Transcript
ShantanaKendall (00:00) how are you?
Cynthia Fox (00:05) I’m doing all right?
ShantanaKendall (00:07) Yeah, good for a Tuesday. Yeah, feels.
Cynthia Fox (00:10) Like busy.
ShantanaKendall (00:11) Busy.
Cynthia Fox (00:11) Busy feels like it should be Friday.
ShantanaKendall (00:14) Is it not Friday yet? Geez I know Andrea just messaged and said that she won’t be able to make it. I don’t know where Cindy is. I’m going to message her back. Well, I’m still trying to find my footing, but I do want to say, thank you for the spreadsheet that had the payers on there. That has really been helpful like just me learning and getting caught up on things.
Cynthia Fox (00:43) Yeah, there she is. It’s me and her.
Cynthia Fox (00:53) Yeah. Come on. Hi guys. I’m so sorry. It’s okay. I’m leaving for vacation and I, in my head think it’s possible to touch base with all of my staff for 15 minutes and it’s not, and I learned my lesson, trying to squeeze it in. Oh, man. I’m like you should have saw like somebody opens the meeting with like, so where are you going? And I, right away, I’m like shit… I.
ShantanaKendall (01:22) don’t have time to talk about that right now.
Cynthia Fox (01:25) Like we all like, Nicole, thank. you. Thank you for meeting us. We have been working closely with Mira and Genevieve. I’m sure you’ve been kind of looped into some of the conversations they are, they want us to sign for like additional, like what do I want to call them?
Cynthia Fox (01:42) Like enrollment package? Yeah, there’s better words than this. Right? Whatever it is. Like, they want us to sign up for more, and we’re coming back like, hey, we did our entire census like this. This was the goal. We wanted to get everybody on our census, not census. We wanted to get every, all of our clinicians… enrolled. We did a big analysis before we signed to see how many like enrollments that we needed and due to and which I believe is like kind of due to the like optum united or the cigna evernorth thing we clearly went over. And one of the things, that I learned from Mira that I did not know previously was she was like when you have a line of business, you know, how well there was a couple of things I learned. But one of the big things and I’m sharing it with you in case you didn’t know her in case I misunderstood, I appreciate it. Yeah, she was like, you know, how we got stuck at horizon and there’s like three what we signed up for medicaid, medicare and commercial. And we do want all three but they were getting held up. And the guidance I got was to do a enrollment change and get the commercial out of it. And she was like, no, you should have canceled it before it passed intake. So when you found out that information, you should have canceled it and did a brand new one by you doing an enrollment or a single change. What is it called? I’m going to open up the platform. So I don’t sound insane. I’m going to use real words is.
ShantanaKendall (03:09) It a demographic change?
Cynthia Fox (03:11) Thank you. A single demographic change. You do get charged twice. She’s like, so the guidance is to close that like cancel the one and completely resubmit. And I was like, fuck, I submit it all of those, right single demographic updates when the client was still technically in the like pre intake phase. So like heads up that’s a thing. Okay. Yeah. So, like, great. Thank you, Mira. I’m so glad. I know that now she gave us other advice that we should have actually canceled all of the united things and then redid the optum instead of keeping them both open and putting in a new line item, right? And then I’m trying to think what else I learned over the past couple of days that one was interesting. So one of your emails said that we would not be charged twice as we discussed and you discussed with your PE and it’s in an email and I sent that over to them. I’m like here’s my understanding on this like take it. I understand that’s not what you would like to do in the future. I understand you want us the second we get wind that something’s a little funky to cancel everything and resubmit everything to the correct payer, I get that. Thank you lady. I totally understand now and I was like, but Chantelle, Nicole and I did not understand that at the time or I would have done it like, trust me, I spend more hours in medallion than I do in my goddamn emr right now. So like we are active and right now, the threat is if we don’t sign up for more enrollments, is that she’s going to turn off administrative access on the first. And I explained to her, I was like, I understand what you’re saying here. However a lot of our tasks are assigned as administrative tasks, when they should not be assigned as administrative tasks, they should be signed as clinical tasks directly to the clinician. So by doing that, you’re holding up enrollments that we have already been charged for that we’ve already paid for that we’ve already used. So you can’t do that because if the tasks were all assigned properly, like the, okay, we’re not going to submit any more cool beans but they’re not right now. So you’re like you’re holding us up and so they can take what they want with that. But I’m sharing that with you and I’m sharing that with Tana, because that is the message I’ve been giving them. The other thing Nicole that I noticed is we’re getting two. This is driving me absolutely. Cuckoo bananas. We’re getting two tasks like now, one is going to the provider, right? As appropriate, like you need to sign this document here’s. The link, right? We’re getting a second one assigned to admin. So, when the provider does it and they close the task, I don’t know that they did it or closed the task. So, like now there’s like a two thing you’ve got to close for it to go through. And so I’m like why are they giving it to me too? Like why do we have to close it twice before it processes? Is that normal? Like should I?
