Transcript
Naomi Denson (00:00) hello? Hey, Naomi. How are you? I’m good. How are you? Good?
Niccole Russell (00:13) Glad it’s Friday.
Naomi Denson (00:18) Melanie’s here. Okay?
Naomi Denson (00:29) Hi, Melanie. I think we’re being funny. What’s going on? How are you? Good? Oh, are we doing? I don’t know what?
Melanie Cannon (00:40) You guys are doing. I’ll stay off. It’s all.
Naomi Denson (00:42) Good. Oh, it’s so funny. All right. Okay. So, just updates. We received that updated group profile sheet. I sent that to Nick this morning. The existing group enrollments sheet, sent that to Nick too. Okay. Where are we on existing provider enrollments? I think we’re working on that, but holding off until we have provider emails for some that we don’t have?
Melanie Cannon (01:13) Yeah, I still am missing 40. So I sent another pushy email this morning to that team to try to get them to do another round and get me those emails. Okay? But I got the other stuff and then I did send you those credentialing P, PS finally since the delegated agreement’s been finalized.
Naomi Denson (01:30) Yep. That’s why I was a minute late because I was distracted with those and sending them to our credentialing team to review.
Melanie Cannon (01:39) Oh, good. Yeah, it’s still draft form.
Melanie Cannon (01:41) I haven’t got anything approved. So, let me know if you guys have any questions or edits or anything that you think should be added. Just let me know and I can do that.
Naomi Denson (01:49) Okay, perfect. And then the pdqs setup, I don’t know if you saw my response to that email, we’re not seeing it on our end under aledade or sipa.
Naomi Denson (01:58) So I was asking her if she could take a screenshot and tell me what their like full org name is, that they’re registered under? Okay, caqh with.
Melanie Cannon (02:11) Did she respond to you yet?
Naomi Denson (02:12) No, I sent that. Let’s see.
Naomi Denson (02:21) I sent it yesterday. Okay? Morning, 10 43 a. M. You want?
Melanie Cannon (02:29) To give them to the end of the day and then maybe ping them again, just make sure I’m on that email. Still you are and say, can you get it to me by Monday? And then maybe see if they’re willing to meet and we can set up you and I can set up a meeting with them.
Naomi Denson (02:43) Okay. Yeah, sure. Yeah. And you, are you’re on that email thread? Okay? It’s on the original thread where you entered her to me? Okay? Yeah.
Melanie Cannon (02:53) Let’s see if they gave us anything by the end of today. If not, I may just have to like set up a meeting for all of us to go over it. I know it’s in a way. I’m sorry, they’re not being more helpful.
Naomi Denson (03:03) That’s okay. There are requests in there, but it’s not any that match the names that I have. So the team’s like, I don’t see what you’re asking for. So I don’t know if it’s under a different name and not straight sipa… or if they have like a different legal name that they registered it under or what?
Melanie Cannon (03:22) Mag M a G, but I don’t remember what the actual name is like, medical associates group or something.
Naomi Denson (03:31) Okay. Yeah, if they can confirm, that would be awesome because that’s it might be in there and we just can’t see it because the names that I’m telling them to look for don’t match.
Melanie Cannon (03:42) Yeah. Let’s hope they get back to us.
Naomi Denson (03:46) And then I’m going to be annoying again and ask about the payr process scoping. I know we have that new template that I had shown you. And then Richard left.
Melanie Cannon (04:01) And I sent that one back to you and I’m getting template names confused. So I apologize.
Naomi Denson (04:06) Wait, let me see. Hold on.
Naomi Denson (04:12) Let’s see… and you might have, I think maybe you did say that you put it in there. Let me see.
Naomi Denson (04:26) Okay. I have one that looks like it was, I brought in on March ninth?
Naomi Denson (04:36) But it’s it doesn’t have any, like I just wanted, to confirm that there… are no, that there are no call outs, specific processes, rosters or anything. This is the latest one that I have that I pulled in on March ninth. Is that when you uploaded it to the couch drop?
Melanie Cannon (05:00) No, I thought I sent one via email. I thought it was via email. Maybe I can check, I had to update that the other day. Let’s see.
Naomi Denson (05:12) I might have just gotten lost in a thread.
Naomi Denson (05:20) Let’s see import.
Melanie Cannon (05:23) Yeah. If you get that, don’t worry, I can send it again. I realized a lot of those plans have more than just commercial. So I updated that whole grid.
Naomi Denson (05:32) Okay. I don’t see it in an email, so maybe it’s in capture.
Melanie Cannon (05:42) I can send it again today. That’s not a problem. Okay. Perfect. Do you know by any chance the rostering questions, like for some of the big nationals, do you guys already have that information?
Naomi Denson (05:57) We, for a lot of them, we do but not all of them. Nicole. Do you want to elaborate on that? I know you’ve learned a lot about rosters lately on like which… ones we have, why we ask the customers for them specifically. Yeah.
Niccole Russell (06:18) So, what you would do for any rosters that you currently have you’ll send them over? I will see if we already have them mapped for automation. If they are not mapped, then I will map them for our team. They’ll go in, do the configuration behind the scenes, so we can automate those rosters. I do know a requirement for the rosters is to know if it’s a prerequisite, and then to give any information in regard to it, like where it’s submitted, how we follow up if you have contact information, anything like that. Does that answer your question? It?
