Transcript
Kat Rivera (00:00) good morning. I think you’re on mute?
Lyndsey Farmer (00:11) There we go.
Kelly Martinelli (00:18) It looks like.
Lyndsey Farmer (00:20) someone else just joined.
Lyndsey Farmer (00:31) Good morning. Hey.
Lyndsey Farmer (00:41) All right. Are we waiting for anyone else to join this morning?
Kelly Martinelli (00:46) It might turn interesting, folks. Okay?
Kelly Martinelli (00:58) We just got off a call. So…
Jeff P. (01:56) Is it just me here from ops?
Kelly Martinelli (01:58) Yeah, nobody else probably has any questions… no.
Jeff P. (02:04) Well, no, I just talked to Monica earlier and then I just got off the phone with Courtney, which I don’t know. She added to this. She was added to this, right? Yep. She said she was joining. Maybe they’re trying to figure out the zoom part… okay?
Kat Rivera (02:35) Been tracking.
Jeff P. (02:36) Your team’s… busy on call line. Kelly. You’ve been busy lately. I’ve been trying to call you, but you’ve been busy?
Kelly Martinelli (02:46) It’s, I have had calls most of the morning. I actually, no, I was, well… you know, I’ve got jury duty this week, right?
Jeff P. (02:56) Yeah, yeah. Yeah.
Kelly Martinelli (02:57) So, I don’t have to go to jury duty. I got excused. That’s what’s up so far? I mean, every night, I got a call in, thank goodness. Oh, really? Yeah.
Jeff P. (03:09) It’s not just like a one day thing. You go in one day. You either get picked or you don’t get picked there.
Kelly Martinelli (03:14) No, you could get on a, you could get on a trial. You could get called to grand jury. You could get just a day. It could be just one day. I’ve never had just one day. It’s usually been a week wow, the murder trials are pretty big. The criminal trials, they’re pretty big. Yeah, they usually last a week. If there’s a murder, you can guarantee you’re on it for a week at.
Jeff P. (03:38) Least, yeah.
Kelly Martinelli (03:41) Molestation, sometimes you’re on three or four days, that kind of stuff, but.
Kelly Martinelli (03:50) It’s also spring break here. So it could be why I’m mucking out… Kat’s, on now, yep.
Jeff P. (04:01) Good morning. Good.
Kat Rivera (04:02) Morning, Sonia. Must have not gotten the updated invite, so, I’m just going to forward her the meeting so she can jump on right?
Kelly Martinelli (04:09) Thanks. Kat.
Kat Rivera (04:10) You can bear with me a moment.
Kat Rivera (04:20) She should be on shortly.
Monica Garcia (04:23) Good morning. Good.
Kelly Martinelli (04:24) Morning. Good morning.
Kelly Martinelli (04:35) How’s it going? Scrub? Are you a scrub? I’m.
Monica Garcia (04:38) a scrub today? Yeah, they got them for the office. I was like, yeah, I’ll take one. I’m a scrub. It’s my Friday. So it’s all of our, I mean, it’s all of our Thursdays. So tomorrow’s our Friday and then I have a four day weekend because I’m off on Monday. So I’m just ready to.
Kat Rivera (04:56) Get the show on that’s not fair. Monica, that’s not fair. That’s not.
Kelly Martinelli (05:00) Fair because I still have jury duty. I still got to call in even on my day off.
Kat Rivera (05:04) On Friday, be careful, everyone in Texas, Kelly is trying to lock up people. Somebody’s going to jail.
Kelly Martinelli (05:10) That’s what I said. If I got to go to jail on my, if I got to go to jury duty on my day off, somebody’s going to jail.
Monica Garcia (05:16) I’m right there with you. I’ve done the same thing. I’m.
Kelly Martinelli (05:18) like, I don’t play, you ruin my day off. You’re going to jail?
Kat Rivera (05:23) They’re going.
Jeff P. (05:23) To be like ma’am, what do you do for a living? She’s like I’m in compliance. They’re like I’m dismissed.
Kat Rivera (05:29) Yeah. Right. Jeff, I send people to jail. She’s been, she’s been hard on that this whole week. Yeah, I.
Kelly Martinelli (05:37) have sent people. I sent a six team away for life. And then the poor Guy, I had to go to jury duty. It never fails. If I have a day off or a vacation, it never fails. I always do jury duty. So this happened before I had a whole week scheduled and it was years ago. So it was like in the early nineties or something like that where they didn’t let you off.
Kelly Martinelli (06:00) And so I just went, I think he’s guilty. I was like juror number 12. I’m like, I think he’s guilty. They’re like you’re dismissed? Hey, Sonya. All right. We’re going to go ahead and get started. We’re going to go ahead and get started. We’re going to give you some updates on the new providers. So I’m going to kind of just give you where we’re at with we’re going to give an update on the new ones.
Kat Rivera (06:28) So, you want me to start Kelly? Yeah, you can start. Okay. So as far as the new providers, we have two new providers that are coming on board that are already in the system. One is Amanda Reyes, and the other one is Christina machar, currently, right now, they’re starting for the month of may. They have been sent out the invites. Okay? One does practice in the state of Texas. The other one is coming transferring from the state of Florida to Texas. Okay? So Christina machar is the one that’s transferring over. She’s still in the state of getting her license done. She did send me an update on that. And then Amanda is in the phase of filling out her medallion information which she’s still pending a few items to get over to us. I have a question. Yes. So.
Kelly Martinelli (07:20) Once Christina gets her Texas license, will she also need to then get her Dea before you do?
Kat Rivera (07:24) Anything? Yes. So once they take the license, they will enroll for the Dea after, and it’ll take about three to five days for them to get that based on the, on that, based on the date that they submit it.
Kelly Martinelli (07:38) Okay.
