Transcript
Dreama Hembree (00:00) I think I need you to sign me. It won’t let me claim host. It’s asking me for the host key? Oh.
Collette Waddell (00:07) Okay. I,
Dreama Hembree (00:10) forgot, I forgot we were going to look at that. And then just now I tried to like claim host and it would not let me and I was like my gosh. Now, I can’t see them in the waiting room.
Collette Waddell (00:20) Yeah, let me, I’m admitting them now, but simultaneously, I am going to.
Dreama Hembree (00:26) Okay. I,
Collette Waddell (00:27) don’t know what?
Dreama Hembree (00:28) Yeah, we need to still fix that in the back end, but, yeah, especially before next week? Hi, good morning. Hi. Good morning.
Collette Waddell (00:42) Dreama. And I just realized we never updated the.
Dreama Hembree (00:45) Link. We didn’t fix the meeting invite. Yeah.
Lynn Kiter (00:47) I thought about that right before, too, didn’t give it a thought till today.
Dreama Hembree (00:52) I went to claim host and it said it wanted the key and I was like my gosh.
Collette Waddell (00:58) And I’m yeah, and I thought, I already like gave her like transitioned everything over you did.
Dreama Hembree (01:04) But it didn’t work. I’ve had issues with that in the past too. So I, it’s on my calendar, not a fix, so.
Collette Waddell (01:11) All right. Quick update for you, Lynn and I’m sorry, I’m totally distracted because Naomi just said we have there’s an updated dbid number for the last four digits for. So I,
Lynn Kiter (01:30) think that’s no wonder. Okay. Yeah. And,
Collette Waddell (01:32) I was like, can you look at this cause don’t know what’s happening and so, she just sent that over. Okay. All right. Let me just, I’m going to send?
Lynn Kiter (01:47) This, I figured there had to be an issue because I mean, they did it verbatim.
Collette Waddell (01:53) Oh, yeah.
Lynn Kiter (01:57) Oh, you cut out. Colette, I can’t hear you.
Dreama Hembree (02:02) Yeah, she’s froze on my end too.
Dreama Hembree (02:27) Just give her a minute here and see if she rejoins or maybe her internet?
Collette Waddell (02:31) Is.
Dreama Hembree (02:32) messing up?
Dreama Hembree (02:55) I think I’m host now. So, whatever happened that works… I need to get rid of… see if she rejoins.
Dreama Hembree (03:22) We can start some of the PE stuff while we’re waiting on her. So we’re not holding everybody up. Let me go ahead and share the screen.
Dreama Hembree (03:36) Oh, there she is. Well, I’m.
Lynn Kiter (03:38) on my,
Collette Waddell (03:39) cell phone, I guess my internet just went out.
Dreama Hembree (03:44) I’m.
Collette Waddell (03:44) so, sorry?
Lynn Kiter (03:46) So,
Collette Waddell (03:47) I’m listening, but I don’t have my full, you know, I’m not up and running on my laptop, but just real quick, Dreama.
Collette Waddell (03:56) Thank you for pulling that up real quick. Lynn, what Naomi noticed in that screenshot was that they were adding our suite number as the last four digits of our dbid?
Collette Waddell (04:15) Can you hear me?
Dreama Hembree (04:16) Yes. Okay. Just making sure when you’re on mute, Lynn… when.
Lynn Kiter (04:21) you’re on mute, then the dbid didn’t change. They made an error.
Dreama Hembree (04:26) Correct. Is that it?
Collette Waddell (04:27) Yeah. Okay. I thought it.
Dreama Hembree (04:29) Was changed. I’ll.
Lynn Kiter (04:29) connect back with them then?
Collette Waddell (04:31) Yeah. The, the four zero eight, four that’s the mailing address, suite number that’s.
Dreama Hembree (04:37) not, oh.
Lynn Kiter (04:38) Okay. I didn’t even, I didn’t even check that.
Collette Waddell (04:41) I didn’t even notice that either, but it was, I guess, yeah, got it. I’m sure. This is likely a common thing.
Dreama Hembree (04:47) So, okay. I’ll.
Lynn Kiter (04:49) get back with them? Okay?
Collette Waddell (04:52) Thank you, Dreama. I might let you just drive but I’m here to jump in and just nope you’re good with the conversation.
