Transcript
Mwinship (00:00) hello?
Jason Zednick (00:01) Hello? Good morning.
Mwinship (00:03) Good morning.
Jason Zednick (00:05) How are you?
Mwinship (00:08) It’s Thursday?
Jason Zednick (00:09) It is.
Mwinship (00:10) It’s Thursday all day long in.
Jason Zednick (00:13) fact. It is. Yeah, that’s true. That was very true. All right.
Mwinship (00:39) Damn, Tina. Yeah, I see Tina hasn’t there, she is.
Jason Zednick (00:44) Yeah, coming in there they are.
Mwinship (01:00) I think everyone’s here from our side was KP joining today, I.
Jason Zednick (01:04) Thought, so, let me ping him and… I know.
Jason Zednick (01:23) All right. I messaged him. Let’s see.
Jason Zednick (01:30) Were you?
Mwinship (01:36) I don’t believe we had any questions for the update. Alyssa’s still trying to get access to?
Jason Zednick (01:42) Yeah, that was my question. Yeah, the,
Mwinship (01:45) rosters. So they’re working on it… and if he sent it the same way, I don’t know how you could have, they took you off that already? Alyssa. Because you were able to have access to them before, yes, so.
Mwinship (02:07) I don’t know what would have happened.
Jason Zednick (02:10) Yeah.
Mwinship (02:21) So, I did not send over the questions, Jason. So I figured we’d just kind of go through these, Tina had a couple questions regarding, is medallion completing education verifications for initial credentialing, if so through what system?
Jason Zednick (02:42) So, we use like… what, even what system? So, like we use education proxies when they are available. So, if they are, they… hold a board certification, then the board certification is sufficient, if they do not, and they hold a license in a state that verifies the education requirements, we consider that sufficient. And then if not, so.
Tina.Ferguson (03:13) You don’t actually do like ama or something to verify their medical diplomas?
Jason Zednick (03:19) Not unless we need to.
Tina.Ferguson (03:22) Okay. If you do that would be scanned in.
Jason Zednick (03:26) Yes. Yeah. If we have to go pull the ama, we will, it’ll be in the credentialing packet as part of the evidence? Yes. Okay. But if we can avoid it, we try to.
Mwinship (03:47) And then… Tina, you also had on there, if there are two medicaid and medicare lines, can the lines without the information be deleted? Paul Gilbert… I’m assuming Tina, this was yours as well?
Tina.Ferguson (04:05) Huh.
Jason Zednick (04:10) Hold on. I want to pull Paul up on my side and take a look because.
Tina.Ferguson (04:15) They sent me emails saying that there’s missing practices. And then when I go in, I have one medicaid that has the practices added, but the other one, not, it’s just kind of blank. So, I wasn’t sure if I could delete those, if that would cause an issue.
Jason Zednick (04:32) The short answer is no, sorry, no, it won’t cause an issue. Yes, you can delete it. One of those as, you know, pulls in from caqh and my only hesitation there is that there is… the potential that if caqh… is re synced to the data, it might pop up again, but.
Tina.Ferguson (05:05) it makes it difficult when I’m putting in a request 100.
Jason Zednick (05:08) Percent totally agree.
Tina.Ferguson (05:09) You can’t really see which one is the correct one. When you’re doing that request thing, it’s hard to see.
Jason Zednick (05:16) Yeah, I, 100 percent agree. Makes perfect sense to me and you should feel free to delete the extra… one.
Jason Zednick (05:38) If it were up to me and it’s not, we would stop pulling those in altogether.
Jason Zednick (05:53) Well, you should be able to, and let me just like check a thing real quick. Hey, KP. Welcome. Hey, everyone. It’s Jason.
Jason Zednick (06:07) There is one thing you can do to… help make sure you’re selecting the right one and it’s… not like it’s.
Tina.Ferguson (06:20) hard to see when it comes up on that little tiny box that you click down on. Yeah.
Jason Zednick (06:25) It’s not the best solution. But if it does help, I’m going to share my screen because the one that the real one we’ll say the one that we want to keep is tied to the group. It’s tied to the group enrollment.