Kat Rivera (07:42) Okay. And then once they do that, we request for them to fill out their medpro applications prior to that, so that we can have all that set and ready to go so that we won’t have any issues waiting for it. Unfortunately, with, locked in, the underwriting department has been looking into specific gaps, specific date ranges, question, the majority of the time. They’re questioning the out of state providers. So, anybody that’s transferring from Florida to Texas, they’re questioning more of their prior employment hours and prior employment gaps. So that’s what they’ve been looking forward, for. So we shouldn’t have an issue with Amanda, but we may have an issue with Christina. Okay. That’s where that is for the new providers. I did want to take the time today and discuss two things, for the follow up for the follow up, I generated one. I’m still waiting for them to get back to me to see, to see what, you know, what the outcome is with the updates for anything that was externally done on our end that Sonia, has put a tracking in for. So, I’m waiting to see how that, how that’s gonna work. So, I don’t have an update, Lindsay, how that’s going for us yet? Okay. The other thing is, we did have several tickets open. Maybe you can elaborate on, you know, the outcome of it because we still haven’t received it to, we, haven’t received an update, from them, you?
Lyndsey Farmer (09:22) Opened tickets with, yeah, as.
Kat Rivera (09:24) Far as the diploma, as far, yeah, as far as, that issue with the diploma that we were having, so the providers are putting in that they’re putting in their profile, but when it gets to upload their diploma setting, it’s it, they upload it, but it’s not being recognized. And then it’s being listed as a task for us to complete. That’s one. And then there’s a new issue. Well, I brought it up last week, but it keeps coming up. They’re asking when the, when we put in a provider and I’m going to utilize the example we send you on Ryan Foley. They, the, team, the medallion team put it in as a request for a medicaid plan and one we don’t do medicaid. So, we keep indicating that we don’t do medicaid, but they’re also mixing up the providers. So that’s why I sent that over. It was listed as Ryan Foley. And then in the body, it had Ronald Paris. So, I don’t know if it was, you know, a confusion or so. I just wanted to make sure. Okay, so, it wasn’t because of the, it wasn’t because of the prerequisites every time they send every provider that they’re getting, they’re looking at what is outstanding and they’re saying superior, well, care needs, prerequisites for medicaid protocol. And then I send back, we don’t do medicaid, please, you know, please disregard and close it. And then like two days later, they’re sending back the same request.
Kelly Martinelli (10:56) Okay. What is the timeframe that we should expect a response? Because we haven’t been getting responses.
Lyndsey Farmer (11:02) From support?
Lyndsey Farmer (11:05) That’s usually, three to five business days, but, should be sooner than that. So, I will follow up with, that team.
Kelly Martinelli (11:16) And how will we receive those updates should?
Lyndsey Farmer (11:19) Be via email.
Kat Rivera (11:22) Everything, and they do send it via email, yeah.
Lyndsey Farmer (11:24) Everything should be yep?
Kat Rivera (11:26) Yes. And they’ll be with their name and who did the task. So, whoever assigned the task to them will get the email back. Okay? My next thing is going to be the Lakeland ad currently right now, since we received the, licensure for that, we’ve updated the system with the documents and I’ll be submitting the address ads to them. Okay? So, basically confirming, I just noticed this morning that in the facility system… the facility mother file, the payers were not added to that file. So, I’m, going to add the payers that they actually have contracts with. So that cause it’s under the same tin number, different mpi numbers. So, the G tool, yeah, the mpi tools are different, but we still need to mimic that location contracts, to add. So, that’ll be going in today. Okay. Let me see what else we had. Okay?
Kat Rivera (12:38) I think that’s it on my book or I just really wanted to get some updates on our outstanding items that we, you know, we’ve been going.
Lyndsey Farmer (12:44) Back and forth go through.
Kelly Martinelli (12:46) Your outstanding items. And, yeah.
Lyndsey Farmer (12:48) And, I sent that email out to you guys in hopes that you would, send back.
Kat Rivera (12:55) What you were?
Lyndsey Farmer (12:56) Looking for updates specifically on, to give me time to prepare to have those updates during this call. So.
Kat Rivera (13:03) It was, it’s been the ones Lindsay that we’ve been addressing for a while. It’s the ones they gave you on this call. Yeah, that we gave you in the last two weeks or the last meeting, the last two meetings. So, you did answer one of them, the answer, one of them was, the, one of them was the, the reasoning behind, the listing that we had, which you answered back, and you told us how to go about externals, But the other ones, we haven’t gotten a response back on?
Lyndsey Farmer (13:37) Okay. So, on my list, all I have.
Lyndsey Farmer (13:46) Here was the Ryan Foley slash Paris, which we just talked about.
Kat Rivera (13:51) We just talked about,
Lyndsey Farmer (13:53) I have how to follow up or I’m sorry, how to enter follow ups in the platform, which it sounds like you ended that… provider mooch tasks are not showing for missing signature.
Kelly Martinelli (14:10) That’s Malk. Yeah.
Lyndsey Farmer (14:12) Malk, I’m sorry, that’s.
Kat Rivera (14:14) all right. That’s fine. And.
Lyndsey Farmer (14:17) then, we completed the training that was on the list.
Kat Rivera (14:24) So, let me go back to the training now that we’re bringing that up. Okay? So, I think that the training didn’t really go well, and, the items that were brought up on the training, was more of an audit. Excuse me, was more as an admin, view versus an auditor view. So, majority of our managers and our, billers and, authorization people will be on that audit view. So, we need to come up with or maybe create a sheet where, pertaining to what they’re going to be viewing, they’re only going to be viewing the payer listing and what’s active and the locations that they’re attached to. The rest of the features like socials and things like that. When we first started the implementation, we were directed not to have that populated, you know, due to privacy. So only admins will be able to view those type of features. So that was more what that’s that was more where I feel the team was a little confused on because majority of the stuff that was shown wasn’t really what we needed and we should have probably been a little bit more specific, you know, when you have requested, you know, the topics that you wanted to go over. So, we can, I can show any of our managers or any of that, of the admins, but like for Monica and Jeff, they need more, of that admin view. So, we, I’ve changed Monica’s, to admin, Jeff. Do you have, do you have view to admin or, are you an auditor?
Jeff P. (16:04) I don’t know. I don’t know off the top of my head.
Kat Rivera (16:05) To be honest, okay, I’ll go back and check because I think that majority maybe that’ll be more helpful, for you and Monica, since you’re the regionals, the managers, oh, yeah, yeah.
Jeff P. (16:15) The managers definitely need some.
Kat Rivera (16:17) I’m sorry. What did you say? Oh, definitely.
Jeff P. (16:19) Need some type of where I can look at their deas or pull their data?
Kat Rivera (16:22) Yeah, that’s what I think is much helpful. And then any questions that you and Monica have, you know, we can meet and we can go over it.