Melanie Cannon (06:56) Does I just don’t think I’m going to get that information anytime soon? So confusing event. So this is obviously a new thing for aledade that we’re doing previously with cipa. This organization that we are working as our like, you know, first, like pilot of this credentialing project. Cipa is the ipa. They don’t do anything for credentialing. Currently, it’s done all at the practice level. It’s like, you know, it’s just the association of independent positions. It’s what cipa is. And technically… like right now, I’m not able to go directly to practices the way that our organization is set up. Like I don’t have the ability to like go right to a practice person and be like, hey, do you have to send in rosters for this health plan? So, I’m just trying to figure out how to get around that and get the information that I need.
Niccole Russell (07:51) So, so what you’re going to do on the payr scoping sheet is or payr mapping, I think you give her the scoping, right? Naomi?
Naomi Denson (08:02) The, yeah, the payr scoping sheet? Yeah. So from.
Niccole Russell (08:06) that, what’s going to happen is once you provide all of your payr names, then I will go up against our directory here at medallion and see what names match, what names. What could possibly happen is you call a payr one certain name, but it’s also known as like a more main go to name for payr’s and so we’re I’m going to map, you have your payr name. There’s a column for medallion’s payr name, and then you would sign off on those and.
Naomi Denson (08:37) We do have, she’s already done the payr mapping Nicole?
Niccole Russell (08:40) Yeah. Okay. And so we.
Naomi Denson (08:41) do have, yeah. So we already added these in. She already, it’s in a different sheet but she already, they already reviewed it and approved. Okay. So.
Niccole Russell (08:53) So, then what would happen there? If you didn’t have any processes? We would, we would go through our main primary, our payr directory for that information. And okay. Is this it? Okay? This is it?
Naomi Denson (09:07) Yeah. This is the last one. I hope she did update it a little bit. She’s going to send me a newer version but this is the template that she had and you can see that’s the name they gave us. That was our map name that she approved, and we pulled them in here.
Niccole Russell (09:19) Perfect. Okay. And then, so… rosters, you’re not sure if you use rosters or you do know, but don’t have the roster.
Melanie Cannon (09:33) I don’t know and I don’t have the rosters. Okay?
Niccole Russell (09:36) So it’s up to you on how you would like to go about that. So we can either follow our main directory, which some of them may have rosters like Aetna. I’m not sure if we have it for Michigan, but we would follow our payr directory unless you had a specific kind of sop that you wanted us to follow. If you don’t that’s fine. We’ll just follow whatever’s in our payr directory.
Melanie Cannon (09:58) Okay. I’m comfortable to go with that due to like the firewall that I have on my side, it’s just harder to get that information directly. Yeah.
Niccole Russell (10:07) That’s fine. If you’re okay with that, we can just follow our normal processes.
Naomi Denson (10:10) Yeah, and I know I’ve beat this to death, but we just want to make sure that we have all of the processes that you would expect us to follow if there were any yes in place ahead of time before you start submitting, we start submitting via our payr directory and then you’re like why do you do it this way? You’re supposed to do it this way?
Niccole Russell (10:29) Right, exactly. Totally fine.
Melanie Cannon (10:30) I very much appreciate it. Yeah, the only change to this is that you.
Naomi Denson (10:36) updated the lines of business, yeah.
Melanie Cannon (10:38) And I think I removed Aetna because I believe I’ll double check, but I don’t believe we have any fee per service contracts with Aetna. I think all of our Aetna stuff is vvc, but I have to check on that.
Naomi Denson (10:49) Okay. All right. Nick, have you had a chance to look at either of the group update templates or the group existing enrollment templates? Do you have any questions or feedback?
Nick Vander Velden (11:03) Not existing enrollments on the group updates. It looks like there’s just like three groups that need to be added. Is that right?
Melanie Cannon (11:14) That’s all I’m seeing? Okay, cool. Yeah.
Nick Vander Velden (11:17) And then I’ll get a… chance to look at the group enrollments in a bit here and I’ll let Naomi know if I have any questions.
Naomi Denson (11:28) Perfect. And then the last thing was, Noelle had emailed me and said, well, she had sent that there was one more revision on the delegation agreement. And then it looked like she pulled that email back and it was like never mind. It’s ready. And then she asked me for merit’s email to send it to for signature and I had asked her to CC me on the DocuSign when she sent it, so I could keep an eye on it. But I’m not sure if she already sent it or there’s still something in our court that’s needed on that.
Melanie Cannon (11:59) So, our SVP is out of office this week, so he’s not going to be able to sign it until next week. So, I’m assuming she maybe just didn’t send it at all yet because John hasn’t signed it. Okay, perfect. So she said likely Wednesday of next week is when he’ll sign it. Okay?
Naomi Denson (12:16) Perfect. All right. Anything from you? For me? No, I.
Melanie Cannon (12:21) Sent over those P PS which I was really excited about finally finalizing. So.
Naomi Denson (12:25) Yes, yes. I was very excited to see that come through which again, is why I was late to our call because I got too excited and jumped right into it. I was excited too yep. So our team will review that. We’ll come back with any questions feedback or, you know, updates on that with you and we will start moving forward. I know credentialing is kind of on hold because you guys are working on the mpdb getting that sorted out, but at least we have those and we’ll have them in place when we do get to that point. Awesome. All right. I hope you have a wonderful weekend. If you do need anything or have any updates, just reach out. Awesome.
Melanie Cannon (13:07) Thank you so much guys. Have a great weekend. Thank you.
Naomi Denson (13:09) Talk to you later. Bye bye bye.