Transcript
Mikel Sprawling (00:00) hi, Collette. How are you? Oh.
Collette Waddell (00:03) I’m hanging in there. How are you doing?
Mikel Sprawling (00:06) Oh, it’s a Monday, I know.
Collette Waddell (00:09) Are you, you’re traveling, right?
Mikel Sprawling (00:12) In the morning? Yeah, I’ll be headed out in the morning. Yeah, tomorrow morning. So, I’ll be headed out pretty early in my time. My flight leaves at six o’clock.
Collette Waddell (00:25) oh, that’s early. That’s like a four a M airport run?
Mikel Sprawling (00:31) Yes. And I did it that way because I was like, okay, if I do this early then maybe I can avoid any delays or, you know… and then I’m like, wow, then I see a day planned for tomorrow and I’m like, okay.
Collette Waddell (00:47) Oh, I wish… this is a company. This is a company like?
Mikel Sprawling (00:55) No, I didn’t do that. I didn’t do that. Yeah, that was in January, so I didn’t do that. So I was just opted to go out like just this time. Yeah. And, you know, I didn’t expect all the stuff going on with tsa to be happening, although I hope that that’s better now, but, you know, I don’t know. So I was like, okay, well, I’ll do it. I’m up early. I’ll do an early morning flight, but I was thinking, okay. It might kind of lay back which I think it kind of might still be kind of laid back that tomorrow, which I pray that it’s because that means I’m going to be up since four o’clock my time. Well, three o’clock my time. So it’s yeah, it’s certainly a lot. So hopefully, I’m not too drained by the time I get there. You know, you never know how you’re going to feel until you get off the plane. So I don’t guess I’ll see how that goes.
Collette Waddell (01:51) Like smooth travel.
Mikel Sprawling (01:54) Yeah, I certainly need it because when I saw that I was like, okay, well, I guess we’ll see how this goes making sure that I have energy. So I don’t want to do too much coffee, you know? But I was like, okay.
Collette Waddell (02:09) Where in California?
Mikel Sprawling (02:11) It will be in, so tomorrow will be in San Francisco. They have a new office that opened in San Francisco, and then they have an office that the corporate office that was already established is in menlo park. So, in northern California. Okay. Yeah. So I packed sweaters because I’m expected to be chilly like, you know, for Florida cold. So, I was like, okay, I know what type of sweaters to bring? So, hopefully, that doesn’t change especially being that being up as early as that. I know I’m probably going to be.
Collette Waddell (02:43) Dry an umbrella check to make sure you don’t need an umbrella. I packed an umbrella when I had my off site in San Francisco. Yeah, last month and I used the umbrella twice.
Mikel Sprawling (02:53) So, oh, yeah. How was the weather for you?
Collette Waddell (02:56) It was chilly. It was like chilly. Okay. Yeah. And so my light charleston jacket that I brought like was,
Mikel Sprawling (03:04) literally cold.
Collette Waddell (03:06) And it was like, I should have brought like a little bit of a thicker jacket.
Mikel Sprawling (03:10) Yeah, that was early.
Collette Waddell (03:11) February. So it might be a little bit better now.
Mikel Sprawling (03:14) Yeah, it said actually, I didn’t even look today for San Francisco. I think I only have menlo park saved. I think I just saved it in my phone to take a look to see. I’m trying to think, I’m assuming since they’re like 30 minutes apart, it’s probably not that big of a difference. Yeah, it should be a bit, but, yeah, I show at 62 tomorrow in San Francisco and menlo park 65. So just a few degrees different. Yeah. So that’s gonna be interesting, but I’m like, well, maybe I won’t be so, so drained, you know, by the time I get off the plane, but I guess we’ll see for certain. You know, how that goes. Yeah.
Collette Waddell (03:54) Good luck with everything tomorrow.
Mikel Sprawling (03:57) Thank you. I.