Monica Garcia (16:30) Courtney will need that access too.
Kat Rivera (16:33) I’m sorry, who else, Monica, Courtney?
Monica Garcia (16:36) Courtney?
Kat Rivera (16:36) Will need that access? Yeah, I certainly need three.
Kelly Martinelli (16:38) Regionals. I,
Kat Rivera (16:40) keep forgetting, Courtney just joined the team. So sorry. Okay. So then we’ll do that because eventually there’s an additional, there’s an additional component as well. Medallion when we went over and Lizzie, correct me if I’m wrong, but it wasn’t an import. It was a template that was given. And then all the information that was taken out of modio was entered into medallion. So Sonia and I have another project that we’re going to do to confirm that all locations and all active payers are reflecting into modio. Okay, excuse me into medallion from modio because modio is going to go away quickly from what Kelly and I have spoke about. So we’re going to be doing that within the next week or so so that we can make sure that every active enrollment reflects in the clinic side and also reflects in the facility side this morning. When I was, that… facility side does not have the active enrollment. But at the time that we did have the product, we only entered active… clinical enrollments. So the facilities, if they’re enrolled with the Aetna united, it’s not on there. So I’m going to go in and I’m going to, I’m going to put in that information because right now that project that we have with lakeline, I need them to specifically mimic Duval’s location because like I said, they’re both mother daughter accounts which are under the same tax, but two different mpi numbers. And I believe we go live with them on four six. All locations need to be added. That location needs to be added to the contract. And I started doing that today. So, but other than that, when I’m entering that information, Lindsay in the notes section, I’m also stating please, you know, please link address to contract Aetna on the tin number and mpi just to identify that for the team under the notes section. Are they going to view that? Because Naomi did say that they don’t look at notes. So will they see that note? Will they want to go in?
Lyndsey Farmer (19:05) It depends. I can put, I can send something over to them to see just to let them know there is no okay.
Kat Rivera (19:12) Can you please do that because I need to make sure, that they, you know, that there’s no hiccups in that project and also that medicare I’m going to list out, that medicare application for that is not going in because we’re doing that internally so they can do the follow up. So I’ll do it like you said, we’ll do, you know, group in turn, we’ll handle and then Medan will follow up. So, Lindsay.
Kelly Martinelli (19:40) I got a question for you. So if they don’t read notes in the system when we have something like this, that is extremely important, how do we communicate with your team? If they don’t read notes? I mean.
Lyndsey Farmer (19:50) If it has to do with something like that, you would have to come through me and then I could bring it to the team. Unfortunately, the team does not have client facing abilities.
Monica Garcia (20:03) Okay. Yeah. Are we going to be able to have? And this might be because we’re talking about the ptan numbers and all of that. Are we going to have the ability like in modio, Kelly? Where we won’t, we’ve.
Kat Rivera (20:16) lost all that.
Kelly Martinelli (20:17) Ability.
Kat Rivera (20:19) I know you’re going to ask… to see what clinic, huh? Can you elaborate Monica what the question is? So pretty much?
Monica Garcia (20:29) You know, how in modio, we’re able to see like the tax id, the ptan, everything’s tied to that one office. Everything like it’s very detailed on what is tied to that clinic because we have different tax id numbers and things of that nature. So it’s all tied to that. Are we going to lose that visibility or is that what you’re talking about?
Kat Rivera (20:52) You’re not going to lose the visibility. The problem is that you’re going to have to do when you go into the pair scene and we can do this offline. You’re going to have to go to the top of the piece and do the down drop, hit the down drop and it’s going to give you all of the locations. Now, you know, how we have to know too. And we have 15 locations. It’s going to be 15 locations, but you really have to look at the name because there’s a specific way you have to look at the name and it’s going to be in there and you’re going to see perfect. So if we go to who’s driving, Lindsay, you driving, Kelly’s, driving? Okay?
Monica Garcia (21:29) Thank you, Kelly.
Kat Rivera (21:30) So, Kelly, go to where it says, let’s do a humana. Let’s go to humana or blue cross, let.
Kelly Martinelli (21:35) Me make this bigger. Where do I go? Payer’s list go?
Kat Rivera (21:38) To hit medicare. No, I want to do it like let’s bring up a doctor and let’s do it that way. So, let’s bring dr mitrod, Ryan, mitrod. Okay. Let’s go to his payer’s. No, no. On the top. Yeah, payer’s and then go to enrollments. Okay? Now, let’s just go to the Aetna. Now click on Aetna for me please. Okay. So you see where it says here, central Texas pain institute. It’s not going to give you that seven four… unless you click into it and you’re going to show you that it’s seven four, but it will show you the, it will show you where it’s linked to. So click into pain specialist of new brunsford real quick. And you’re going to see the address, the tin number, excuse me, go down. It should have the tin number there somewhere.
Lyndsey Farmer (22:42) I can actually show you something that would be beneficial to you. Perfect… this is… an option, but it’s just a long.
Kat Rivera (22:57) We’ve requested a report. Yeah.
Lyndsey Farmer (23:00) I’m going to show you that. Okay. Are you able to see my screen? No, it.
Kat Rivera (23:06) Hasn’t come up yet. Okay?
Kelly Martinelli (23:09) So, let me.
Lyndsey Farmer (23:11) exit this out. Okay? So when you’re on this page, you can go right here to export payor enrollments… and then that is going to.
Lyndsey Farmer (23:31) You an email?
Lyndsey Farmer (23:37) I’ll give you one second while the email populates.
Lyndsey Farmer (24:00) Sorry, it’s going to take a minute because it’s a large file that’s downloading, but I think that this will be very beneficial to you and kind of hopefully what you’re looking for… but also while we’re waiting for that email, I also wanted to show you here in groups. You’re also able to see a quick view of like what providers are linked to, what group here?
Lyndsey Farmer (24:36) You just wanted to take a quick… thank you.
Kat Rivera (24:50) I think what we’re more looking for is that specific provider. So if Monica comes in, she’s looking for a provider, and then in modio, it automatically you go to healthpayer and it opens up all their things, all their, yeah. So, I think she’s looking more at an individual look versus a group look. This is more for like reporting on a weekly basis that we’re going to be sending to leadership, which is a good thing Kelly, for the report you were looking for, maybe this is something we can utilize.
