Transcript
Karla Torres (00:00) good afternoon, Renay. Hey.
Rae Tompkins (00:29) Hi, Renay.
Diana Rodriguez (00:34) There we go. Hi, Renay. How are you?
Rae Tompkins (00:37) Good. How are you?
Diana Rodriguez (00:38) Good. Thank you.
Diana Rodriguez (00:51) Oh, and my background is always black.
Diana Rodriguez (00:57) Here we go. You don’t look that sick and that’s good. I put makeup on. We all do that. You should have seen me five minutes ago. I keep myself on mute though.
Karla Torres (01:15) Hello? Good afternoon. It was like, I guess it’s because I’m on mute. We usually use teams on our regular day to day. So zoom is different.
Diana Rodriguez (01:28) Yeah.
Rae Tompkins (01:29) I’m happy to switch these to teams if that’s more preferable totally up to you. Yeah, that would work. Yeah, get that switched over and.
Karla Torres (01:38) Ray, I know we and I don’t know again, how we usually handle the meetings. I know I joined the last one, but do you usually have an agenda? What are kind of like also the expectations from our side? I just want to make sure too that we both have areas where we discuss our issues as well. I did send you an email, Ray just a few minutes ago about kind of understanding the really the facility credentialing kind of step by step. So whenever you get a chance, if you kind of give me… again what that kind of looks like and what you guys follow, just to make sure we add it into our kind of like our policy and we really understand what, how, you know, the medallion and then how we will handle it.
Rae Tompkins (02:34) Okay. Yeah, we’ve put together some documents over the time of the conversations. I’m happy to make sure that you have those as well. I do want to call out. I just had a chance to review your email actually. And one of the information that was requested is why the profiles aren’t being completed. So the medallion team does not handle the data entry aspect that is on the carenu team to provide the information we don’t pre populate based on what’s not missing. So like if it says 50 percent, we still complete the whole file, we’re just not going in and adding any missing information, but I’m happy to provide a document that kind of shows the ownership of who does, what? That way you have complete visibility.
Karla Torres (03:14) Yes, that will help us a lot. And just a quick question. Does all of this information is on the scope of work on the contract? What is medallion responsible? And what is carenu responsible for?
Rae Tompkins (03:29) Yeah, and anything contract related, I can loop in Molly Dwyer. She’s our account manager, but everything that we’ve you know, discussed I can provide, you know, what we were previously sending to Pauline as far as ownership of what the medallion team will own, what the carenu team will own just for complete visibility. Perfect. Yeah. Awesome. Well, to answer your other question.
Karla Torres (03:55) I apologize. I know you have your agenda. Kathy winings is no longer with the company, so we can remove her as well.
Rae Tompkins (04:03) Okay. Yeah. Sorry, she’s just pre populating still on the invitation, but I can get.
Karla Torres (04:07) her in, no, no, no worries.
Rae Tompkins (04:09) Perfect. And then, yes, to your point, I do make an agenda prior to each call kind of collecting any information that we’ve discussed over the week as well as sending a recap after our meetings with any, you know, high level details that we discussed.
Rae Tompkins (04:23) But I will switch this to teams for our next call just for easier logging in. So going based off the agenda items for this week, I wanted to flag if we had any updates on moving the files from facility, you know, the ready queue to committee. Obviously, some of those are sitting in there are a little bit aged. So just wanted to kind of start the conversation of moving.
Diana Rodriguez (04:47) Those over, they’re not really ready. Does I don’t know if you saw my email earlier this morning? I was asking if medallion verifies the ofac.
Rae Tompkins (04:59) not for facility files. So.
Diana Rodriguez (05:02) They don’t do that for the facility files even though they do it for the providers.
Karla Torres (05:07) Correct.
Diana Rodriguez (05:10) So then we would have to do that manually is what you’re saying, right?
Rae Tompkins (05:15) That’s just not part of our current facility scope. So I provided a list here based on the email that you provided. So we’re not reviewing the accreditation. Yeah. And I think.