Niccole Russell (06:05) So usually it’s duplicated if it’s over 21 days. So I.
Cynthia Fox (06:10) was okay. That makes sense. These aren’t but that does make sense if it’s over 21 days. I love that. By the.
Niccole Russell (06:15) Way, now, I did look at something. I did look at a report yesterday for the team to see duplicates. I saw one that could have been considered a duplicate. I only saw the one.
Cynthia Fox (06:26) I’ve been closing that one.
Niccole Russell (06:32) What I’m thinking, the verbiage is the same in the task. But what I’m thinking is it’s really for the provider and then one for the org, for the ao, because that’s normally how medicare works, right? So you have to have your ao, sign off on the medicare on the provider application. So it is not worded like that. It is worded as if it were to go to the provider. But, and I did let them know this is the only one that I’m seeing that I can see is a duplicate, however did?
Cynthia Fox (07:03) You look at the closed ones as well. I’m sorry, did you look at the completed ones as well?
Niccole Russell (07:08) I did not look at the completed. Okay, because.
Cynthia Fox (07:10) I’ve been going through completing them.
Niccole Russell (07:12) Okay. Tick, tick because.
Cynthia Fox (07:14) Like if she’s closing it off on the first, I’m like hell, no, like I’m going to close these, so they don’t hold us back.
Niccole Russell (07:19) No, yeah.
ShantanaKendall (07:21) But yeah.
Niccole Russell (07:21) I just went through outstanding and looked at those.
Cynthia Fox (07:24) So, if you could look through the others, okay? I don’t know how to pull a list or you could send it to me. I don’t expect you to necessarily waste your time but if you could send that to us, I’m happy to identify the ones that have been.
Niccole Russell (07:37) If you go into the platform under the analytics tab, there’s a task summary at the top. All right, I’m in.
Cynthia Fox (07:46) It and,
Niccole Russell (07:47) so, this is where I pull the outstanding task. So if you scroll all the way down to the bottom, it has completed task, love this and that’s kind of where, and you can download it over to the right. There’s a little thing that’ll populate when you hover over it, you have the three Lissy’s dots and then you can download it.
Cynthia Fox (08:07) Love that. Thank you so much. I will use that.
Niccole Russell (08:09) You’re welcome. So I actually, yeah, I went through the outstanding when they said there were duplicates. I was like, so I went through the outstanding and I looked and I only saw the one which is considered a duplicate. I think they probably used the wrong template would be my guess. So, it was one for the provider and one for the admin, and that was a medicare one.
Cynthia Fox (08:34) So, but,
Niccole Russell (08:36) I actually, yeah, I actually went like one by one and looked at the title, looked how it, you know, and it’s hard when you have a lot of data to do that. Usually, I like to use pivot tables, but I’m like you can’t really use a pivot table on this one. So I.
Cynthia Fox (08:49) wonder if we could just use, the conditional formatting?
Niccole Russell (08:57) That like.
Cynthia Fox (09:00) The duplicate?
Niccole Russell (09:01) Values. Yeah. What was that? I’m sorry?
Cynthia Fox (09:06) Like sometimes there’s duplicate values… so.
Niccole Russell (09:11) It’s not really, so you can run it as a report. And I was going to do the duplicate, however, if it’s not labeled the same, you’re not really going to see that it’s a duplicate, if it is a duplicate.
Cynthia Fox (09:23) I mean, let me share my screen, okay?