Collette Waddell (03:59) Have I have been, I was out of office for the first half of today unexpectedly headed to take my little one to the pediatrician’s last minute.
Mikel Sprawling (04:08) So, thankful.
Collette Waddell (04:10) I thought it was strep but strep test came back negative.
Mikel Sprawling (04:13) But he woke.
Collette Waddell (04:16) Up in the middle of the night coming downstairs crying. His throat hurt and he never wakes up. And so like we never go to the pediatrician for him and only for his one year like, well visit.
Mikel Sprawling (04:28) Yeah. And,
Collette Waddell (04:29) so, I was like, okay, well, now, I know that you’re actually, you.
Mikel Sprawling (04:33) Know, so.
Collette Waddell (04:34) I was convinced I convinced myself it was strep and it came back negative, but.
Mikel Sprawling (04:40) It just was irritating him.
Collette Waddell (04:41) And, like he couldn’t swallow? Yeah, yeah.
Mikel Sprawling (04:45) No.
Collette Waddell (04:46) On ice. So, I was just on another meeting with a colleague and she was like my son used to get like negative tests for strep, but he ended up having strep and I was.
Mikel Sprawling (04:56) Like, wow, didn’t.
Collette Waddell (04:57) even consider that? Yeah.
Mikel Sprawling (05:00) Yeah. Wow. That, that’s frightening, right? You know, especially if you’re getting tested for it and then you’re not, you know what I mean? And then you’re being told no, and then that means you won’t get well, I guess the antibiotics for it, right?
Collette Waddell (05:15) Because you can treat strep, you know, there’s medication for it, but then they’re like it’s just viral and, you know, like, well, then why did I come here? But we’re leaving on Friday for spring break and I just wanted, yeah, no, if like he needed to have treatment this week, you know, I just wanted to be third.
Collette Waddell (05:32) Yeah. So I am like behind today, I, just because I was out for a couple of hours taking him to that. So.
Mikel Sprawling (05:40) No worries from.
Collette Waddell (05:43) No.
Mikel Sprawling (05:44) Worries, I think I have pretty, I think I have pretty possibly potentially hopefully simple things to ask for. So, it’s mainly with the pre delegation audit I have for, well, yeah, pre delegation for humana, and they just had some stuff on there. So, I just wanted to know if we had like if I can give them this information, it’s due next week. And so I have the bulk of much of it. It’s just, there were a few things that I was like, okay, I’m going to have to ask about these. So that way I can turn that over to them. And, you know, don’t have any issues with that, but, yeah. So tell me if you want me to go first, how do you want to do it? No.
Collette Waddell (06:34) You, go ahead. This is, I’m pulling up the email that you sent with like the three items like, yeah, ncqa certificates, I… am, I believe.
Mikel Sprawling (06:48) I have some stuff that you sent me before from when we were doing centene, but they were asking. So humana was asking for some different information. They were asking for a point of contact like they, and I was like, okay, well, let me see if I can get that for them. And then, yeah, they just had some questions that I did not want to answer incorrectly.
Collette Waddell (07:15) Right. No. Okay. Appreciate it. Appreciate that. Yeah.
Mikel Sprawling (07:19) Let.
Collette Waddell (07:20) me, I’m just going to work on a response. So you have it in an email, but we’ll just kind of cut through it. So, okay, contact is going to be Merritt miller, who is our director of operations and let me just drop her like signature stuff in there.
Mikel Sprawling (07:43) Okay. And,
Collette Waddell (07:47) I’ll just put that in the response there.
Collette Waddell (08:00) Where did it go? I just had it here.
Collette Waddell (08:14) Garrett miller… director of operations. She oversees our credentialing and licensing teams.
Mikel Sprawling (08:26) Oh, okay.
Collette Waddell (08:28) But that is her contact. I’m just going to reply to this email just with that response there. So we are a ncqa certified cbo. So I’ll just respond there.