Karla Torres (05:25) Renay, I think. And I’m sorry, Ray, and I think that’s what we’re trying to understand what is the scope of facility credentialing, what you guys are doing that will give us a better understanding.
Karla Torres (05:39) And the reason why we’re asking is because we did have another consulting group that was helping before transferring over this kind of service to medallion that was doing our facility credentialing. And that was part of what they were doing with the facility credentialing. And Renay just let me know if I’m misspeaking here just because this is kind of a new area as well for me… and that’s the whole reason too Ray that we were asking. Yeah.
Rae Tompkins (06:15) And this was the list that I ran by our team prior to our jumping on our call. And I can certainly go back to the team to understand why we’re not pulling it for facilities. But as of right now, we are only pulling it for as you mentioned, Renay, the providers and not facilities. And we do, you know, we’ll provide it if it’s provided to us in the full packet. But it’s not something that we’re outreaching for. But again, I can send kind of more information on ownership when I send over all those previous documents that were sent to Pauline kind of outlining the exact verifications at medallion, our ownership, what we’ll outreach for. That way it’s documented once more. So.
Diana Rodriguez (06:56) Real quick. The last one where it says, W, I, I’m asking if they look at this here, it says, no, we just include in the packet, but it’s not in the packet. I do not believe, go ahead we provide.
Rae Tompkins (07:15) It in the packet, if it’s provided to us, but it’s not something that our team is outreaching to collect.
Diana Rodriguez (07:21) No, exactly. But what I’m saying is it’s in the packet that I send to you or medallion. Okay? But they’re not loading it into like the main page where it’s asking for W, I, they’re not even loading it there. And I don’t believe it’s in a packet. And for some reason, my computer will not let me. So, I.
Rae Tompkins (07:45) do know that we previously spoke in our last call about including the documents that you provide over directly into the completed file. But as I mentioned if the W9 form is not pre populated data entered, you know, by the carenu team, we’re not going back and adding that information manually into like the percentage portion?
Diana Rodriguez (08:05) Okay. I understand that, but you’re saying that it’s included in the packet, which I do not believe that it is being included in the packet. Like that medallion is creating. Well, I’m just going back like I’m going to go back to hangar, which was the last one that y’all created? I’ll just go through here real quick?
Diana Rodriguez (08:33) There’s no W9 in this packet?
Rae Tompkins (08:37) Would you and I, just to understand the expectations I can go back to the team? Would you like us to extract the W9 that you provide and add it with the application that we’re creating?
Diana Rodriguez (08:47) Well, see, the thing is that when I started doing this here, I thought that by me sending the packet to medallion… that it would be either loaded by you guys into the system or it would be part of the medallion packet. But what I’m sending with, you know, the CMS letters and the medicaid letters, those are not even part of anything. So that’s like, I guess maybe where I’m confused like I’m sending like a whole packet to you with all the documentation that we list on the cover page of the application, but they’re not all going into the system, so.
Rae Tompkins (09:31) They are uploaded. And that was something that we previously talked about moving forward. Our team is adding it to profile documents so that for visibility, you can go back. It may not be for that particular file because it may have been a conversation prior to that happening. So these files may be a little bit older than when our team was informed to add the full packet. But I just want to understand moving forward. Would you like the packet that you’re providing to us to be included in addition to the work we’re completing? So that way it’s the medallion verifications, and then the full packet from carenu attached all together?
Diana Rodriguez (10:05) Yes, right. It should be because if we get audited, I’m going to assume that they’re going to look for the medicare and the medicaid?
Rae Tompkins (10:15) Absolutely. So that information is stored in our, it is being stored previously in our profile documents. They’re adding that full packet that you provide. So in the event of an audit, the information is on file, but I can flag to the team to include your full packet with all the work that we’re completing. So it’s all in one place for you moving forward. So.
Diana Rodriguez (10:36) Is that being like, okay. So I didn’t understand what you just said. So, is that being like held like within carenu, like the like, because I don’t see like I don’t see the medicare medicaid, anything, right? So where would I find that if I just like went into like say hanger, prosthetics, where would I?