ShantanaKendall (09:27) Well, I don’t know. I haven’t particularly been looking for duplicates, but I know I have… within just yesterday. And today, some of the ones that I’ve closed were like it should have been assigned to the provider and having to send a team chat or email to say, hey, could you go and do this here’s? The link or look for an email? Yeah. And I feel like a lot of the tasks or even the providers doing those tasks. And there’s been a holdup in some of the enrollments. Like I’ve had to go in and do like service tickets to say this was done. Can we get a status update like something as simple as like a taxonomy not being right? And it would be changed and I would say, hey, this is done. Can you update it? You know? So, I think that just from the couple of days that I’ve been able to see things, the assignments have held up a lot of the enrollments that could have been completed.
Niccole Russell (10:27) Yeah. And I will say on this report as well, make sure you’re looking at the payer name to see if it’s a duplicate, because if it’s a medicaid?
Cynthia Fox (10:34) Yeah.
Niccole Russell (10:35) New Jersey, but then there’s a medicaid New York that’s technically not a duplicate as well. Yeah, I.
Cynthia Fox (10:41) Hear you.
Cynthia Fox (10:46) Why are these?
Cynthia Fox (10:54) It’s hard because if you’re using templates, it’s like I’m trying to figure out a very easy way to show some of the challenges. MHMM… they, would they have the same id or? No? They probably wouldn’t I.
Niccole Russell (11:12) think every task has its own unique id. Yeah, I separated it by, I tried a pivot table, but then again, like I said, it’s.
Cynthia Fox (11:24) like the.
Niccole Russell (11:26) report that I originally ran with that. And this one may be different. The report that I originally ran even though it had it in the system when it populated on here, which I can see, the fields, it actually did not on my other one. So then I went to this report, but I went to outstanding instead of completed like.
Cynthia Fox (11:47) Even this, like, do you see how it says medicare E signature required via Pecos? So.
Niccole Russell (11:54) That could be for both, that can be for the ao signature and it could be for the provider.
Cynthia Fox (12:13) Like, what about the update? Caqh?
Niccole Russell (12:22) Yeah, I think those should go to the provider.
Cynthia Fox (12:26) I can’t update their caqh… let’s see. Caqh. Must be reattested.
Cynthia Fox (12:41) Caqh update.
Cynthia Fox (12:47) Provider application, kindly update the service location, so that’s me and provider caqh. So that’s… them.
Cynthia Fox (13:01) Please update the Sim. Okay, the provider is not board certified and we are unable to process the application without that, please confirm that the provider is certified. And if, yes, please update the same information in the caqh. So that might be… needs to update caqh.
Cynthia Fox (13:28) So that one’s me… needs to update caqh.
Cynthia Fox (13:43) That one’s kind of iffy, I’m not going to highlight that one.
Niccole Russell (13:58) It looks like there was another one that could be considered a duplicate that showed up yesterday, I guess after my research… but again, it’s medicare. So one could be for the provider signature and one for the ao, if.
Cynthia Fox (14:15) you like, definitely, it’s a lot of the closed ones though. Nicole. So like look, I would hope the open ones are actually taken care of because we’ve been like focused on cleaning up current environment because like then it’s on us, right? Like if we see it and don’t say anything, it’s totally on us. So like we’ve been doing our best to close everything out that we possibly can also. Nicole, there was like a ton of submissions from like pre my time that were just like pending there. They were just like sitting there. So I was like Jesus christ. So I like started to go through a ton of the pending ones that I’m like I don’t want these on the docket to get done. So I like went through and I closed out like a trillion of them which you probably are seeing the like there’s still a lot that are not completed, but like I’ve been closing them all out. Anything that was, I don’t know… like I’m like, dear God, like I even saw ones when I downloaded a list of ones that are for providers who no longer work here. And so I submitted tickets about those two. Like I’m like these people don’t work here anymore. I see when I pull this list that they have pending enrollments, can you please go in and delete all of these?
Niccole Russell (15:33) Yeah. You know, if you deactivate an account that opens up head for you headspace, I thought.