Dreama Hembree (04:58) Yeah, no, I have the agenda up and we’ll jump into the PE enrollment stuff. So, for traverse the humana, behavioral health denials that we received from that location. So I flagged that back to the team. I have them checking to see if number one, the contract has behavioral health services, and number two, is it active? So kind of a pullover from last week, Lynn, of what we had discussed before, so that’s in progress. So kind of doing a discovery on the back end? And then once I have that information, okay, we’ll get a plan together of how to move forward. Any questions on that?
Lynn Kiter (05:37) No, I think only, well, I will add, but you may have it in your notes that medallion had determined that the current or what was the current humana agreement did not include behavioral health?
Dreama Hembree (05:55) Okay.
Lynn Kiter (05:57) And then later… it appears that the humana agreement that they did have got deactivated so, which would be related to the medical and that’s all per medallion discovery.
Dreama Hembree (06:18) Okay. So, do we?
Lynn Kiter (06:20) Want to the denial letters that came? I’m not sure if they were, I mean, I would think they were for the behavioral health, but I’m not sure.
Dreama Hembree (06:28) Okay. So, do we want to pursue adding behavioral health for that?
Lynn Kiter (06:32) Location we do. Yeah. And we need to make sure that we have a medical… group agreement still, which it appears that they’re having trouble linking providers now to that original agreement or the group enrollment for medical okay?
Dreama Hembree (06:50) Let me make sure that that’s in the works. And then if I need you to go in there and request anything in the platform, I will let you know.
Lynn Kiter (06:58) Okay. And.
Dreama Hembree (07:00) then Sadler’s, enrollments, I went through all of those last night. I did not see anything… outstanding that needed like direct attention. They’re all processing. I believe out of memory, blue cross and Melina, she was already connected to the tin. We were just waiting on locations to load to the profile. So I went through all of those. I’m going to keep an eye on those to see, you know, in terms of updates and stuff, but I didn’t see anything jumping out at me that needed, you know, immediate attention in terms of errors or anything like that. So, everything.
Lynn Kiter (07:35) I think only the ones that we’ve already highlighted that they appear that medallion did correct? Yeah.
Dreama Hembree (07:41) They were correct?
Lynn Kiter (07:42) The just that these all go back to November. So there’s like a huge, you know, time gap here.
Dreama Hembree (07:51) Hopeful we’ll be getting approvals on those soon with the time frame. Obviously, they’ve been processing for quite a while. So, and especially those couple of pairs where she’s already linked. They’re just loading locations. I’m hopeful that those will go quickly. So I’ll continue to look through those and make sure that everything looks okay on my end. And.
Lynn Kiter (08:12) Then one thing I did want to highlight to you Dreama, that we had to both Colette and Naomi before, you know, federally qualified health centers have a very high medicaid population, you know, of patients and we are allowed to get retroactive claims paid back to the date of a clean application. And when we don’t have a clean application at the get go, it is, you know, a huge financial issue sure.
Dreama Hembree (08:47) No 100 percent. And I hear that loud and clear and I will get with the team and make sure that, you know, that’s something that they are aware of. We can, like I told you with the blue cross, we can put quality checks in place to make sure that those are, you know, triple checked before they’re going out. Obviously, it’s the utmost priority to send them out without errors to begin with. But to make sure because that does impact your effective dates for those locations. And then, so moving on to the vba roster, we’re going to use the existing implit import. I can’t even talk anymore import, thank you template to populate the providers with a separate tab for each center provider list. So, Colette has that one and she’s working on that one. Yeah. Is there anything you need to add on that?
Collette Waddell (09:39) And Lynn, I think you already had that template. We talked about it briefly and I think it’s just because if I, you’re just going to be providing like the name, it was just like those core elements, right? That from… when you had typically send, you know, when we input, when we added like the new center in just… names those critical like identifiers to load the providers. And then are you, I thought we.
Lynn Kiter (10:14) clarified on the vba that we’re going to create a report for every provider in every instance identified as a primary care manager. That was the vba, is the internal storage that we’re trying to get. Am I following your question or not?
Collette Waddell (10:43) But we needed, didn’t you need to add providers to the platform that weren’t already. Oh, correct. We.
Lynn Kiter (10:49) Will.
Collette Waddell (10:49) Need to. Yeah. I’m.
Lynn Kiter (10:51) sorry. Yeah, I’m following.
Collette Waddell (10:52) You, we will. No. Okay. Yes, that’s what I, I’m sorry, I wasn’t clear I.
Lynn Kiter (10:58) Got what you mean? Now? Okay. I’m on a different thought here. Okay. Yeah, then, okay. Yeah, that’ll work just.
