachelsiPhone (22:12) Got it. Okay. It.
Connor Morley (22:14) Shows you what information is missing. Like, are there legal claims that are outstanding? What’s the financial information?
RachelsiPhone (22:23) And can we do that on the website? Yep.
Connor Morley (22:25) You can do it directly, you have access to this page. So you have the ability to just go in and fill everything out right here.
RachelsiPhone (22:32) And I had a question about that because we went back and forth about the therapy institute, and I found that when I was having to do, the payr requests that it was more helpful to have the therapy divided out from the multi specialty clinic just because there’s some differences between the two. Would it be all right if we added the therapy institute as a group?
Connor Morley (22:57) As a group or a location, because you only have.
RachelsiPhone (23:00) One, a location? Yes, location?
Connor Morley (23:05) We.
RachelsiPhone (23:06) have them at, we have it as a second address for the multi specialty clinic, but I found that it was just a little complicated as to like how I was entering the provider’s information. I need to go find my spreadsheet.
Connor Morley (23:21) Yeah, Nicole, do you have any concerns with us doing that?
Niccole Russell (23:27) I’m sorry, my internet kind of glitched out and I had to disconnect and reconnect, what was that? So?
Connor Morley (23:33) They have a location with a secondary address. Is it better to just split out that secondary address into its own location?
RachelsiPhone (23:41) Yes.
Connor Morley (23:42) Okay. So, yeah, you can go. You can go ahead and do that. Okay. You do have the ability to also add a new practice. So, okay.
RachelsiPhone (23:50) It’ll.
Norma Mendo (23:51) ask you for what is probably best on your end… for the easiest way to separate them even though it’s the same group with just two addresses.
RachelsiPhone (24:05) Well, we would just enter in the required information, right? I’m assuming.
Connor Morley (24:09) Yep. So, I think therapy institute, I… can’t type institute… and then you could add in the mpi street address, all of the information here. And then just, we’ll need, we will need some of this additional information as well, just to, if we want to associate providers with it and get them directly enrolled with the payers at this location.
RachelsiPhone (24:43) Okay. That sounds good. Okay?
Connor Morley (24:48) No problem. All right. Oh.
Norma Mendo (24:52) And Rachel, he did kind of confirm that the Ada has no affiliation to generate any. Yeah. So, it’s okay.
Connor Morley (25:01) We don’t have, yeah, we don’t have an integration with the Ada that’s.
RachelsiPhone (25:05) what I thought? Yeah. Okay. That’s okay. Yeah. All right. Okay. All.
Connor Morley (25:13) Right.
Norma Mendo (25:14) Well, all right. Thank.
Connor Morley (25:15) You, Connor. Thanks everybody.
RachelsiPhone (25:17) Yes, thank you. Thank you.
Norma Mendo (25:19) Bye, bye bye.