Cynthia Fox (15:40) So, too, but then I saw them on one of the reports like I didn’t even know these people worked here because it was like before I started on this project and I saw them on the like upcoming report. Like, you know, you could see the like the credits that you used and then below it, you could see the credits that are like upcoming. That’s how I identified them and I like sent them and they didn’t say request stopped yet. So like I went in and I submitted a ticket about it, I was like please make sure that all of these have like requests stopped. So I submitted that maybe yesterday, maybe the day before, maybe the day before that time, is relative. At this point. It’s running together, right? It just is going. So I put all those through Nicole. There’s also an issue I’m facing where I go to deactivate them or to request a cancellation. So instead of just putting in the note because clearly nothing happens when we put in the note, I’ve been going into the support ticket and then it gives you that little thing and it’s like how can we help you today? And you can click cancel request. I’m getting this like weird error message. It’s like a weird thingamajig. And it’s not for all of them and it’s not. I can’t find the logic behind it. Like it’s not like it’s a certain status or it’s a certain person. It’s just randomly. And so I’ve been submitting support tickets about it. So like I’ve been trying my best to like, yeah, yeah, I’m following your directions as best as I can. I feel like I’ve been submitting them but I’m letting you know like there’s notes that’s like submit it for cancellation and can’t get through. And then you’ll see a support because I can’t support. I can’t submit a support ticket exactly on that. I have to go through like the other way to submit a support ticket, but that’s happening on more than one account. Probably only like three or four people like three or four enrollment requests. It’s not like an overwhelming issue but I’m letting you know that is something I’ve been submitting.
Niccole Russell (17:42) Okay. Yeah, I know.
Cynthia Fox (17:44) When you make.
Niccole Russell (17:46) A comment on a line, they actually, the team is not notified of that. They just see it the next time they go in for follow up, but if you make a comment on a task, then they see that they get triggered for that and it falls into their follow up bucket.
Cynthia Fox (18:01) Why is that though? Oh?
Niccole Russell (18:04) I don’t know. I’m learning like I said, I’ve only been here since the end of December, so I’m still learning the ropes as well. But yeah, that’s just the way the system works. Is they, my… guess is because if there are numerous amounts of comments then it kind of overwhelms the staff to not really know.
Cynthia Fox (18:29) What’s a priority or what?
Niccole Russell (18:31) You’re working on, right? Yeah. So that would be my guess.
ShantanaKendall (18:36) So, in the case where, cause I think I’ve come across some that they didn’t have an open task, but it was like a holdup on the line. So that would be the appropriate time to do a support ticket and not just do a comment because I’ve had to go in and do a couple of support tickets for ones that were just sitting and they could have gone push through. Yeah.
Niccole Russell (18:58) So, anytime you need any sort of update on the line that’s what you use that support for?
ShantanaKendall (19:05) Let me see. So if.
Niccole Russell (19:07) you need to follow up on something if you need something pushed through, if you have questions about it that’s yeah, that’s the channel to go to.
Niccole Russell (19:22) And… I think.
Cynthia Fox (19:32) Like a DocuSign signature.
Niccole Russell (19:34) Needed.
ShantanaKendall (19:38) yeah, for those, yeah.
Cynthia Fox (19:41) Like we’ve been getting those too, and they’re not over 21 days it.
Niccole Russell (19:46) Could it will say task over 21 days? Yeah, put them in red and not the provider.
Cynthia Fox (19:54) Let’s find out. No, it’s for Alex Hansen?
Cynthia Fox (20:05) Who’s a provider that’s not our group, but.
Niccole Russell (20:07) I’m wondering if it’s group related. It’s just related to him as well?
Cynthia Fox (20:11) That’s payr, enrollment ever north behavioral health?
Niccole Russell (20:18) No, it’s probably for him then, so.
Cynthia Fox (20:22) These are the closed ones. So like, I think using the open ones, you’re seeing a cleaned up version, of our, I think if you go to the closed ones, you’ll be able to see better our issues. Tana, good job closing them all out though, like snaps for you because I’m very pleased that most of these are closed on our end. That doesn’t mean they were completed though, right? Like Nicole, like it does not mean they’re completed. It means that we’ve probably submitted something that says send this to the right person.
Niccole Russell (20:53) Right. My.
Cynthia Fox (20:54) team’s also getting emails from providers about like signing and filling out documents. Is that intended behavior or should it go through the platform?
Niccole Russell (21:06) If they’ll get communication through their email, yeah.
Cynthia Fox (21:11) It’s like you need to complete these three forms and send them back. Is that common? Okay? Just because sometimes you get to fill them out on the platform. So, I was like, is the platform supposed to be our source of truth?
Niccole Russell (21:24) It should all be filled out except for like signatures. So, if the,
Cynthia Fox (21:30) forms aren’t usually, what happens?