Tina.Ferguson (06:43) Right. I know that, but when you go to put the request in, you can’t really see that it?
Jason Zednick (06:48) Is there, it is small, but it’s there. So, like if you do a demographic update and you do the medicaid enrollment, you can see this one has the group.
Tina.Ferguson (06:59) Okay. Gotcha.
Jason Zednick (07:00) Yeah. And same for medicare. So that at least helps you know, which is which?
Tina.Ferguson (07:05) I have to be super careful on it.
Jason Zednick (07:07) Yes. Yeah. Again, if it were up to me, we would not pull those in at all. I don’t think it’s helpful.
Jason Zednick (07:27) Akp. Hey.
Mwinship (07:37) Okay. And then the last question that we have is more geared toward the notifications that are being sent out. And since we turned the notifications on, of course, we have had some feedback from the providers because a lot of the notifications that are going out are basically looking for their residency diplomas or certifications and their medical certifications, medical boards. Is there a way that, and I don’t know if this is possible and I don’t know if it’s required. So, Tina, Alyssa, let me know that we can turn off the notification request for residency or is it an all or nothing kind of thing?
Jason Zednick (08:30) I.
Tina.Ferguson (08:31) know we do need the medical diploma for an initial medicare application, do?
Mwinship (08:36) We need the residency piece that?
Tina.Ferguson (08:38) I don’t know for sure. I’ve just always uploaded it.
Dchandle (08:43) Yeah, we’re getting a lot of feedback from the doctors that they don’t even have certificates from residency. I get the medical diploma that one’s okay. But I was just wondering if we could make it optional or something like that for the residency.
Jason Zednick (09:00) I apologize. My connection was a little unstable. I missed the first part of that. Do you have an example of someone who?
Mwinship (09:06) So, for example, Taylor ballinger?
Jason Zednick (09:09) Ballinger? Yeah.
Tina.Ferguson (09:19) Under documents, it’ll say she’s missing medical diploma and the residency or just the residency? I don’t remember hers. I.
Mwinship (09:27) think she was missing?
Jason Zednick (09:28) Both?
Tina.Ferguson (09:28) Okay. And,
Mwinship (09:30) she was not very happy that we did not already have those on file, but we looked everywhere that we could possibly think that they were also checked with our human resources department. Nobody had them. So I did tell her yesterday that she would need to upload both of those.
Jason Zednick (09:49) Okay. So… short answer is, yes, I can change what is considered required… which if it is not required, they would not like get notification, that it’s missing. The longer answer, is that.
Jason Zednick (10:18) for like residency diploma. I personally don’t know off of the top of my head why we have that required?
Jason Zednick (10:30) There will… be scenarios, I must assume based on the requirement that there are scenarios where we do need it, in which case, if you request, if you make a request for us to perform that work and we don’t have it, we’re gonna have to task for it, which is fine. Like that’s totally fine. We do it all the time, it’s just, I just want you to know that like we may look for it. And if it’s not there, then we are still gonna reach out for it, but it won’t be, you know, I,
Dchandle (11:02) think that would be perfect. If we could do that for the residency, just the residency one that’s the one that seems to get everybody upset.
Tina.Ferguson (11:13) Sure.
Jason Zednick (11:14) Sure. Okay. So I can go in… and look… at the configuration and make that… residency diploma optional. Yes… that should be fine.
Tina.Ferguson (11:40) Thank you very.
Jason Zednick (11:41) Much. Yeah.
Mwinship (11:43) Yeah. Now, do you know if for any of the ncqa guidance, if there is anything that those are required, I, I’m going to be honest, I do not know.
Jason Zednick (11:58) For residency? Yeah, no, I don’t think so. Okay.
Mwinship (12:02) I can.
Tina.Ferguson (12:03) Do it. I think it was possibly one of the, some of the insurance plans might ask for that.
Jason Zednick (12:07) That’s my enrollment that’s my guess. Okay. Certain insurance plans asked for it. And so we determined it was worth it.
Tina.Ferguson (12:15) Right. Tina.
