Transcript
Deanna Koulakjian (00:00) hi.
Leigh Howle (00:01) Deanna. Sorry, I’m a little bit late. My computer is resetting and I had to reopen login, Google and everything in my workspaces. So I apologize for that.
Deanna Koulakjian (00:13) That’s fine.
Leigh Howle (00:16) Hi, cam. Hi, Marna. How is everybody today?
Deanna Koulakjian (00:22) Hi. How are you?
Leigh Howle (00:24) Doing good.
Deanna Koulakjian (00:27) Hi there. Hello… so.
Leigh Howle (00:33) I didn’t have too much on the agenda, but I did want to go over the issue tracker and then anything that you all wanted to discuss. Do you all have anything specific that you wanted to go over?
Deanna Koulakjian (00:46) Yeah, I kind of want to get this emblem thing put to bed. We really do need it on the… list of payers for both New York and New Jersey. We do have a separate process. We’ve asked our payor representative and she agreed that we have a separate process and a separate contract. So I don’t know why medallion’s pushing back. I guess as a client, I’m asking why can’t you do what we’re requesting for something that we have?
Leigh Howle (01:13) Totally understand where you’re coming from there, Deanna. So the payor directory team does extensive research before adding a payer into the directory because all clients then are able to make that request and they want to be sure that it is an active payer and that this payer does accept applications for provider enrollment, credentialing, you know, contracts. So they’re doing a due diligence on this and thank you for agreeing to let Brenda Ruby. She’s one of our payor directory team members reach out directly to empire and just confirm with them. So I did see some messages yesterday where she is actively engaging and trying to get some concrete information. And then once she has confirmed, she will add that into the directory and I will send you an email and let you know what that update is when she’s finished with her review.
Deanna Koulakjian (02:14) Okay. But we’ve been doing it for two years and we’ve been using the same application. So I guess that’s sort of proof already that it’s there’s a process. Yes, I don’t know what other research she needs to do. My rep has confirmed it. What do you need? Like an act of congress?
Leigh Howle (02:30) Exactly. So, yeah. So the reason it was previously, you know, when the payr directory changed… customized payr names that’s when this new workflow was… initiated. And so, yeah, I.
Deanna Koulakjian (02:48) get all that, but it’s just like it’s been so long and now it’s like, okay, we can send all this to medallion except for this one, we can send all this, but we can’t do that. I mean, so it’s just getting too much carve out on our end. So we’re just asking, can this hurry up? Because we’ve been doing it for two years. There’s obviously a process. We have a contract. We proved that we have a separate process. Just seems like it should have been done by now.
Leigh Howle (03:10) I’ll escalate with this when we get off and ask her to give me some type of conclusion by end of day today. Thank.
Deanna Koulakjian (03:19) You.
Leigh Howle (03:20) I’m going to turn my camera off. So I’m not too open to stare at me here that’s all right?
Leigh Howle (03:30) And I’ll go ahead and share my screen and you all can see I’m typing on our shared agenda right now just to kind of document this.
Leigh Howle (04:02) Okay. Did you have anything else, Deanna?
Deanna Koulakjian (04:05) Other than that, there’s one other things that we’re no longer participating as of tomorrow with the mount Sinai ipa, except we are, we’re no longer using their contracts for any payers, however they have an employee top tier level that we will still be using mount Sinai ipa for credentialing, to stay on the top tier and not go to the second tier, which costs their employees more. So we also have to have that in both New York and New Jersey, drop down menus, it’s an actual process. We’ve also been doing that for two years. So that has to be listed as well.
Leigh Howle (04:44) Okay. So just to make sure I’m following on this one, for the payr directory, it needs to say mount Sinai, and there needs to be both New York and New Jersey in that drop down for requests.
Deanna Koulakjian (04:56) Yeah, it has to be, it’s both New York and New Jersey. We do extend it to both. And it has to be, I don’t care how, I mean, I don’t know what you’re putting previously like mshp, mount Sinai health partners or whatever previous language was, but I want to make sure there’s a mechanism for that so that we’re also not carving that out on our end.
Leigh Howle (05:15) Okay. It is. I’m in it right now and it does have New York. I will ask that they include New Jersey and it’s spelled out M o UNT, let me just add it here. So it’s a little bit easier when you all go to make that request. We.
Deanna Koulakjian (05:29) know, we know the abbreviations. It’s just, we need it there. So, yeah, we cannot ask for it when we have providers who need it, okay?
Leigh Howle (05:41) Did you have anything else? No, I’ll be quiet now. You’re fine. I’m flagging it right now to the directory to have New Jersey added.
Leigh Howle (05:56) I appreciate your feedback. Okay? And that has been submitted.