Niccole Russell (21:32) Is a form will be completed and then we’ll need a wet signature or notarized or something like that. So, in that case, we upload it and… advise the provider of that. But actually completing a form, no, that is not the provider’s responsibility. So.
Cynthia Fox (21:48) Tana, the one that you helped Ivana, work on, was that a wet signature or was that a fill out form?
ShantanaKendall (21:56) It was a fill out form.
Niccole Russell (21:58) Could I send that to you as well?
Cynthia Fox (22:00) Yeah, let.
ShantanaKendall (22:02) me, see if I can grab it.
Cynthia Fox (22:07) I think I did already. I,
ShantanaKendall (22:09) think it was for horizon, no unitedhealthcare. She just,
Cynthia Fox (22:17) was like, what is this? And I’m like girl, I don’t know. Yeah.
Niccole Russell (22:22) If it’s an enrollment application, the enrollment team should be completing that and then sending for signature, really the it’s like notarized, obviously, all that would have to be completed.
Cynthia Fox (22:35) It’s there’s one, there’s a lot of different ones that the team has been getting. But like the criminal background check attestation.
Niccole Russell (22:41) The tin should be completed, the mpi should be completed. The name should be printed. They should just have to probably sign and date.
Cynthia Fox (22:51) Like a DocuSign though, right? It.
Niccole Russell (22:54) Depends on the instruction. If the instruction says it needs a wet signature, then I,
Cynthia Fox (22:59) mean, there’s an online signature field. So I would have assumed it would have been a DocuSign.
Niccole Russell (23:03) Yeah. Configured.
Cynthia Fox (23:04) Okay. So this came directly to her and did not come through the platform. So, should I be flicking these to you to assess if this is intended behavior or not? Like we’ve been telling them to figure out because we can’t wait like we’re like just fill it out girl, but I’m not, I’m like I.
Niccole Russell (23:21) would say because it’s a digital signature, they have to put her email in and that’s why she’s receiving them. Okay? So paper applications, we can upload, right? But if it’s a digital signature, it will require an email and it sends directly to their email.
Cynthia Fox (23:37) Okay. And,
Niccole Russell (23:40) I’m guessing if those fields weren’t completed, I’m guessing our again guessing assuming our team wasn’t able to go in and pre populate that information for then it to be sent to her.
ShantanaKendall (23:54) Would be my guess. Yeah. So in this instance, just because it came directly through email, is it something that we would need to send directly to the payer or would it need to go to medallion? And then they?
Niccole Russell (24:10) Was there a task on it? There should still be a task?
ShantanaKendall (24:12) On it. No, I’ve seen a couple where we’re just getting the documents emailed directly and there isn’t a task. So I have just been sending them to the payer. Okay? I would.
Niccole Russell (24:28) Have to have specifics on that one. I can go back and just say, in general, there needs to be some sort of communication whether it can be uploaded back. Yeah, obviously, if we can submit that via portal, we don’t want it mailed. But if it can’t then of course, we.
ShantanaKendall (24:47) would have to mail that.
Niccole Russell (24:49) Or y’all would have to mail that. But yeah… if you have some examples, I can take that back and ask, hey… because.
Cynthia Fox (25:01) If all of the providers are going to get these emails, I need to prep the providers to sign the emails because Yvonne is a supervisor. She’s good. She’s able to be like, hey, I don’t know what this is. Do you know how many people probably got those emails and were unprepped for it, that’s my concern. We’ve got a large team clearly, I mean, large, respectfully not to like, you know, they’re companies but large for us. So like us being able to change, manage this, is insanely important. Like, yeah.
Niccole Russell (25:39) I know medicare is one they’ll get a, they’ll get a E signature for in their email. She.
Cynthia Fox (25:45) Got that one. Whatever.
Niccole Russell (25:46) Payor, this is, I see the docusigns are going out. Let’s see there’s actually a DocuSign for evernorth, Jessica McLaughlin. It’s actually set as an org task. So that needs to be reassigned. Thank you. Let’s.
ShantanaKendall (26:04) see, this one in particular came from optum. I checked the completed, the assigned and the completed for Ivana. I didn’t see any, just quick glance. I didn’t see any for optum or uhc, and that was, this is like a most recent one that came directly to her email and then she forwarded it to Cynthia and I, so I… guess like in the, that’s a case to where moving forward, we would need to have a task created so that we can upload it and then that it can go through the portal. So.