Mwinship (12:16) Do you know if you or Lissa, do you know if you have had to provide that information? Or do you, did you just automatically provide it if we had it? I’ve never had to provide it. I,
Tina.Ferguson (12:27) I automatically did it for medicare enrolments… right? And then, Jason, I don’t know if you saw that email I sent you about that financial info that popped up?
Jason Zednick (12:43) Yeah. I did see the email. I have not looked into it yet. What was one of the providers again Neil?
Tina.Ferguson (12:52) Knight, it appears to be some of the people that I put medicaid revalidations in for… and I know there was a new window on the medicaid application that we had to fill out, but we bill through copc. So this would be the same information that’s on our groups. I wasn’t sure.
Jason Zednick (13:15) Yeah. Why this?
Tina.Ferguson (13:17) Added it just popped up.
Jason Zednick (13:19) Recently, I have to be real honest. I’ve never seen this.
Tina.Ferguson (13:23) Yeah. I just noticed it yesterday. They were, it was popping up and I noticed it was on the medicaid reval people and I didn’t know if it had something to do with the new section in medicaid and that section of medicaid looked to me like if the doctors were being paid directly, they would need to have their bank information, but it’s going through copc. So I have, I’ve been answering no on that.
Jason Zednick (13:51) Yeah, I mean, that makes sense because.
Tina.Ferguson (13:54) They’re not going to want to put all this billing information in and it’s already under a group, but.
Jason Zednick (14:00) That’s a bunch of info that if they’re if the groups pay, like why would we even need it? Yeah, let me flag this ask.
Tina.Ferguson (14:10) Yeah, I didn’t want that going out as an email either.
Jason Zednick (14:15) Actually, let me check.
Jason Zednick (14:22) Excuse me one second.
Jason Zednick (14:31) I can check… meals… and then financial info. We have billing info.
Jason Zednick (15:30) How strange. Yeah. So, I’m just sort of like looking on the back end, seeing about like, well… what the configuration is like in terms of fields that are required the same thing I would do like when I’m going to turn off the residency thing and it looks strange to me. So, yeah. So let me follow up. I’m not sure what’s happening here, but I’ll research it and either let you know that, hey, we need it for xyz reason or make it go away. Yeah.
Dchandle (16:05) Hey, Jason, can that go? Can that residency piece go away before Monday’s emails?
Mwinship (16:13) Yes, thank you very much. Yeah.
Jason Zednick (16:22) It’s pretty quick. I should be able to do that today. No problem.
Jason Zednick (16:36) Any other questions, top of mind or can I pivot over to our good friend, KP?
Mwinship (16:46) I don’t have anything else, Tina, Alyssa, deb, I don’t.
Mwinship (16:56) all right, great.
Jason Zednick (16:58) Hey, KP. How are you?
Kunal Parwani (17:01) Hello doing okay, good?
Jason Zednick (17:05) Good, good. So, I think we’re still trying to get access to the delegate roster. They’re you know, working with their team on that, but I wanted to ask because we haven’t synced on the consolidation piece. Yes. Yeah, yeah.
Kunal Parwani (17:21) Yep. So I identified three scenarios which we would need to take care of. One of the scenarios is where every item is or every field is a true duplicate, you know, like the effective date line of business, they’re all the same across multiple lines. That part is a little easier. We just delete the duplicates. We essentially pick one and we delete the duplicates. I’ve already initiated some convo with epd with our engineering department because they’re going to help us delete those. The other two scenarios are in which either the line of business differs or the effective date differs. I know we saw a couple of examples last week. I found quite a few more scenarios. So in that scenario or in those last two scenarios, essentially… I’m going to send over those… rows and… we’re going to need essentially to sign off in saying that, okay, you know, what we’re attempting or understanding to that approach is correct? I’m hoping that copc doesn’t have to, you know, look at every single line but you still have to give it a quick, just a quick review… so that’s where I’m at. So I can probably pull those and send those sometime today to you, Jason kind of confirm and then we can forward those to the copc team.
Mwinship (19:09) Do you know approximately how many providers have different?
Kunal Parwani (19:14) Because it.
