Transcript
Rheta Larson (00:00) hello? Hello? Good morning. How’s everyone doing today? Well, how are you? Doing well? Thanks for asking. I think we have everyone at least from our end. I don’t think Amy will be joining today, but are we waiting for anyone on yeldon?
Lisa Frank (00:23) No, I sent an email to Ken and Kenny this morning and told them that they’re off the hook unless they have anything that needs to be heard by this.
Rheta Larson (00:31) Group. Gotcha. Okay. And I know I sent you an email yesterday pretty late in the evening, so I understand if yeldon didn’t get a chance to review it, but I did attach the corrective action plan as well as just opening up broadly for any questions that you only have on the file that we sent on the 20 eighth of last Friday so we can jump in either of those two places and work through the agenda. And then I definitely want to carve out time to go over the corrective action plan. The file.
Jason R. Hough (01:05) was much smaller, much cleaner. I am anxious to see what our outgoing looks like in the coming week and then what your, what the subsequent incoming report looks like because I think it’s just going to, I think it’s going to be much more in line with our expectations. So, yes, I absolutely noticed the change, and as a whole, it was much better data… that.
Rheta Larson (01:40) is good to hear. And that’s what we definitely want to keep a pulse on and just make sure we’re flagging anything in real time as we see it so Nick and myself can investigate further. But I’m glad to hear that the filtering worked for you all… other than that on the file?
Rheta Larson (02:00) Was there anything else from inbound? Outbound? Any questions or any specific files or requests from that file that you have questions on?
Jason R. Hough (02:10) No, not right now, we’re also cleaning up the mismatches. So I’m curious to see how that’s going to go on our next outbound file. I think I’ll have more feedback on specific maybe anomalies… not next week but the week after.
Rheta Larson (02:30) Okay. Yeah, we will.
Jason R. Hough (02:32) We resolved the psypac licenses although they’re not going to pop up on your list anytime soon because as we were resolving them, we just updated them in our system, but we instructed the staff to use the primary state code. So they shouldn’t be an issue moving forward.
Rheta Larson (02:49) Okay. Awesome. Yeah. I think that’s exactly what we were looking for. So, as long as we have that home state tied to that psypac license, our team should be able to validate that problem if it comes through manually. If it goes through automatic. Thank you for the update there. The one thing I did want to flag because it looks like, this was an issue that the team flagged. This license came in for Megan neals. I don’t think it was, I don’t know which file it was a part of. I can double check on the date there, but I just want to flag like this nuance with license types. Whenever something occurs, what the team will do is the license will come through if it fails automation for any reason, it then goes to, the medallion staff to manually validate. And that was the case for Megan neals, due to her profession. She was listed as an LPC. So she came through as an LPC.
Rheta Larson (03:44) The license number came through as eight, three, three, one, two, five, eight. However when we pulled that license, nothing existed for that license at the time. I.
Jason R. Hough (03:54) Can tell you why? Okay. The state of Idaho sometimes for reasons I do not understand converts the license number upon renewal to something else. So this, and we found it, I already updated in our system, but we are aware of that anomaly. Okay?
Rheta Larson (04:18) Perfect. I’m glad we’re aligned there because what our team did since we understood that they do convert the LPC license to, I think it’s the clinical counselor from there. Like that old license doesn’t exist with that profession. So instead of deleting it or like marking it here, we just added a separate license. What is going to work best for you all in these cases, when that arises, do you want us to go that route? Or do you want us to flag it as needs attention for y’all to review? I.
Jason R. Hough (04:47) Would flag it because I would much rather update it in our system ourselves. Okay?
Rheta Larson (04:53) Gotcha. So moving forward if we find any more for Idaho LPC where they have basically converted the license to a different profession type, we’ll mark it as needs attention with notes relevant to that profession. Yes. Okay. Gotcha. I’m glad we’re in line there, I can go back and clean this one up if y’all prefer, but I just wanted to show you like what we did in this case, nah.
Jason R. Hough (05:19) It’s a moot point. We’ve already found that one.
Rheta Larson (05:23) Got it. Okay. I will make a note of that.
Rheta Larson (05:31) I just thought it needs attention moving forward. All right. Anything else on the file? Nick? I’m sorry. Did you have anything you wanted to add? I don’t think so. No, nothing.