Niccole Russell (26:38) You know what? I’m wondering if you’re getting the docu signs because it’s going directly to their email and it’s to notify you that there’s a docu sign out.
Cynthia Fox (26:48) There, I don’t know they maybe, but they put a link in it, like to sign it from the link, it’s like an active link. So when I go in, I’m like, ooh, do I have something I need to sign? And I click it and I’m like, no, I don’t, so then I have to like, I have to copy it, send it to them formally in an email and say, can you click this link and sign it? And then they do, and then I have to go back in and close the task, which is definitely not intended behavior like that’s. Wacky.
Niccole Russell (27:17) See in this task, it says, please follow the DocuSign URL located in the task to sign your agreements, but there’s no.
ShantanaKendall (27:26) Wait, is that you? Okay?
Niccole Russell (27:32) They put, thank you. And the you, is the link? Okay. Huh, that one’s expired. Anyway… now the side can’t be reached.
Cynthia Fox (27:48) Okay. So.
Cynthia Fox (27:58) Yeah. There’s a lot of like an application had been submitted to medicare on your behalf. Please log into pucos and sign the application electronically within three days. This is the email link and it’s for, am I still sharing my screen? Yeah. And it’s for Hana medicare, New Jersey… like… she needs to be informed of this. Like I, so, so these are the, if you could, and you know what? Tana, when I’m on break, if you could go through this and do a very similar analysis, it would be fantastic.
Niccole Russell (28:35) Okay.
Cynthia Fox (28:36) Because we need to like, I just want to, I… don’t really, I would love for this to go smooth going forward. Like I would love for this to be something that does not require to pay a full time staff member to do plus me, Nicole, who I oversee quite a few functions here at forge health, right? I oversee operations. So, the fact that I’m wasting time this much time in a system is, has now gotten to the point where like now I’m before, I was excited because I was like, I can’t wait to learn this. And now I’m like, no, no… like.
Cynthia Fox (29:19) I don’t know. And some of them were totally us like sins of the past were all like I was going through ones from like, and I’m like she clearly put in a note to ask for this to be canceled, but she didn’t put in a cancellation request like she just like you said, they don’t read those.
Niccole Russell (29:34) I.
Cynthia Fox (29:35) don’t know if she knew that like I have no idea if she knew that or not, but she’s no longer here. But like those are the things that I’m seeing… that I’m like man. But again, Nicole, if she wasn’t working with her person, then that’s on her. Like if she wasn’t working closely with the person when she had questions like that’s not.
Niccole Russell (29:54) A problem. Oh.
Cynthia Fox (29:56) We are working closely with you. We are asking the questions. This is a.
Niccole Russell (29:59) Different game.
Cynthia Fox (30:02) Like even this like documentation needed?
Cynthia Fox (30:12) Please upload the updated LPC like girl, that is, I don’t got her LPC like that’s a, her problem?
Cynthia Fox (30:23) Provider must be enrolled with medicare. Oh, yeah. Yeah, this is one of those ones that we probably should have canceled and then completely resubmitted the request. So we were not charged twice.
Cynthia Fox (30:43) All right. That one’s definitely us current updated group Coi that’s a, if that’s a group thing that’s our problem.
Cynthia Fox (31:05) Yes, Tana, anytime you see something with like the group practice or something that is something we should be handling, skip over it. But anytime it’s something that should be directly related to the provider, please highlight. And then Nicole, if you’d like to do the same, like I’m happy for us to share our assessment with you too.
Niccole Russell (31:26) Yeah, we can look at that. I was advised yesterday, it was duplicate, so I was specifically looking for duplicates.
Cynthia Fox (31:36) It’s both.
Niccole Russell (31:40) But I do have a ticket in for your misaligned… task and I’ve tagged my manager in it. So hoping to see movement… I’m hopeful I’ll follow up on it every few days, so hopefully we can get some of this stuff cleaned up for you because I know that. And I’m going in right now with these docu signs and I’m asking them to assign to the appropriate provider.
Cynthia Fox (32:10) Thank you. That will be immensely. I know Tana has been doing the same thing, but that would be very helpful. We also have a ridiculous amount of open tickets. So like if you can like give them a little nudgy nudge, most of them are cancellations from like old things. But like still, if we’re looking at a contract and we’re like, hey, you’ve got this many things like coming up if I’ve canceled all of them and they haven’t been canceled, we can’t have a productive conversation about it which I would love to do. So here’s, another one like prompting you to sign the application. You don’t know that’s coming. Kelly got no idea… but that one’s ours. All right. I got to stop doing this. I do have another meeting guys. I’m so sorry, but I’m… going to send this over to Tana. All right?