Rae Tompkins (10:59) Find.
Diana Rodriguez (10:59) that.
Rae Tompkins (11:00) we’re not pulling medicaid or facility files, right?
Diana Rodriguez (11:04) But you just said it was being held somewhere or it’s.
Rae Tompkins (11:06) in like the packet that you provide us is in profile documents, but we’re not.
Diana Rodriguez (11:11) Profile documents? Okay?
Rae Tompkins (11:13) Yeah. So if you click on the facility, there’s a portion that’s called profile. And again, this may have been prior to the conversation, our team wasn’t working backwards. So as of last week, I’ve told them to include that document in the profile as that wasn’t something we previously discussed, but that’s where they’re putting it now.
Diana Rodriguez (11:31) So, okay. So I have hanger, prosthetics and orthotics up on my screen. And am I supposed to be like on the main page or someplace else? Because I really don’t know where I’m supposed to look.
Rae Tompkins (11:47) So, if you click on, do you want to share your screen, I’m happy to.
Diana Rodriguez (11:52) Okay. Can I share, where do I go to share here? Share?
Diana Rodriguez (12:04) Okay.
Diana Rodriguez (12:14) So, can you see my screen or not?
Rae Tompkins (12:17) Yep. I can see it. And if you go to documents.
Diana Rodriguez (12:20) Right.
Rae Tompkins (12:25) So the full facility application that you provided us was uploaded on March eleventh.
Diana Rodriguez (12:31) On March eleventh.
Rae Tompkins (12:32) Is that, the first one? The accreditation information is that the?
Diana Rodriguez (12:38) So this is only, this is only medallions that’s what I’m saying, there’s nothing from us being loaded into here.
Diana Rodriguez (12:51) And I think the other two are the same, okay?
Rae Tompkins (12:54) Yeah. Let me go back to the team and ask them to upload the document that they were working off of. Obviously, since these are already in the ready queue moving forward, we’ll make sure that your full packet is included with the work we’re completing, just so you have it all in one place. I think there was some confusion by the team whether you want it uploaded to documents or uploaded with the application we’re creating. So I’m happy to go back to them and level set to make sure that they’re including it all together.
Karla Torres (13:18) Yeah, because Ray, I don’t believe we have technically that many facilities pending, right? So, how are we? And right now, I handle contracting as well. So, our facility contracting is not one of those that we’re focusing too much on facility contracting. So right now, how many facilities are pending?
Rae Tompkins (13:43) There are 73 facility files in the readyq dating… back to October 20 25.
Karla Torres (13:53) And when they’re in that queue, that means carenu, has to review.
Rae Tompkins (13:57) Correct. That means the medallion team has completed their initial processing obviously with the understanding that these files will not have the CMS preclusions or mpdb because we are not doing any retroactive work, but any files future state will be included. And that was something that we flagged to Angelica and Pauline. Okay?
Karla Torres (14:19) And what is that? The mpdb?
Rae Tompkins (14:24) The national practitioner data bank. Okay?
Karla Torres (14:35) On your end, Renay, out of those 73, how many have you had the chance to actually review?
Diana Rodriguez (14:44) I looked at all of them. Okay. So, the Sam needs to have at least a header date. There’s a URL, but each one needs to have a URL and at least a date stamp showing like when it was pulled, the one that the… we called the hanger prosthetic. I do see that they did include the Sam with the date on it, which is perfect. But all the other ones going back, they have to be like, well, everything has to be redone because it doesn’t show the date stamp although they have like a stamp, not really a stamp but it’s a like their checklist for medallion that they put like whoever’s doing the credentialing, they have their date that they completed the work, but the page itself or the verification itself does not have that date on it.
Karla Torres (15:43) Okay. And the date is necessary, yes.
Diana Rodriguez (15:47) To verify that they looked at it on that date because you can just pull anything.
Karla Torres (15:52) So, how are we able to then kick them back to medallion for them to start the process again? So that.