Lyndsey Farmer (25:19) Sure. I know in one of the last calls that came up, it was, we were trying to figure out how we could quickly view what providers were associated with, what location.
Lyndsey Farmer (25:36) But yeah, if you want just an individual provider, you can do this.
Kelly Martinelli (25:39) That way we’ll show ptan and npi number. I mean, I know it says npi number. We’ll show the ptan and tax id number for each one.
Lyndsey Farmer (25:48) For the one I just showed you.
Monica Garcia (25:50) Yeah, it has the tax id number for you’re. Just going to have to know like Waco was a ctpc clinic.
Lyndsey Farmer (26:01) That makes sense.
Monica Garcia (26:01) Waco, was a ctpc, new braunfels, was a ctpc, Duval was a ctpi. So, if you don’t know those.
Lyndsey Farmer (26:10) Like what they?
Monica Garcia (26:12) Used to be, this is where it’s going to get confusing because not everybody knows like Georgetown was a ctpc, cedar park was ctpc… bastrop, is a ctpi?
Lyndsey Farmer (26:24) So, how do we fix that?
Kat Rivera (26:26) That’s what I’m just to give you an update. That was the old way.
Monica Garcia (26:31) Yeah, that was the old way before we.
Kat Rivera (26:32) Came under, that was the old way. Yeah. So that’s why these tax.
Monica Garcia (26:34) Numbers come in to be. Where, if you don’t know what the old office was originally linked to, then this is kind of like.
Kat Rivera (26:42) That was where you went exactly because you have to know which that’s how we did it. Yes, that’s how we could done to our providers if we know that, you know, and based on the contract, if that location, the providers going to those five locations, we were doing those five locations under whatever tin number they were going to be practicing at. But now, yeah, moving forward because of issues of coverage, the way that the prior manager in credentialing credentialed them was with the old providers, they were credentialed under across the board with, yeah, 15 locations each. And the plans will come back saying we don’t service this area. We don’t service this region. So, what happened now is we’re all providers under o two and seven, four across the board are being credentialed, they’re all 15 locations or 13 locations, whatever we have. So that’s how, so this is as per Angela, At the time and in modio?
Monica Garcia (27:35) This is already separated out. You didn’t need to know ctpi or CTP?
Kat Rivera (27:39) Exactly because it had the name you didn’t need. Yeah.
Monica Garcia (27:42) You didn’t need to figure.
Lyndsey Farmer (27:44) out.
Monica Garcia (27:48) Which location was an old, I?
Kat Rivera (27:49) Mean, I think it’s going to get a lot of you getting used to Monica because yeah, no, no, yeah, I’m just saying for me, I know the system is more detailed, you know? Yeah.
Monica Garcia (27:56) But if managers like aren’t newer managers, it’s that’s where it’s going to be. Yeah, where we may have to go back to just.
Kat Rivera (28:09) We may have to go back on printing out like the way Lindsay’s showing us printing out those sheets and giving them to each of your managers on that Monday, like we used to do before, yep, that’s what I was thinking.
Monica Garcia (28:18) Is having to go back to that un email of like these are, let me.
Lyndsey Farmer (28:24) show you this report because this may help you also. Okay. And you guys are able to pivot this out any?
Monica Garcia (28:35) Way that?
Lyndsey Farmer (28:37) You want it, so you can pivot it out by the payer by the npi by the tax id?
Kat Rivera (28:44) And then.
Lyndsey Farmer (28:45) it will show you what providers are under each tax id?
Lyndsey Farmer (28:56) This kind of the way that this report comes to you, is it’s pay or state group name, npi tax id, so forth. But you are able, you can take this report and pivot it any way you want to, but,
Kat Rivera (29:10) it will be, will this show pending? And will this show active or this is only for active?
Lyndsey Farmer (29:16) This is going to be, let me see.
Lyndsey Farmer (29:27) Under billing status. Yeah, these are all active. Okay? And is this?
Monica Garcia (29:34) The same report you downloaded that we were waiting for?
Lyndsey Farmer (29:37) Yep. Okay. Yep, this is the one. And then like I said, if you guys play with it, you can, I know that Jack and I were playing with it last week a little bit and you are, when you pivot it out however you guys want it, we were able to get the payers the tax id and then all the providers kind of listed. So you can do it. However makes sense to you guys, would you be?
Kat Rivera (30:07) Able to design it in a way to show the in process as well. So that when the two region, when the three regionals go in and they have a question, usually, you know, we will put in process in modio that they can just run a report and just get what’s in process. If they want to do that as well to see the, I can.
Lyndsey Farmer (30:29) Try that would have to be a tech ticket to be taken back to our tech team. So I can put the feedback request in. I can’t guarantee that it’s something that.
Kat Rivera (30:38) would be, do you agree to something like that? Or do you, would you like her to do that to go back and see if we can get a report that would show in process versus?
Kat Rivera (31:04) What? I’m sorry, I was texting it’s. Okay. Would you, she was emailing me? Would you agree to have a report that shows in process? So that all three regionals will be able maybe on a weekly basis to, okay? Because we don’t have that we only have an active status and they’ll have to, sometimes they’re very busy and they can’t go back to look at, you know, each line item. Maybe they can pull something on their end that they can share with their staff on what’s you know, on what’s active, and what’s in process? If they can do something like that, don’t know, but Lindsey says she’ll look into it for us. Yeah. And I just.
Lyndsey Farmer (31:39) Looked into right here too. I’m going to have to wait again for that email to populate. But in the enrollment requests, you also have a download button that you can export. So I’m looking to see if this has, what you’re looking for.
Kat Rivera (31:54) Got it.
Kat Rivera (32:00) But.
Lyndsey Farmer (32:00) again, it’s a large report.
Kat Rivera (32:39) Another call to jump to too. Yeah, I think, I know what your call is about. I just saw an email not from Doug but from somebody else. I know, right? I do have something else, but Kelly, I can catch up with you on it. It’s about dme and how we’re going to record it in medallion. So I can circle back with you. Can you, before?
Lyndsey Farmer (32:56) Lindsey?