Jason R. Hough (05:44) Further from me.
Rheta Larson (05:47) Gotcha. Okay. So the next part that I’ll hop into is going to be the corrective action plan which this kind of just breaks down what we discussed in our smaller sync and then just operationally what occurred on the magellan side, where it resulted in y’all receiving the full universe of licenses that were coming through and then having to work through those hundreds if not thousands of licenses.
Rheta Larson (06:14) So that’s kind of just the overview here. And then what medallion did do that included a review. So, I know we already touched base on these. These were the ones that were flagged by Jay. There was very specific line items that were highlighted. We did go through those, we did uncover exactly what the error was, whether it was automatic manual, if it was data mismatch from magellan. And I think we discussed that in our last sync as well. And then additionally our team is moving forward. I know Nick, you’re going to do this on the next file as well. But for the inbound and outbound file comparison, what we’re doing is we’re pulling the previous file that you sent on the second and then comparing to what we sent back to you all on that Friday and just making sure we don’t see any discrepancies and we kind of flag it up front to you all. If we do see something and we’ll follow suit for the one that was just sent on the twentieth. And then what you’ll send back on the sixth, I think it’s scheduled for that next Monday, first Monday of April… but that was just the review portion on what we uncovered. I kind of broke down those root cause analysis and then corrective action measures. This one we’ve already talked about. I know we did a few things on our end to alleviate the manual validation errors. Reviewing and coaching was held with those individuals that will be an ongoing process with our team. If we ever see any sort of discrepancy that’s human error. Our team will coach the individuals involved and then make sure we’re correcting it in real time. And then the automation. I think this one was specific to Tennessee, but we turned off the automatic validation for that state because it was pulling bogus data because there were so many profession types. So we want to, in the future, if you happen to see anything, definitely flag it, so we can get ahead of it as well and make sure the automation is pulling correctly. Any questions on those two point areas for automatic or manual validation? Nope. Okay. And then at least for the corrective action measures we took on the files that we’re sending. For the inbound outbound file medallion will send, I know we were previously sending the full universe of the licenses back to you all. So now we’ve set the filter on the inbound file for you all to only look at the licenses that will expire in the next 30 days or have expired within the past 30 days. So we’ll continue that trend and you all will continue to receive a smaller and smaller list for those.
Lisa Frank (08:58) Okay. Wait, clarification on that. So… all right. I guess I hadn’t played that out completely in my mind. So I knew that we agreed that you were going to filter on our outbound. So the file we send to you for that 60 day period of time, I hadn’t absorbed the fact that you were only going to send back those providers that are within that band of time also. So that’s what we’re doing.
Rheta Larson (09:31) Yeah, we’re sending back whatever the filter is from what we received. Is that correct to say, Nick? I just want to make sure that aligns.
Nick Vander Velden (09:40) Yeah, we’re sending back that like 60 day window. Okay?
Lisa Frank (09:45) And.
Nick Vander Velden (09:46) on the file we receive, I’ll still probably evaluate the whole thing… or like… yeah, I’ll see what the, I just haven’t had a chance to look at like that 60 day window on the one that we received from you guys yet. So maybe I’ll have a better answer after I see that file. So.
Lisa Frank (10:07) Just a couple things there. So, Nick, as you nailed down your process on our outbound… what we want to prevent is you spending any time or resource or, you know, any potential for you returning to us information about provider licenses that are current. So, so… the important piece of this to us is that on our outbound, you are filtering on that 60 day window. From our perspective, we don’t think that you probably need to work anything outside of that 60 day window.
Nick Vander Velden (10:49) Yeah, that makes sense. Okay?
Lisa Frank (10:51) And then, Jay, since I hadn’t absorbed that they were going to be sending back just the providers that are in scope for monitoring, I guess that means that if there was anything that… was flagged as needing attention, and it was right on the cusp of that 60 day and about to fall out, then that provider could become invisible on the next file. So like as you get into a steady state, I’m sure it won’t be an issue. But right now, you could potentially lose visibility to providers before you’ve worked them.
Jason R. Hough (11:30) No, I can’t because they’ll be on our outbound file. As long as I’m disrupting the two. I will always have a clear universe.