Cynthia Fox (33:50) Okay. I’m so sorry, I do have to hop Nicole. But like big picture, I feel like I have. And obviously I shared with you this morning some of the little like fun little tricks that Mira has taught us. I feel like going forward. I like understand… that don’t… ever let it ride like canceling and completely resubmitting is like a better friend to you than letting it kind of process. I also and you and I had clarified this a few weeks ago but like just to verbally say it again like optum for any behavioral health, evernorth, for cigna, and then carillon for. , anthem. Yeah. And then what we should have done is the second we heard about it instead of just creating a second line item, we should have canceled and then created the second line item. Instead of just creating the second line item. They did not cancel it for us. They let it pass intake charged us. And then the optum line was created as per what the task said to do. But then it charged us a second time. Fun little facts. We now know, we did not know. But we now know now, you know too. And then just getting these tasks all cleaned up would be absolutely lovely. And then getting any of those pending like I can’t even have a productive conversation until I like thoroughly understand what actually is pending. So if all of those cancellations once they’ve all processed and all of the tickets are closed, then I think I’ll have a better understanding of what is to come plus since… we did not have the information that I now have because of Mira. As of yesterday, two days ago. I don’t know whenever we met and had the original conversation, it could have been Friday last week. I don’t even know but she told us just recently understanding that we submitted them both. And then also understanding that we shouldn’t have been charged for them both. I pulled a list of all of the enrollments that we have been charged for that we have used, but it doesn’t tell me what it’s for. I have no idea if it was, it just says enrollment, like was it united? Was it optum? Was it, this, was it that, so I request it from Mira. But I’ll also request from you if I could get my hands on really a better assessment of where these 400 actually went. So I’m able to go in and advocate for our team. Did?
Niccole Russell (36:25) You look at the provider summary on the analytics tab?
Cynthia Fox (36:28) So, I did. So here’s, what I did, I went to analytics, yeah, have fun with me for a second. And then not the end, the completed requests, I believe. Or maybe I didn’t maybe she told me to do this, hold on… now.
Niccole Russell (36:48) That’s where you see the usage. But if you need a report to pull, that’s going to be under the analytics tab.
Cynthia Fox (36:53) Okay. So, is this consumption… not the in progress request, but the completed request, is this like going to help us understand consumption? Yes, got it. So like Esther’s a bad example, but like… there looks like there’s double line items for tricare?
Cynthia Fox (37:23) Maybe they’re from different years. Like maybe it’s at, I don’t know.
Niccole Russell (37:30) It could, I think this is overall unless you and it.
Cynthia Fox (37:33) Brings me to tasks like when I go to click to better understand, it just, it brought me to tasks not the actual… hover.
Niccole Russell (37:45) Over that line that we’re what’s yeah, right there.
Cynthia Fox (37:50) I’m still in tasks that’s.
Niccole Russell (37:51) taken you, yeah.
Cynthia Fox (37:53) The same thing happens if I’m in my account and I’m in usage. And Mira said because I said to her, like I don’t actually know what, like what, which line item this was for, right? So, like this is all medallion core, pay your enrollment, right? Like if I want to go here and I go to pay your enrollment and I click, it brought me to tasks again, right? So I don’t know if that’s intended behavior, I would assume it’s not.
Niccole Russell (38:23) No, I think I would create a support ticket and ask them to look into that because it should, if it’s got a link, it should populate to the correct to.
Cynthia Fox (38:33) The appropriate. Okay.
Niccole Russell (38:38) But I’ll continue to take a look at these tasks and I will let the team know once… those are cleared out, then you feel like you will have a better understanding to have that conversation with them, okay? Listen.
Cynthia Fox (38:54) I promise you, Nicole, like I’m not, I know historically, we have not used this portal. Well, we have not monitored it. Well, we actually haven’t even used our enrollments that we have paid for like this has been mismanaged, but since we have signed this new contract and hired Tana, we… have been dedicating a ridiculous amount of time to trying to do this well and I just want to.