Kat Rivera (32:57) Gets off the call. Can you ask her what’s the best way before we jump on? Okay, thank you. So, Lindsey… my question, we have a dme, we have a dme, we’re… doing now, we’re going into dme. So we have a listing of basically the approvals, the approval letters, any demographic we want to separate it from the actual medicare to medicare, dme, in the system. When I tried to test, it wasn’t letting me do it. So I would have to do medicare and then I would have to put dme under the category that’s optional. And then put in the number under the id provider id. We will put the number in there. Is there any way that you guys document dme? Or can we, you know, when you put Texas? And then you put the, can we put like medicare dme in there and make that a category?
Lyndsey Farmer (34:00) I can check with my team to see I have not had any dealing specifically with dme, in this model. So, I’m not 100 percent sure. I think it’s based on state. So when you put in medicare, it’s looking for a state and when you put in dme, it’s not recognizing that because it’s state specific.
Kat Rivera (34:22) So, I have to put in actually, you know, it says optional. I mean, I named it medicare dme, and that was the only way that it would, you know, that it would save it.
Lyndsey Farmer (34:32) Yep. And.
Kat Rivera (34:32) that’s what we’re going to have to do, but, yeah, I think that that’s probably the.
Lyndsey Farmer (34:38) Way, because it’s set up state specific. That when you put in something other than a state abbreviation, it’s not going to recognize that. I can take it back and just be sure and follow up with you guys. But, I don’t believe that it’s going to recognize it in that particular way.
Kat Rivera (34:58) Okay. If you can, if you can just see if there’s anything that we can do now also, I know you said that we couldn’t do, I’m not too sure because I wasn’t in the meeting that you guys had, but we’re having, we’re going to have a big issue with the plan listing, not the name of it, but, you know, the filter where it says medicare. So we used to identify it because like blue cross blue shield, the Texas has like choice essentials, you know, bronze, whatever they have and our madaket, our managers are used to our regionals are used to looking at that because that’s, how modio had it broken down? Would there be any option which I think the answer is no, is there any way to do a filter or to do naming convention, something unfortunately?
Lyndsey Farmer (35:47) Our system is not set up that way, that is more, geared towards scheduling and medallion does not handle any type of scheduling. So we do not offer it to be broken down in that particular way. And there’s no plans right now for us.
Kat Rivera (36:05) To, for myself and, Sonia, we’re going to have to meet and just meet and mess with the system to see how we’re going to generate those product lines. Because like our ipas, literally, that’s another issue that I’m not an issue, but it’s a little bit hard. So, we get requests, let’s just say from the medallion team saying ascension health, right? Let’s say ascension. I’m just saying health, and under the ascension health, we got cigna. We have, when we originally started this project, I broke out the, I broke out.
Lyndsey Farmer (36:40) Ascension health.
Kat Rivera (36:42) But then, I was also breaking it out by product and I was told not to do that because you guys don’t identify it as that you guys identify it as one name. How are we going to determine when I, when there’s a provider that has the cigna line of business that’s not a direct.
SoniaFigueroa (37:00) How are we going?
Kat Rivera (37:01) To identify that you?
SoniaFigueroa (37:04) Know.
Kat Rivera (37:04) To match that provider saying dr X has cigna under ascension… and dr X has, you know, apn, well, that’s the.
SoniaFigueroa (37:14) Thing, it’s an ipa that has like, you know, so we.
Kat Rivera (37:19) can’t we can’t list it, as 14 different contracts. We have to list it as ascension and that the notes section is not going to help. So you can probably go back and I know you’ve been looking into it but it’s really going to be.
SoniaFigueroa (37:32) When we go and,
Kat Rivera (37:33) we start checking and comparing who has what?
SoniaFigueroa (37:37) The lines of.
Kat Rivera (37:38) Business, it’s going to be an issue for us, to,
SoniaFigueroa (37:42) know.
Kat Rivera (37:42) You know what I mean? Like, to… make sure that, it, it’s mimicked correctly. So, my issue is that’s my biggest issue. And, and I’m going to be honest with you. Nobody’s going to know to go in the notes section. And Sonia and I can’t go into each ascension and put in like 30 notes in there saying that they have this, they have this plan because they’re going to be like, oh, you know what I mean? They’re not going to know to go to ascension to do that. So, if there’s a way that you can, maybe I.
SoniaFigueroa (38:13) don’t know work?
Kat Rivera (38:14) Around or?
Lyndsey Farmer (38:17) Take it back. That’s the biggest issue.
Kat Rivera (38:18) And I’m going to tell you right now, the regional managers are going to come back with, this is too time consuming.
SoniaFigueroa (38:25) I yeah.
Lyndsey Farmer (38:26) I understand that completely. I just, and I can take it back again, but there is.
SoniaFigueroa (38:36) I’m sorry?
Lyndsey Farmer (38:36) For whatever happened in the past and what you may or may not have been told previously, but we just don’t well, we wasn’t.
Kat Rivera (38:42) included in those, I was not included in the implementation. Yeah, I’m VP before Kelly. So, yeah, I.
Lyndsey Farmer (38:50) can I will take it back again? But as of.
SoniaFigueroa (38:54) right now, the.
Kat Rivera (38:56) note section, if it’s going to be that we have to use this note section and that’s our only option, the characters of the note section, is it ongoing or is a specific amount of characters that it will take? Because sometimes note sections have character?
Lyndsey Farmer (39:11) Yeah, limits number.
Kat Rivera (39:12) Assigned.
Lyndsey Farmer (39:13) yeah, I believe it’s unlimited. But if it’s not, if it does stop you, we, that’s an easy fix, we can get a character limit. We can get that to be extension, yeah, sorry.
Kat Rivera (39:26) Okay. That’s something Sonia will look into. Maybe we can test it on Thursday. We can look into it because we’re going to be actively working in the medallion portal, the platform from Monday on because we have to make sure that our old providers have, you know, what they need and it mimics, right? So that we can start utilizing this actively and move away from modio. Okay? Next thing, the next small project is going to be, we have providers that were.
SoniaFigueroa (39:57) not included.
Kat Rivera (39:58) In specific contracts or have no location, and we need to add them onto those contracts. This will probably be in the next, you know, two or three weeks that’s going to be another excuse me project that Sonia and I will be working.
SoniaFigueroa (40:16) We will.
Kat Rivera (40:17) enter those as tasks.
SoniaFigueroa (40:18) As well and say,
Kat Rivera (40:22) medallion will take over this to please add. Will that affect our will?