Jason R. Hough (11:42) They’ll still be expired. So they’ll be on our outbound file every month.
Lisa Frank (11:46) They’ll still be on the outbound. But if they’re more than 30 days expired, medallion’s not going to look at them and won’t be returning them on the inbound.
Jason R. Hough (11:54) No, no. I understand that the goal of this whole time is to clear out the back wall. Yeah. Okay. And we’ve mostly done that. I think when you see the new outbound file, don’t take it at face value because you have to remove the providers that we are currently tracking. And know we have license issues. We also have to remove the providers that are slated for downsizing. That left about 1,400 between Yolanda and. I think we smashed almost all of those. Okay. That’s.
Rheta Larson (12:26) great.
Lisa Frank (12:28) All right. Super I.
Rheta Larson (12:30) will also add, I know from our last conversation, you all were questioning if we leave it in a needs attention status and you don’t action, it will that fall back into the normal cadence for ongoing monitoring. And it will, it won’t prevent it from going back to our team to validate. So that’s not going to cause any issues on our end. Also. So I just want to clarify like it will fall back into the cadence regardless if you action it or not. Thanks.
Lisa Frank (12:56) For bringing that back up, I had forgotten about that. So there’s no need for us to status providers in your system as long as we’re addressing them in ours, whatever’s on the outbound file. And within that 60 day band, you guys, will you’ll… work even if the last time you saw, it needed attention, correct?
Rheta Larson (13:17) The only thing I will say is again, that could be utilized as a tool to kind of explore a breakdown in anything that comes back to you all that’s a mismatch or not correlating correctly in your platform. So I would definitely try and hop in there and like look at any of those things to see like what our team explored and why there was a mismatch. And then what the solution would be in these operational syncs, we can correct it in real time. I can easily do that with you all sure.
Lisa Frank (13:47) Jay, have you been on the portal yet? Have you had any need I?
Jason R. Hough (13:52) Signed in once but not beyond that. No, I have not had any need because like I said, comparing the outbound and the inbound together gives me pretty good sight lines to what we need to touch. And I have not come across any licenses where we couldn’t figure out what the issue was. Okay? Good.
Rheta Larson (14:15) To hear overall, that was some of the areas that we kind of broke this down. And then we just jotted down some long term preventative measures which will continue to work off the current monthly file you’re sending. We’ll have the filters in place. We obviously will continue to verify licenses based off of profession type and state. So again, that will filter through the automatic validation and manual validation. And if there is something we will coach those specific individuals as I discussed and, or discuss it with you all in real time on these operational sinks. So definitely make sure to continue to partner with Nick and myself via email or on these sinks to address those. And then I kind of just broke down here. What I showed you in the last sink, should we be unable to validate, or if something on the license is inaccurate, there’s a sanction or it’s expired, we move that to the needs attention for your review and resolution. But I’m happy to set up a separate sink with you, Jay and Lisa, if you all need to go through that again… other than that, this is in place, the teams are aware who are manually validating these as they come through. So we’ll keep a pulse on that with our licensing teams. And then Nick and myself are also committed to, you know, making sure we’re flagging these in real time with you all, any questions on the corrective action plan?
Rheta Larson (15:48) Anything else you’d like to add Nick in this summary? No, I don’t think so. Perfect. All right. As you all digest it. And if you see anything in there that you have further questions on or you want to specifically highlight, let me know Lisa via email and we can get back to you as soon as possible.
Lisa Frank (16:07) For sure. Okay?
Rheta Larson (16:11) That is all I have on my piece. Is there anything you all want to address or chat through aside from the site pack, I can give that information to the team as well.
Lisa Frank (16:22) I’m all set if Jay is.
Jason R. Hough (16:24) Yeah, I’m fine. Okay.
Rheta Larson (16:27) Looking forward to how these roll out in the next couple of files that go out? So we’ll keep a pulse on the next file that comes in from y’all on that Monday in April. And if we see anything, we’ll definitely flag it.
Lisa Frank (16:42) Okay. All right. Sounds.
Jason R. Hough (16:44) Good. Thank.
Rheta Larson (16:46) You so much for y’all’s time. I hope you enjoy your day. Thank you. Bye, bye bye.