Cynthia Fox (39:27) I don’t want to feel like because historically we’ve ignored it, that now we shouldn’t be treated this like she made a comment like historically it has been mismanaged, or something. And I’m like I get that, but it has not been mismanaged in the last two months. Like, so, okay. So let’s like let’s start anew, and you made a lot of money off us last year by us not submitting any enrollments which is fine. Let’s let that die like that’s. What happened. We signed a contract for that, but like going forward like we need to be collaborative and if we’re asking like even before I got you, I asked Mira, like I was like, I’m not clear, do I submit it to optum or do I submit it to united? And she’s like your person will be able to tell you this information. But, and then when I went back to her and I was like hold on, I had this conversation with her. This was the guidance we received. She was like we shouldn’t be listening to her and taking guidance from her. And I was like, listen, Mira, you told me that I need to speak to her. Now, I’m speaking to her. I have it in writing. Who who am I supposed to believe? She’s like you should know your contracts, like, I know my contracts. I didn’t submit for them both. I asked which one to submit to. So like, no. And so I’m having a very hard time with like the customer support… because I adore you and I think you’re fantastic. And I love that. But like y’all need to align on the back end so so we can continue to work together. Like, I can’t and.
Niccole Russell (41:04) I’ve been told I’ve been told as far as payers go that… the clients know their contracts, they submit the request. I’m not really supposed to interfere with that. I mean, I can answer your questions. Obviously, you know, if you have a question, I can answer it, but I’m not supposed to really direct you because you should know where, to request those lines… but the,
Cynthia Fox (41:28) second, we get one back that’s like you should go to optum, like nope, this should go to optum, right? I would have had an opportunity to cancel all of the, all of them and resubmit. But that wasn’t the guidance that you were given when you reached out to your PE, that wasn’t the guidance I was given from you. So like I.
Niccole Russell (41:47) believe if I recall correctly, you even stated that they had processed some under united. They did some under optum, which is why.
Cynthia Fox (41:57) I didn’t.
Niccole Russell (41:57) opt them to get it. So.
Cynthia Fox (42:00) Yeah, that’s exactly why I wasn’t sure that’s why I asked because I was like hold on. I’m really confused. This doesn’t make sense to me. Same thing with cigna and evernorth, and so Mira, and I understand it going forward like they’re like this is how it is. And I’m like, well then get Nicole, and whoever else, is the middleman here on board? Like that’s? Not. Okay. Get your team on board, get your tasks on board, get your guidance on board. Like we paid extra, like Daniel, a man on our team was like, no, no, we’re not going through them for everything. And I said I need a point person. I need someone to help me because I don’t know how to use this platform like I need someone. And so we went across a certain threshold just to get you. So you’re able to give us guidance. And like Mira was aware of all of this. So I’m like, no, no, no. Like I made it clear I needed help. Yeah. And if you’re my help from an operational perspective, which you’re fabulous. But like she, everybody needs to be aligned over there. Like, I can’t keep, I don’t I shouldn’t need to be proving my point. I shouldn’t need to be submitting a 1,000,000 tickets. I shouldn’t need to be monitoring this like the, I… hear you we hired you guys because we don’t have the expertise in house like this shouldn’t be an issue where we’re like it’s just as much work to work with you guys than it is to just do it ourselves and learn ourselves. Like if I’m spending this time learning your platform and I can’t get quick guidance, might as well just learn the availability platform and do it that way. Like, it just doesn’t make sense to me. So I’m so sorry for venting. I’m just venting, you are wonderful. And I really appreciate you.
Cynthia Fox (43:38) I’m just, you are wonderful. I love working with you. Thank you. Okay. I do have to hop in 15 minutes late for my nap. Enjoy your.
Niccole Russell (43:48) Vacation. Don’t think of any of this, my.
Cynthia Fox (43:50) God, please. Listen, I’m putting my phone number in this. Listen, Tana’s your girl like not contracts. Daniel’s our contract person, but Tana is your person. Listen… this is, my personal phone number. You text me. Okay? You text me if there is a drama, you text me if you’re like girl, they shut and you walk, you text me for anything. Okay. I’m yours. All right. I promise, I will answer in the middle of the night from Europe. I don’t care. I need this to go smooth. Okay? I.
Niccole Russell (44:19) need this to go smooth? Okay?
Cynthia Fox (44:21) Thank you, both. Bye.