SoniaFigueroa (40:28) That.
Kat Rivera (40:29) affect our task numbers… because I know that we have a specific in the contract. I would think that we have a specific amount of numbers that we could do based on the amount of providers we have not that it matters, but they said also that it goes into the next tier, you know, that we can borrow from the next year or whatever. Yeah, if that’s the case, will we?
SoniaFigueroa (40:53) Be able to purchase?
Lyndsey Farmer (40:55) Like that?
Kat Rivera (40:57) Limit, will we be able to purchase more or it’s just going to keep dragging into the following year because I’m going to tell you it’s going to go into the following year based on the contracts. We have 42 to 50 contracts.
SoniaFigueroa (41:09) That is a,
Lyndsey Farmer (41:10) question for Jack. He’s your account manager?
Kat Rivera (41:12) Okay. So I’ll take it to Kelly and then Kelly could, yep, yep, Jack will.
Lyndsey Farmer (41:16) Answer any contract questions, additional purchases, things like that. I just don’t have any knowledge on exactly how that works.
SoniaFigueroa (41:25) Okay.
Kat Rivera (41:27) Okay. And my… last question is going back to the ipas that’s my biggest concern.
Lyndsey Farmer (41:34) So the.
Kat Rivera (41:35) ipas, when they have, oh… now, I want you to speak more to this because you do it in and out. I don’t the MD applications?
SoniaFigueroa (41:49) We have a new provider. We do the ipas?
Kat Rivera (41:54) And it requires for them to like put in an initial request for MD application. And then it goes and that’s just to request them to join the network?
Kat Rivera (42:04) Sonia, those are done electronically, correct? Well, the,
SoniaFigueroa (42:09) thing is with the ipas, is you have to submit it through their link and then,
Lyndsey Farmer (42:15) one.
SoniaFigueroa (42:17) That’s just to begin the credentialing, then they send you a link to complete an MD application?
SoniaFigueroa (42:25) So that we have to upload all their information in there. And then that’s how they process for their continuous credentialing. There’s no MD app that has to be completed that they sent over to us. So I don’t know how that can be put into the in medallion so, that can be taken care of or would that be something that we would have to continue doing?
Lyndsey Farmer (42:54) Are you okay? So it’s a two part. So you, it’s a two part? Yeah. Okay. Yeah, we have a lot of those, some payers, not even ipa some payers have a two part? So that’s something that can be updated within the project plan?
SoniaFigueroa (43:09) So we can, and then they would, and then medallion would go ahead and take care of that MD app, correct? Yes, we.
Lyndsey Farmer (43:16) would put that. We would put the instructions in the project plan that it’s a two part. You’re going to fill out this particular piece first. Then you’re going to wait, you’re going to get an email link and you click the link and then finish the process.
Kat Rivera (43:29) Gotcha. Yep. Okay.
SoniaFigueroa (43:32) That’s fine. Thank.
Kat Rivera (43:34) You. Yeah, you’re welcome. I don’t have any, anything else other than, you know, if you could come back with the updates, you know, and I always tell you if you can get it as soon as possible, I know that you have to do your research but other than that, I don’t see any other outstanding tasks other than you can let them know that I’ll be adding in those locations ads to go out.
Lyndsey Farmer (43:57) Yep. I will take that.
Kat Rivera (43:58) That’ll be done today. And then… you also.
SoniaFigueroa (44:03) fixed the issue where they’re asking for the professional degree.
Kat Rivera (44:07) Instead of, yeah, she’s looking into that was, I think that, yeah. Okay. She’s looking into that. I’m thinking if there was anything else, did I miss anything Sonia?
SoniaFigueroa (44:20) Not that I’m aware of right now, I think you.
Kat Rivera (44:23) Oh, did we ever find out why the, when a provider is invited? I know that was one of my questions but we just stuck with as long as they’re at 85 percent, we can move forward, but did we ever find out why when a provider gets at 100 percent and then we submit the request, it comes back to us kicking it, saying provider at 77 percent. Did we ever find out why that was kicking back?
SoniaFigueroa (44:52) The.
Lyndsey Farmer (44:52) percentage is going to constantly change depending on what is outstanding for that provider. So it could be at 100 percent right this minute. But if something gets tasked out to you, it’s going to drop. I think you did.
Kat Rivera (45:04) Answer that before. Yes. I do remember us talking about that. You did, I don’t have any questions right now and don’t I don’t have a lot of questions. Yeah.
Lyndsey Farmer (45:12) Don’t worry about that fluctuation depending on.
Kat Rivera (45:14) What’s needed?
SoniaFigueroa (45:15) Yes.
Kat Rivera (45:15) Yep.
Lyndsey Farmer (45:16) Yeah, it’s going to constantly fluctuate depending on if a license is expiring or caqh or anything like that. It’s going to constantly go up and down. So, yeah, please just keep an eye on it. If there’s anything that doesn’t look right? Or it’s asking you for something that’s not needed or something like that. Just let me know. But otherwise, it’s just because of something that’s outstanding for that provider that’s been tasked out.
SoniaFigueroa (45:44) We have a new.
Kat Rivera (45:44) provider that we invite and let’s say the email is incorrect. Let’s say we did a mistake on the email or the provider says they never received the invite. Is there? I noticed one that we had a provider like that and I tried to send the invite out again. It wouldn’t let me resend the invite?
SoniaFigueroa (46:04) Okay.
Kat Rivera (46:05) It wouldn’t let me resend the invite and it would, and, for the ones that were like gmails when we first started, and we tried to update them, we updated it but it was still going to their Gmail. So, that was, and I believe you fixed it. It was, it was chica, and I know you fixed it because that was one of the ones that we had to do a double entry for. Yeah, because Naomi told us do a, you know, submit it again with the right one. So we did that, but then it didn’t capture the enrollments.
SoniaFigueroa (46:41) Okay.
Kat Rivera (46:42) So that email it should have.
Lyndsey Farmer (46:44) Now, I think I got that fixed.
Kat Rivera (46:46) Okay, perfect. Okay. Yes, please take a.
Lyndsey Farmer (46:49) Look at it and make sure everything is there.
Kat Rivera (46:51) Yeah, that’s what I wanted to. Yes.