Mikel Sprawling (08:43) Okay. Ncqa.
Collette Waddell (08:51) CDO is… and then the certificates are attached and then a blank copy of the credentialing and re, credentialing applications.
Mikel Sprawling (09:03) Yeah, like a PDF. I was, because they’re asking for that as well. I was going to tell you that I tried to ask the support first. I was like, well, maybe they can help, but it was the bot… so I was like, okay, just.
Collette Waddell (09:24) Put like let me connect or connect me to a human or something, I think got it. If you think if you use the word human, then it’ll like switch it out of the, you know, bot mode.
Mikel Sprawling (09:38) Understood. Yeah, I had already had this part drafted and I was like, actually I’ll just throw it in here and see if call it because she probably would know whether or not they had that available, but available. But, yeah, humana centene didn’t ask, but humana, but you know, how that can be some payers. Do some payers, don’t so, and,
Collette Waddell (09:56) I know I have a copy of the initial file and really all it is because there’s actually no like PDF form. It’s all like in the it’s just generated from the profile, you know, all the information platform. So really, it’s just a, almost like a blank what that PDF looks like when you get the file in the ready. Okay, it’s basically like a blank one of those. Got it then redacted. I know I have a initial one and I can ask, I’ll ask merit for, I’m sure she’s had to pull together a one for a recred. Yeah.
Mikel Sprawling (10:43) Okay. I’ve.
Collette Waddell (10:44) had to send a recred one before, but I’ve had to send the,
Mikel Sprawling (10:47) initials. Okay. Yeah. I mean, we don’t have any recred anyway, but I, she asked for it. So I don’t want to give them any room to come back and say something wasn’t given. So I’m like, nope, I’m gonna give them everything we have exactly.
Collette Waddell (11:07) My gosh. I just had to say… sometimes I try to work organize myself and then by.
Mikel Sprawling (11:18) doing, no, I can’t listen you.
Collette Waddell (11:20) Know, I’m like,
Mikel Sprawling (11:21) you’re preaching to the choir, you… know, you’re… preaching to the choir here, I say every day and then I have my like to do list that I want to definitely get done that day and it’s it. Nope. Just doesn’t I said, let me just do what I can do at this point. Do what I can do. That’s where I’m at, no?
Collette Waddell (11:45) Yeah, there’s no, like it doesn’t help to have a list anymore. I mean, like because it’s like I feel like I never make a dent.
Mikel Sprawling (11:52) In.
Collette Waddell (11:52) my.
Mikel Sprawling (11:52) right. Stay.
Collette Waddell (11:54) Yeah, whatever is flying in. Yeah, yeah, certainly.
Mikel Sprawling (12:00) Because I’m like, okay, well, these, I definitely know I need to get done. So, let me just do this. So that way I have it here and as that habit as a hot item to knock it out, but yeah, I feel like no matter how organized I try to stay, it doesn’t work that way for me. So all.
Collette Waddell (12:20) I’m actually gonna send you the first two items and then I have to go find where the PDF is saved for the blank application. And so… I’m just noting that one’s gonna come in a separate email, no.
Mikel Sprawling (12:38) Problem. No problem whatsoever. I mean, I’ll still be working on it, but yeah, if we have all the things this week, I’m gonna go ahead and just send it over because I finished the roster on Friday. So I was like I’ll go ahead and send it over to her. And that way, you know, I can see what else they, when they come back with the file request, how that’s gonna go? Yeah.
Collette Waddell (13:01) Gosh. Now, it’s really bright driving me crazy that I can’t find. And I’ve already given you our… the medallion credentialing information, integrity policy and training documents. You have that stuff? Yeah.
Mikel Sprawling (13:21) I’m gonna pull it up just to be sure. Yeah, I have the, I have our delegation, Rj shared the delegation agreement with me policy. I have the medallion policy and procedures, ncqa approved verification sources, grid, the credentialing information, integrity, and the training and the certificates. I have those. Okay? All right. Yeah.