Collette Waddell (11:07) The those core. And then, I can’t remember if we actually touched on this when we just load the providers to get that shell of a profile in the platform, you know, are we keeping it just a shell or did you want to, for us to do like when we add the new centers and we, you know, do the one time import from caqh to try to populate their profiles. I guess just let us know, you know, are we just adding providers, their name, the core elements just to create the shell of the profile? Or do you also want us to do an import like a sync to pull data in? Does that make sense?
Lynn Kiter (11:49) If we could provide a template for you to pull the data, that’d be probably preferred?
Collette Waddell (11:58) Okay. So I guess then just identifying the data fields that, which we.
Lynn Kiter (12:06) have.
Collette Waddell (12:07) yeah. Okay. So you’ll just fill those in and we’ll just ingest that correct? Okay. All right. That solves my question. That was much easier. I.
Lynn Kiter (12:17) Should have just started. Yes. And then we could provide, you know, a unique spreadsheet for every new instance or group or we could put them in, which will probably be the way that it’ll go. We’re probably not going to have all of the data all at one time, right? To be able to put one on a different sheet. So. OK.
Collette Waddell (12:36) Exactly. OK. So that’s the plan. Yeah, we’ll just use that existing document that you have been using previously, and we’ll just get them in there.
Lynn Kiter (12:49) OK.
Collette Waddell (12:50) And I think that was all for that piece. And then that immediately kind of ties down to the primary care manager, field visibility. So dreamer and I worked on going into the configuration settings for every single instance and making sure that everybody has that service based disabled. So that way everybody all instances now are, you know, configured that same exact way.
Collette Waddell (13:25) OK. So I just wanted to, and then I think the next item we had on here was the death master. So, yeah. So we submitted a technical ticket to get that added for all instances. So that’s in the works that’s been submitted.
Lynn Kiter (13:50) OK, once.
Dreama Hembree (13:51) We get that complete. We’ll give you an update from the team. OK, you know, that’s been completed.
Lynn Kiter (13:55) And then that element would be in any future credentialing and recredentialing file, correct? Or will it be? OK, perfect. Exactly.
Collette Waddell (14:08) Yeah. You’ll see it like if you’re in like the, if you’re in a provider’s profile, who’s going through credentialing right now? For example, if you were to click on the verification tab within their profile and you kind of scroll down to the there’s like the sanction section, it’s going to be, it’s going to show there. You’ll see it right now, but it’s grayed out because it’s not being like pulled into the PDF packet that’s what we’re wanting to make sure that is like turned on so you’ll see that and it’ll be on like the checklist overview page of the actual PDF document, you know, packet. And then you’ll also see it within platform under that verification tab. So, and yeah, we submitted it so that it’ll be for all initials, all recreds and all provider types.
Lynn Kiter (14:57) So, okay, great. So.
Collette Waddell (15:00) We will just let you know once we have an update, you know, on when that is launched and live. But it usually doesn’t take too long. And then I think the last item and I saw right before we got on the call a few minutes, you had already responded with some of the answers and I hadn’t gotten to those yet. But of those just clarification questions that we had for that delegated roster.
Lynn Kiter (15:29) Yeah. After you have the opportunity to review, definitely reach out if you need any more clarification, but hopefully, and I did lift up, you know, we’re continuing meridian is still reviewing all of the data. We provided them 10 additional credentialing files or we’re going to be today. Okay? And I don’t know if like the, I know we have to provide like a monthly update to them of any provider with a change, an add a deletion. I don’t know what day of the month that’ll be. But, and then what we were hoping to do, if we can, we were hoping that the report would be built that we could run it at any time. But if that, you know, if we can’t do that, then I did or in conjunction with it, I did provide like the method that we’d like to obtain the roster? Okay?
Collette Waddell (16:29) Okay. Yeah. Right now, it’s not even something that like dreamer or myself has the ability to even access this is on the engineering tech, the technical team side. So we don’t even have like I don’t even know where it lives and where they do this, but.
Lynn Kiter (16:50) But they.
Collette Waddell (16:52) do that. So. But what I was thinking just now as you were speaking is maybe for the, in the sense of getting an initial date and cadence set up, we can always come back, you know, if in a month from now, okay, you have an update moving forward. We need it on this date. Every month, we can go back to our team and we can just have them update the cadence, yeah, the information. So that way at least we have something to start with, you know, yeah.
Lynn Kiter (17:22) And then within the, in the document, I think it’s the five a, the pages that need to be completed. There’s an instruction sheet at the very beginning with like the cadence of the quarterly and semi annual reports, and then the definition of what everything, you know, what each sheet should include.