Leigh Howle (06:17) All right. Okay. Kim, or Marna, did you all have anything that you wanted to go over before we move on to the issue tracker?
Deanna Koulakjian (06:26) I don’t think so. Nothing for me. Okay?
Leigh Howle (06:33) All right. Sounds good. So, on the issue tracker, I’ll go ahead and move on to that one. And there was just a couple of questions. I had, let me scroll down… on row 20 for horizon BCBS. Which provider was this one for?
Deanna Koulakjian (07:09) Sorry, that was me. And I don’t it was probably.
Kim Martin (07:15) It says that’s high. She said, what provider is this for? Though? I believe that was for a doctor. What’d you call it?
Deanna Koulakjian (07:22) Was it Matthew or… oh, my… could it have been showit? Yeah, it may have been showit. There’s just been so many that have had issues. Oops, good one there.
Deanna Koulakjian (07:45) It’s… probably him.
Deanna Koulakjian (08:00) I believe. Yeah, it’s showit.
Leigh Howle (08:03) Okay.
Deanna Koulakjian (08:06) Sorry about that. No.
Leigh Howle (08:08) Problem. Would you, would you spell that for me?
Deanna Koulakjian (08:10) SH o HET.
Leigh Howle (08:14) Got it. Okay. Perfect. And I’ll go ahead and mark this pending medallion. And then I’ll send this over to the team for processing. And then on this one, row 25 for dr Lehman for local 1,199. I just wanted to give you all an update on this one. The hospital arrangement was sent over on 327. The payer did confirm receipt and I tried to log into ceqh but, you know, I couldn’t get in, and then I tried to just check that the ceqh PDF, would have the hospital arrangement listed and it was missing in his provider profile. So I was just wondering if you all could confirm?
Kim Martin (08:58) Ceqh is updated with the provider’s hospital information. That profile was from previously before the doctor obtained his hospital privileges, which a covering doctor was loaded. So that should have been submitted with the application in its original format. So, but that information is correct on ceqh.
Deanna Koulakjian (09:17) I think there was a form that was uploaded that had the covering on it. Yes, that was already there from the early beginning.
Kim Martin (09:23) Correct. It just wasn’t submitted with the application, which it should have been, but that’s neither here nor there.
Leigh Howle (09:30) Okay. So then the miss on this one was there is a hospital arrangement uploaded in the provider profile, and the team was required to send that over with the application, correct?
Kim Martin (09:42) Well, now he has hospital privileges. So now the actual hospital information is in his medallion profile and his ceqh. But when they originally submitted the application, they didn’t provide the hospital information, which this is all the time. He’s not the first provider. This happened with, they always forget to supply the covering physician form as well. So, it’s constantly getting kicked back for multiple providers. They need to make sure they submit that we load that information into medallion when we load the other documents for the provider. So they need to make sure that they submit that as well with applications.
Deanna Koulakjian (10:16) Yeah. All the applications should have that covering letter or their letter.
Deanna Koulakjian (10:25) Okay. I think our work plan has that in there too to include the covering letter, yes?
Kim Martin (10:33) It does.
Leigh Howle (10:38) Okay. That gives me a direction to go in that’s really helpful. I’ll swing back and just make sure that the team is submitting the hospital form and that they are getting that out of the provider profile. Caqh is updated and it’s also listed in the provider profile as well. So, you know, there’s two places that it could be obtained. So thank you for that. Okay. Let me move this one to medallion. I think this is the last one on row 31 for postiglione… for wellcare. I just wanted to confirm that any audiologists with wellcare would not have a new enrollment, right? But any demographic updates for wellcare, audiologists, those, do those demos do need to be processed.
Deanna Koulakjian (11:33) Exactly. If they’re already participating, they’ll do the update, but they won’t accept new enrollments unless we go through hearusa. And the company doesn’t want to group contract with hearusa. Okay? It’s sort of a bipolar thing in our end, right?
Leigh Howle (11:50) I get it. Okay. I’ll make sure that if there were any, I know there were some stopped enrollments in addition to postiglione. So I’ll just have the team review those and if there were any demographic updates for wellcare for audiologists, those will be put back into process. Okay? And then, okay.
Deanna Koulakjian (12:06) Yep. Sounds good.
Leigh Howle (12:09) Okay. That was all I had. Did you all have anything else to go over?
Deanna Koulakjian (12:16) Not today, not today. No.
Leigh Howle (12:19) Okay, awesome. Well, we get a little bit more time back in our day today. I appreciate everybody’s time as always. And, yeah, I hope everybody has a great rest of your week.
Deanna Koulakjian (12:32) You too all.
Leigh Howle (12:34) Right. Thank you.
Deanna Koulakjian (12:36) Take care. Bye bye.