Collette Waddell (13:47) And I just found… the… initial PDF. So I’ll get that over to you right now and then on the.
Collette Waddell (14:06) I will work on the re, credentialing.
Mikel Sprawling (14:10) Okay. I appreciate that. Call it.
Collette Waddell (14:20) Yeah, I’m just like scrolling through, okay, initial application for the credentialing… application to follow… that font. Got real big. Let’s… see.
Collette Waddell (14:48) All right. Okay. Just sent that one. So, I just have all I have left to find is the re, cred PDF, got it. The blank one. Got it. So, I’ll work on that and get that over to you.
Mikel Sprawling (15:00) Excuse me. Thank you. Yeah.
Collette Waddell (15:03) No worries.
Mikel Sprawling (15:05) I appreciate that. Yeah, that helps out a lot and.
Collette Waddell (15:13) Let me know like I’m here this week, I’m just out starting Friday. So if like, it’s like something comes up via email and I just see that it’s like, you know, get find it and get it back to you. I will absolutely try to do that before I’m out.
Mikel Sprawling (15:30) Okay. And,
Collette Waddell (15:31) then if not, I’m back the following the Monday after.
Mikel Sprawling (15:36) Spring break. Got it. Yeah, not a problem. I do have one other request. So, we do have a ad hoc credentials committee member. He’s a physician. He’s a contracted physician with sprinter. He’s in medallion in the profile platform right now, but his profile is incomplete, you know, it’s one of those things I’m probably gonna have to, you know, nudge him to get it done. His name is Richard and I cannot pronounce the last name we call him. Dr. Ricky, last name is, though, his first name is Richard. Last name is M, IS, I a, you probably see him. Okay. He is going to serve as the ad hoc credentials committee member. And I like, I wanted to see if you could have him set up like,, dr, Arun villavalum, because I need him to sign approve, dr V because dr V can’t approve himself. Right? Yeah. So it’s yep. And then he sent, yeah, because I was waiting for him to return his confidentiality agreements and stuff to me. So once he did, he’s done that. So I wanted to make sure we’re good to go there and I’ll meet with him and kind of give him an overview of what he needs to do. But I have dr V just kind of sitting, yeah.
Collette Waddell (16:54) What do you want that committee to be called? The?
Mikel Sprawling (17:02) One for the clean, the MD clean. We have one for the MD clean files with. So, is that the one you’re referring to? Or? Yeah.
Collette Waddell (17:12) Because dr, V, is that what? Yes.
Mikel Sprawling (17:18) Is.
Collette Waddell (17:19) on the sprinter health physician clean?
Collette Waddell (17:27) If I add this provider to that, then any file that’s assigned to that committee, it’s going to require both of them to sign off on it.
Mikel Sprawling (17:37) Okay. It’s.
Collette Waddell (17:39) like I need to create like a special committee in the drop down just in the, you know, for the platform, like as a way to like make it only go to dr Ricky got?
Mikel Sprawling (17:53) It, okay.
Collette Waddell (17:55) So, again, it doesn’t it’s not necessarily, it doesn’t mean that it’s like your formal meet committees. Yeah.
Mikel Sprawling (18:01) More.
Collette Waddell (18:02) of like a administratively in the platform like to kind of buy to allow him to be assigned, you know, specific files that are only, yeah, to review. Okay?
Mikel Sprawling (18:20) So, I guess the same spinner health physician, dash clean. I don’t want to say ad hoc, but.
Collette Waddell (18:32) I mean, almost like I’m trying to think of like, yeah, it’s like when you need, the other person who is like has the authorization to.
Mikel Sprawling (18:47) Like designee, can we say designee? Yeah.
Collette Waddell (18:49) Or?
Mikel Sprawling (18:50) Maybe, would that be something like that be okay? Or?
Collette Waddell (18:53) I mean, you can call it whatever you want?