Mwinship (19:16) might be where like when some of the new products come into play with a insurance company, you know, some of them might have the original date of I’m just going to use like anthem or I’ll use quality care partners, their antidote marketplace. So all the providers that we had at the time may have a different effective date because the effective date, you know, because that just came into play a couple years ago. And then the newer providers would have the same date.
Kunal Parwani (19:57) See that last piece again. So the,
Mwinship (20:00) newer providers would have the same date. So for like antidote, they would have the same date as quality care partners because they are the same where the older providers would have a different date because the quality care was first. And then the marketplace product antidote came into play. You know, just a couple years ago. Same thing with anthem and the medicaid products. Okay? If that makes sense?
Kunal Parwani (20:34) Yeah, it kind of does. So that is a nuance that I did not know about. So I appreciate you telling me that.
Mwinship (20:44) Yeah. So it would just be, you know, for providers, you know, that the older providers are going to have one effective date because, you know, that’s when the product came into play and then you might have which you’re going to have the different dates, and then the newer providers because they’re being credentialed or enrolled at the same time. It’s going to have the same date. Yeah. So that could be where you’re getting the different dates.
Kunal Parwani (21:14) Yeah. The piece about the dates is it’s tough. I know we talked about it last week for that one example and, you know, we kind of talked about which date to pick but… the logic that we defined at that time or, you know, kind of the path forward, it might not apply to all of them. Okay?
Mwinship (21:37) Which, and we can definitely take a look and see, you know, if maybe that’s the trend that we’re seeing.
Kunal Parwani (21:44) Yeah. So I should have, I should have some data out to Jason today and then hopefully we can have it out to you sometime tomorrow.
Mwinship (21:52) Okay.
Kunal Parwani (21:53) To have some confirmations, but, yeah, it’s I was just looking at the total number of rows… there’s a lot. So, and,
Mwinship (22:06) that could be, and I don’t know, can you look at the insurance? Is it a specific insurance plan or?
Kunal Parwani (22:12) Well, we’re cleaning up pretty much all the enrollment lines, right? So, like I’m looking at all the like the lines that I will have to clean up, which is over, it’s over like 20,000. So, okay, it’s just taking a while for me to validate. Okay? But, yeah.
Jason Zednick (22:41) 20,000 total.
Kunal Parwani (22:44) More than, yeah, more than 20,000 total.
Jason Zednick (22:46) Ah, I see. Okay. Yeah, that is a lot. Okay. Yeah.
Kunal Parwani (22:53) So, I kind of have to be careful in how I apply like my logic of identifying these three different, like identifying the rows and putting them into these three different buckets that I talked about. Yeah. So, yeah, that’s taking a little bit.
Jason Zednick (23:06) No, that makes perfect sense. Yeah. Okay. Well, let’s when.
Mwinship (23:15) You’re.
Jason Zednick (23:16) ready, no rush and we’ll look and assess, yeah, yep.
Kunal Parwani (23:22) That sounds good.
Kunal Parwani (23:26) And, yeah, for the delegated piece, whenever you do get access Alyssa, yeah, go over them, feel free to, you know, drop me an email. If you find anything or if you have any questions or anything like that. I did kind of give them a kind of an overview before sending them out to my eyes. They look good. But obviously, I don’t know which providers should be showing up or not. Okay. So, you’re going to know that better, but, yeah.
Mwinship (23:52) I’ll look at it and I’ll let you know.
Kunal Parwani (23:54) Sounds good. Thank you.
Jason Zednick (24:00) All right. Anything else?
Mwinship (24:05) I do not have anything all.
Jason Zednick (24:08) Right. Great. Well, I’m going to make… residency diploma optional. I’ll make that update for you. I’m going to inquire about the financial info section, which is super weird. And then once KP is ready, we’ll share his spreadsheet… and we’ll take a look.
Mwinship (24:32) All right. Sounds good.
Jason Zednick (24:35) All right. Well, thank you all.
Mwinship (24:36) All right. Thank you have.
Jason Zednick (24:38) A great day, you.
Mwinship (24:39) Too. Bye, bye, bye bye.