Lyndsey Farmer (46:53) But I believe I got that all fixed. We took that back to our tech team. We had them actually do the whole transition. So, okay, hopefully, it’s right? Because it, no, that’s fine. Was people that actually knew what they were doing?
Kat Rivera (47:07) That’s just a, that comes with the territory. When you get a new software. Yeah, that’s a nice, just one thing, I would like if you can elaborate with the team that we do not take anything medicaid. Okay? That they don’t have to send a request that they need the enrollment done due to medicaid because we only practice medicare.
SoniaFigueroa (47:26) Okay. Oh.
Kat Rivera (47:26) I think Jeff has a question. Sorry, Jeff, I didn’t see your hand up.
Jeff P. (47:29) No, that’s okay. It’s actually a, I have two questions. The first one’s a two part question. I think they’re both for you. Kat, the first one is regarding something you said in the very beginning. You said that we’re credentialing two new providers, MDS. I assume, yes, do we have an, do we have an estimated start date for those providers? And do we know what locations we’re credentialing?
Kat Rivera (47:49) Them at. So, for Christina, I have to go back to the Doug email. I can forward you the email to let you know. But Christina’s not going to another year location. She’s going to. I believe she’s going to Monica’s location, but they’re both starting in may. They’re both starting in may. Got it. Yes, they’re both starting in may. I can give you the update. I’ll send you the emails out. And if you have any questions from there, then I guess we can, you know, get together if you want.
Jeff P. (48:17) Yeah. No, I’m just curious start dates and location dates.
Kat Rivera (48:19) Yeah, the start dates. I know it’s may they didn’t give me a specific start date, but hold on a second. I can check onboarding really quick.
Monica Garcia (48:27) Okay. Yeah. Will you? Because I thought.
Kat Rivera (48:29) Those.
Monica Garcia (48:30) start dates were going to be.
Kat Rivera (48:34) It changed. Hold on one second. I think it.
Monica Garcia (48:35) Changed because I thought Mashad, Christina was going to start like.
SoniaFigueroa (48:41) July… you know what?
Kat Rivera (48:44) You know what? Monica, you’re right? You’re right about that. Yeah, July. So, like September, I always call Sonia and myself may because we always have to be ahead of the ballgame, but hold on a second. Okay. I think you’re right?
Monica Garcia (48:56) And I think Reyes was going to start like August because she was finishing fellow at the end of July. I could be wrong. I could be wrong.
Kat Rivera (49:05) No, that sounds about.
SoniaFigueroa (49:06) Right. I’m looking at the email that.
Kat Rivera (49:08) Doug sent?
SoniaFigueroa (49:14) Over for Amanda. She’s looking to start… September first?
Kat Rivera (49:20) Okay. So September because I know she’s finishing July and then August, she’s completing her program.
SoniaFigueroa (49:26) Yeah. And July 30 first?
Kat Rivera (49:28) She has to start before that. So may, okay. Yeah. And then Mashad, I’m thinking July. Yeah, that was right. Yeah. July, that was right. July and yeah second.
Jeff P. (49:41) Question do we have? Did we get dr parris’ ptan, dr parris’?
Kat Rivera (49:48) Ptan, I wanted to explain that to you. I don’t think that we need to jump on this call, Jeff about it, but we can, but I don’t want to keep Lindsay on the line but I’ll let you know what happened with that to recall. Dr Parris was a locums, he was supposed to be starting in December and they jumped them to November. So when you’re doing a locums on the 60 day bracket, you cannot submit any enrollments for that provider because the payers will kick back. So we did submit some for him and medicare was one of them we submitted and it kicks back saying that he was rejected due to signature because we could not submit that for him at the time the enrollment originally went in January because remember he finished.
Jeff P. (50:32) his.
Kat Rivera (50:32) locums, January seventeenth and January eighteenth and started his permanent Ea. So at the time it went in, when it went in, there was a malpractice case on him that wasn’t reported. If you remember, we had an issue with the Coi. So that takes place. And then the E signature was already sent in and submitted. Now they will retro back from the date of submission. So they will retro back. He’s a known provider in Texas. So we have to do it 855 R on that provider. Okay? And that’s what? And that’s what was upholding it. So the rep, I sent Sonia the day that you guys were all three were meeting. I sent Sonia on March tenth. The rep did reach out to me and told me that they were going to be in process, but she was already doing that. So that was a component of the 60 days that wasn’t discussed in the meeting because Sonia wasn’t given enough time to research the matter. We have a large two projects that we’re working on which was the ortho project and the crna project, and we’re specifically assigned to specific tasks. So that’s why it wasn’t given a clear explanation. So I understand you were coming from with, why was it taking so long? But that was left and.
Jeff P. (51:45) My, my, and my concerns not regarding medicare because I know we can retrograde that and pay it back. My, my concern is how does this affect his tricare credentialing timeline?
Kat Rivera (51:55) So, tricare timeline, he’s an active provider in, he’s an active provider in tricare because he’s already known to Texas. Remember, he had his own practice for 30 years. Yeah. So what happens is, once we go and we submit because it was submitted, there’s no, and I know you’re gonna probably disagree with me but tricare is up to 120 days. They are not gonna budge if they’re in that timeline.
Kat Rivera (52:19) Unfortunately, they’re government and they’re not gonna budge. So if he’s within that time frame, if he has medicare, if he doesn’t have medicare, it’s not gonna affect him.
Jeff P. (52:28) Okay. But they’re not gonna.
Kat Rivera (52:29) Process him until they decide that, you know, that time crunch is met and they’re still in the line and I think Sonya gave that update if I was.
Jeff P. (52:36) Yeah, yeah. I mean, it’s coming. We got, we got probably about another two weeks, two weeks.
Kat Rivera (52:43) Okay. So then what we’ll do is in availity, we have an option to go and, you know, chat with them, and confirm and just to let you know when the blue cross is done, that automatically goes over, to triwest and then tricare because the contracts were merged together. So, they all will be together. So the tricare and the triwest will be at the.
Jeff P. (53:07) Same time. So, my understanding is the blue cross is already done and we’re about two weeks out from the 120 days.
Kat Rivera (53:12) Okay. So I will confirm that, and I want to let you guys know as well. Please do not count the weekends because I do not count the weekends.
Jeff P. (53:19) Okay. So we’ll say, so we’ll say three, we’ll say three and a half weeks, yes.