Mikel Sprawling (18:55) Yeah. Okay.
Collette Waddell (18:57) But like, you know, to where it would almost like, I think like if I see it in the drop down, it’s like that’s just like for those like where the people that normally review files can’t be reviewing the room, you know?
Mikel Sprawling (19:10) Yeah, I think designee is good because that just helps me because what the platform that I used to use at the hospital, I had to add in the designee task to have them go in and it triggered an email for them to sign it and it would help me know that it’s going to go to dr. Rickey and I’ll have that noted here on our end that it’s going to go. So it can mirror the exact name, just designee, maybe in parentheses or something. And that way that’ll.
Collette Waddell (19:39) yes, there’s an email that just says that way I like just can save that. So that way, like for historical reasons, I can say we’ve added dr Rickey on to this, you know… to kind of fulfill this need or this purpose, but,
Mikel Sprawling (19:56) just, yeah, absolutely.
Collette Waddell (19:57) I’ll just put the provider, the provider’s name, and then what the new kind of special committee like title got it should be. And then I’ll just do a copy and paste when I’m building it.
Mikel Sprawling (20:12) Got it. Yeah. Okay. All right. I’m taking those notes now and you need the name and,
Collette Waddell (20:19) I can do that within like five minutes once I get okay.
Mikel Sprawling (20:22) Real quickly… got it. And I think the last thing Collette, were you able to find out if there’s a report that will show if there’s edits made in the credentialing file?
Collette Waddell (20:43) A report?
Mikel Sprawling (20:45) No, yeah. Oh, okay. Did.
Collette Waddell (20:48) I show you the feature to be able to go in and see edits.
Mikel Sprawling (20:55) Yeah. I just didn’t know if so I was able to see, but I think the way that they had it worded was more leaning more towards, I have to go back to that email because I know when, I looked at seeing how they had it, they had it more towards like and… I know what they’re referring to. But like a report that would generate the show this and sometimes there’s no, no changes. You know, many times there’s no changes, but say this verification was actually scanned in on another provider’s profile and we had to go in and fix it. Like that type of thing is what they’re looking for.
Collette Waddell (21:33) Yeah. So we have for our own ncqa certification. We have our own like that credentialing information, integrity policy. There might be another document out there about that… data. We do our own audit of like the universe of like changes. And then we can give customers. Like our findings. Did we already talk about this? Like sometimes I’m like wait a minute. We.
Mikel Sprawling (22:14) did touch on the integrity information. We did touch on it. Okay. It’s just centene had that request that I can ask them if me doing because it was what it was, had it where the way it was worded was that it was something needed to be sent to me monthly. But if I’m going to be doing because I’ll have to do the integrity information, the integrity piece yearly. Anyway. So if I’ll have to do it, I guess I can talk to them about would that suffice or do I have to have a monthly report? Because I see what you’re saying, but I’m assuming that you guys wouldn’t do that monthly, you probably would do that annually as well or semi annually, yep.
Collette Waddell (23:00) Yep.
Mikel Sprawling (23:00) Okay. Let me make a note. I can.
Collette Waddell (23:06) Ask, I’m, gonna go back and look at, to see if I can find that email too from you about centene?
Collette Waddell (23:16) Because… you also… and when you re, are you reviewing the files when we’re releasing them to that ready queue? Yeah.
Mikel Sprawling (23:30) Is essentially.
Collette Waddell (23:32) Your own audit and review of the files that we’ve prepared for you. So like, yeah, also… should be able to like incorporate that as to like part of your own like auditing process and.
Mikel Sprawling (23:46) Like, yeah to.
Collette Waddell (23:47) Flag and identify if we inadvertently like attach the wrong document to a provider’s file. So that level of review should meet. Yeah, let’s do a little bit more on like this one. I’m not. Yeah, no.