Collette Waddell (17:50) Okay.
Lynn Kiter (17:51) I did lift, you know, highlight that in the email too.
Collette Waddell (17:54) Okay. Thank you. Yeah.
Lynn Kiter (17:56) There is though a hard date for the quarterly and semi annual.
Collette Waddell (18:04) Okay. All right. Yeah, we’ll take all of that back, and then if the team has any, you know, further questions, we’ll loop you back in, but that should be, that should be good so that we can get this rolling.
Collette Waddell (18:25) And then the,
Dreama Hembree (18:26) only other thing that I had that was still pending from last week was the request to move the caqh provider attestation for the providers not enrolled. So, I did take that to the team and I’ve asked about that. So as soon as they give me an update on how that’s done, we’ll go in there and make adjustments. All right?
Dreama Hembree (18:50) Any questions for us on any of that or anything we didn’t include?
Lynn Kiter (18:54) No, I’m looking, I don’t find anything new to add. Okay, I think we covered everything that we did have, just double checking. Oh, I know for carefree medical, we had indicated that they’re going to have an address change and we’re nearly to the point that we need to initiate that. Do you have any further feedback on how to?
Dreama Hembree (19:25) I asked Naomi about that one because I just wanted to make sure I was giving you like the best instructions. So let me circle back with her. When is your address? When does it take effect? Well it?
Lynn Kiter (19:36) Already changed? Oh, okay. We did get permission or we got notification from medicare. We don’t have to change the npi and ptan, they didn’t have an interruption in the grant award or anything. Okay? So that’ll be good from an enrollment point of view, but we need to secure the change with Michigan medicaid before we can do the medicaid health plans. We’re ready though to report to the commercial payers. Whenever you give me a plan.
Dreama Hembree (20:09) Okay. So we’re going to start with commercial payers. The npi is staying the same. Are you keeping the old address or that’s going away completely? You’re.
Lynn Kiter (20:19) not using that went away. Okay.
Dreama Hembree (20:21) So, this is a brand new address going forward. Okay? For all providers, correct?
Lynn Kiter (20:26) Correct. Yep. They had a flood and had to vacate the prior building.
Dreama Hembree (20:31) Okay. Let me get with her, and then I’ll get you some instructions on that hopefully by end of day, if not by tomorrow by the latest. Okay. Yep. All right. I didn’t have Colette. Did you have anything else?
Collette Waddell (20:46) No, go ahead.
Lynn Kiter (20:48) Lynn. Okay. Yeah. The only other thing I wanted to lift up, we are needing to move forward and broaden payer enrollment. We have members that have been waiting and we’ve been hoping for improvement. I wonder if do you have anything new to share about quarter two improvements that you relayed were coming? We’re nearly to quarter two. Are we thinking beginning of quarter or end of quarter? Do you have anything new… to relay? Because we have a few centers that are quite large and I’m a little worried… so.
Dreama Hembree (21:29) I know, and obviously, I’m a little bit newer. So, Colette might have some more information than I do, but I know that they have really layered in a lot more support in the PE team in terms of, you know, QA QC quality measures, more training, additional support. Like I said, so they’ve really beefed up those departments, Colette, do you have additional context to add to that?
Collette Waddell (21:55) Not to no, just exactly to what Dreama you were just saying, Lynn, but we’re happy to maybe take this back just to our leaders to.
Lynn Kiter (22:05) Just.
Collette Waddell (22:06) make sure like what, so that we can really give you like a proper response on where we’re at with everything. I don’t want to. Okay. Yeah, I don’t.
Dreama Hembree (22:13) want to, we want you to feel comfortable handing the work over to us, yeah.
Lynn Kiter (22:18) We’ve kind of held them off to the point that we can, and we need to either make it work or regroup. I think.
Dreama Hembree (22:27) Yeah. So let us go back on that too, and then we’ll be, we’ll reach out in terms of that, okay?
Lynn Kiter (22:33) Well, I appreciate that. Thank.
Collette Waddell (22:36) You. Yeah, we’ll get back with you on that, and we’ll work on connecting with our leaders on that.
Lynn Kiter (22:43) Anyone from our team with anything that I’ve forgotten or that you’d like to add? Okay. All right. Well, thank you, everyone.
Dreama Hembree (22:55) Thank you. Thank.
Collette Waddell (22:56) You appreciate it have.
Dreama Hembree (22:57) A great rest of your day. Bye bye.