Kat Rivera (53:23) Okay. So let’s just, keep it to that time frame because we go back to them saying that. And then they’re like, no, we got, you know, they will literally say, don’t call me back till this day, well, my.
Jeff P. (53:34) Understanding, well, like what we experienced with dr Mashad and ajaz, who were all in tricare before they got done a lot quicker because they were previously in, it was my understanding, yes.
Kat Rivera (53:44) That’s right. And that’s what?
Jeff P. (53:46) That’s.
Kat Rivera (53:47) what should take place with tricare? But since they merged, Jeff, you know, that, it’s been chaotic, and they don’t want to mention that too. Yeah. So, and they don’t backbill, so I wouldn’t the only ones that are back.
Jeff P. (54:01) No, I’m.
Kat Rivera (54:02) going to go there, we.
Jeff P. (54:03) We, it’s to because dr Paris comes back next week and dr Lowe is not going back there. So we got to figure out what to do with all these tricare patients. So that’s why my concern is not necessarily medicare ptan, I’m just concerned it’s how is this going to, if this?
Kat Rivera (54:17) Will affect you? I’ll check for you. I’ll check for you and I’ll give you an update where they are with that. So give me until you, please give me until tomorrow, I’m going to put it on my calendar, yeah, but I’ll give you.
Jeff P. (54:26) I’ll give you until Friday because he comes back Monday. Well.
SoniaFigueroa (54:31) We don’t work Friday, Jeff, I know unless you’re working.
Kat Rivera (54:34) tomorrow, Jeff, I need a day off all.
Jeff P. (54:36) Right. All right.
Kat Rivera (54:39) All right. Well, I got to drop. So I’ll talk to y’all, later. You’ll get it back tomorrow, okay?
Jeff P. (54:42) Thanks. And.
Kat Rivera (54:43) Anything on Lindsay’s radar guys that you guys still have questions on?
Kat Rivera (54:48) No, I have to drop. Sorry, thank y’all, Monica. Are you good, Courtney? I think that was really cool. So, Lindsay, I have something else for you.
Lyndsey Farmer (54:58) Okay. I did just want to tell you that report did come through. Okay? So, if you guys want to play around with that one as well, it might be beneficial because as I’m looking at it, these are all of your in process ones.
Kat Rivera (55:15) Okay. Oh, cool. So that’s perfect.
SoniaFigueroa (55:19) Okay. So, it’s.
Kat Rivera (55:20) from the screen, right? So.
SoniaFigueroa (55:22) Where can we find the report that you did? Yeah. So.
Lyndsey Farmer (55:26) Let me show you quickly what I’m looking at here?
SoniaFigueroa (55:33) Okay. So.
Lyndsey Farmer (55:34) This is in your view. Okay? So when you come here to payers, you’re going to go to enrollment requests and then you’re going to go to this export right here, click it, and then it’s going to send you an email, and then you’re going to click the link in the email and it’s going to bring up.
SoniaFigueroa (55:58) And then we can filter it however.
Lyndsey Farmer (56:00) And then you can filter it or pivot it or however makes sense for you guys?
SoniaFigueroa (56:07) Do we have to save this or would this not change anything if we?
Lyndsey Farmer (56:13) Not going to change directly? Okay? It’s not going to change anything on our end. So that’s your report that’s open for you. So you guys can do what you want with that. And then just the other report that’s going to show you everything under tax ids and all that is going to be under the enrollment tab. And,
SoniaFigueroa (56:30) right here. Okay. That’s the one.
Lyndsey Farmer (56:34) that you’re going to be able to break out based on tin provider and payr?
Kat Rivera (56:39) Perfect.
Lyndsey Farmer (56:41) Perfect.
SoniaFigueroa (56:43) So, I think that might.
Lyndsey Farmer (56:44) be helpful. Unfortunately, it’s not going to give you product line that. I know that that’s a big thing and I’m going to take it back again and see if there’s anything. But at least that will give you kind of a quick printable… version that I know you guys were concerned about the front desk and, yeah.
Kat Rivera (57:07) It’s only because it’s only because I’m going to be very honest, the team, the regional team and the management team, they, you know, they don’t they have everything happening so much at the front desk, you know, how it is and they don’t they’re going to what’s going to happen is that it’s going to come back to us to find out what the plan is. And then we’re going to have to create probably like a ticket system for me and Sonia because it’s just going to be more.
SoniaFigueroa (57:33) Usually.
Kat Rivera (57:33) We are asked, we’re asked to do the medallion system. But if I’m sorry, not medallion modio, if medallion doesn’t hold anything to show those lines of business. We’re going to have to create a ticket business because we’re going to be getting a flux of calls on a daily basis and we have a lot of projects and we’re growing so fast that we one, we don’t have time and two, we would need to make time and that’s something that, you know, we’re trying to smooth out the process, not make it worse. So, you know, that’s where we’re coming from with that. So we’ll work on it, see how it goes and come back to the table if it doesn’t but it’s something that, you know, we’ll have to work out perfect.
Lyndsey Farmer (58:14) And play around with those reports. Let me know. Yeah, let me know if those kind of suffice what you’re looking for as far as the tins and all that. Yeah, the.
Kat Rivera (58:23) system’s user friendly. It’s just that like I said, there’s a lot of components in there that we haven’t really like messed with yet. And so we need to go ahead and do that. So, we’re going to do that next week. When we come back, we’ll do that, and then we’ll the next meeting’s in two weeks, right? In another week, was it?
Lyndsey Farmer (58:39) Every week? Yes? Yep?
Kat Rivera (58:40) Okay. So then we’ll have an update for you on the next meeting. Okay? Perfect. And then I.
Lyndsey Farmer (58:46) will send out the agenda a couple days before the call. Yes. So whatever you guys want to discuss on the call, just put on the agenda and that will give me some time to look at and.
Kat Rivera (58:56) What I’ll do is I’ll send out an email to the managers and the regionals on what exactly they want, so that if they have questions on what they want to view, I can bring it back to you and put it on that list as well. Okay? It can just be streamlined.
Lyndsey Farmer (59:12) Perfect. Okay. Thank you so much. I appreciate you guys. Thank you. Have a good one.
Kat Rivera (59:18) Bye you too. Bye.