Mikel Sprawling (24:05) No problem. I’ll also, I’ll ask too. I’ll ask that question and I’ll let them know about the report that be my, the review that I do before I actually send it, right? So, you’re okay. You’re.
Collette Waddell (24:18) receiving and reviewing every single file that we’re processing for you? Okay?
Mikel Sprawling (24:24) Yeah. Okay. Yeah, I’ll make that note and that should count or something. I hope. So. I’ll definitely ask them because I’ve sent them.
Collette Waddell (24:36) Yeah, it’s not like we’re doing it. And then we’re just handing them straight to your committee. So like, yeah, it’s like you’re there’s like an administrative like level of, yeah.
Mikel Sprawling (24:48) Review.
Collette Waddell (24:49) Happening.
Mikel Sprawling (24:49) Right. I’m going to ask them. I haven’t I’ve been asking for feedback from the credential and integrity program, that I do policy that I did internally and I haven’t heard anything. So I was like, I guess that means I did okay because nobody has said anything, right? And I’m like I just don’t want it to, you know, hit me one day where I have to go and do something else. And, yeah, as of now, I haven’t heard anything back. But, yeah, it’s been over a week. Well, going on two weeks now since I replied and I haven’t received any feedback. So I’m assuming I did okay. And plus they were requesting a roster, another roster. So I’m like, well, does that mean we’re good? But I thought I would get some documentation to support it. It’s just me like trying to be double sure. Yeah, yeah, yeah. But I’ll find out between.
Collette Waddell (25:47) The payers. Yeah.
Mikel Sprawling (25:49) I’m definitely gonna ask that question. I’ll ask that question and see if I can get some clarity. I’ll go back to the specialist that was working with me with the audit review and I’ll see what he says because he was pretty good about providing some clarity. It’s just, I haven’t received it from the other folks. So I’m just curious to, you know, make sure that I can get that information. But yeah, I will definitely find out this.
Collette Waddell (26:12) One is like a follow up. Okay, both of us kind of, yeah, try to see what else we can dig up. Yeah, okay. Email. And if you get, again, if you get clarification between, and if you get clarification while you are, while I am out next week, don’t hesitate to, you can send an email to support like don’t use the bot but like send an email.
Mikel Sprawling (26:41) And.
Collette Waddell (26:42) then just, you know, that like, you know, that your engagement manager is out for the week, but, you know, if there’s anybody and they should be able to get that to our credentialing director, merit, if she can help reply back, I.
Mikel Sprawling (27:00) Appreciate that. Yeah.
Collette Waddell (27:01) Yeah.
Mikel Sprawling (27:02) Okay. So.
Collette Waddell (27:04) You could just say like, you know, preempt it if you start the conversation, like, I know my engagement manager is out for this week, but, you know, if there’s anybody from the credentialing team that could help me answer this, you know, in her absence, that would be great. And then hopefully they can flag that to merit and her team. I appreciate.
Mikel Sprawling (27:26) That color. I’ll definitely do that. I’ll follow up with centene before I sign off today and see just what details I can get from them. Hopefully, I’ll get a response. So even.
Collette Waddell (27:36) if you get something in your email and you just forward it to me just for like just to like, This is what they sent. I don’t know. Okay, we’ll try to figure that one out. So that way you have that squared away, safe travels. Yes.
Mikel Sprawling (27:51) Thank you. You’re so welcome. I appreciate it. Yeah, I’ll touch. I was just gonna say, I’ll touch base with you then, I guess, you know, if I get the answer, and then when you return, I do have a hard stop today.
Mikel Sprawling (28:01) At four. I have an interview actually, I’m interviewing somebody for a spot. So hopefully, yeah, yeah, they’re trying to build it out. I mean, I got one, but goodness knows, I can use a couple more but, you know.
Collette Waddell (28:14) Well, good luck. I hope it’s a good positive candidate.
Mikel Sprawling (28:19) So, thank you. Thank you. I appreciate it. All right, thanks, Collette. Bye.