Rae Tompkins (15:59) Was flagged to us more recently. So, moving forward, as Renay mentioned, we are capturing the URL and date stamp, but I do want to flag that. The information that we’re populating and capturing whenever the agent signs off in dates is compliant as we’re capturing those dates and urls, it’s just in a different way that carenu is asking.
Karla Torres (16:16) So, what?
Rae Tompkins (16:18) We’re doing past tense is an accurate source of date and, you know, capturing, but to, you know, follow up on what carenu requests specifically that’ll be future files. And I can share the exact date when that was flagged to the team. And when we’re when we started that process.
Karla Torres (16:38) Yes, because then at this point, now, since they’ve been sitting there since October, nothing has really been done. So what are going to be the next step? Either we kick them back, for medallion to re credentialed because they cannot just sit there, right? So we need a solution as to what we’re going to do, with the 73 files to make sure it goes through the process correctly. So that’s something we could probably Renay add into the list to kind of discuss with Angelica on our Monday meeting as to what are we going to do? Because I’m assuming then for, this case, we will be paying double for those facilities to be re credentialed. I’m assuming right? If we put push them back through the queue to credential, I’d.
Rae Tompkins (17:32) have to double check with the account manager, Molly to confirm, but it’s definitely something I can provide more context into.
Karla Torres (17:38) Yes, please. And I know we do have a meeting Angelica and myself with Molly. I believe midweek next week, but it will be, it will be helpful to know ahead of time to be prepared for the meeting.
Rae Tompkins (17:51) Absolutely. And I do want to flag that we’re trying our best to be more transparent. We’ve had a lot of conversations with Kathy, a lot of conversations with Pauline. So all the documentation that we’ve put together and previously provided, I’m happy to make sure that you and Angelica have on file just so we can make sure everyone’s on the same page.
Karla Torres (18:12) Right. Yeah. And we’re trying to understand this is a big picture, right? I think we kind of hear like the pieces here and there. My whole thing is understanding what is in reality is the scope of work for medallion when carenu kind of starts what’s really like. Like I mentioned kind of a job or a policy however you guys call it of what it looks like whenever you’re starting credentialing team is reviewing it, what are the kind of like the step by step? And what are the checklists that they use to make sure that we have everything that’s needed and it is passing ncqa and CMS compliance?
Rae Tompkins (18:54) Absolutely. Yep. And that’s been previously provided. So I’m happy to make sure that you have a copy of it, perfect.
Rae Tompkins (19:03) But as far as, you know, if you want us to reprocess the files, I’ll double check with Molly to ensure that there’s any kind of cost association, but those files can be easily archived and reinitiated. Renay. So if you’ll just let me know any of those files that need to be reprocessed, I can make sure that they’re put back into place yes.
Karla Torres (19:19) Before we proceed with that, let’s make sure I get the information, and then we’ll have a meeting. I don’t know if you’re going to be able to provide that by tomorrow, because then we have a meeting with Angelica Monday, and then we could kind of touch base and then kind of get it back to you guys on Monday to get it recredentialed.
Rae Tompkins (19:39) Yeah, I can probably have an answer to you by end of day. So I’ll make sure to get that to you awesome.
Karla Torres (19:47) I think that is one of our big topics that we want to try to kind of push through. I know that the meetings are a little bit kind of more limited. So, I know Renay and I connected before the meeting and this is something that we want to kind of understand on our side first. Then I don’t know Diane if you have anything on your end for providers or we don’t yeah, I think that so far, thank you, Karla. Alrighty.
Rae Tompkins (20:21) Well, I’ll send these notes Renay, that you had flagged over just so you have it in writing. I’ll add this to our facility process outline so that it’s captured there as well. Karla. I’ll check with Molly on the cost association and I’ll make sure that you have all those facility process documents to have on file.
Karla Torres (20:37) Okay, awesome.
Rae Tompkins (20:38) Alrighty. Thank you so much. Thank.
Karla Torres (20:40) You. Bye bye.