Transcript
DANA MANNS (00:00) hello, Rheta. Hi.
Rheta Larson (00:02) There. How are y’all doing today?
DANA MANNS (00:05) Good. How are you?
Rheta Larson (00:07) I’m well, thank you for asking, good.
DANA MANNS (00:11) Thank.
Rheta Larson (00:11) you also for being flexible and moving our scheduled sync today. I appreciate y’all’s flexibility.
DANA MANNS (00:19) Not a problem. Not a problem. I want to take a minute just to introduce the new member to our team, newest member to our team, Yolanda, Clark, who is the credentialing coordinator, and we’re so happy that she is in this role. We finally have this role filled. And I think that this is definitely going to help us having a dedicated person in the role to fill some of the gaps, make sure information is being passed on to medallion updated in medallion. So a critical role, and we’re glad to have her on board. So she will be working very closely with you Rheta, and let me take a step back and ask again just for Yolanda’s purpose as well, pronounce your first name because for some reason, I always think I’m pronouncing it incorrectly.
Rheta Larson (01:25) Yeah, no, you’re good. It’s a hard one, but it’s. Rheta. Yeah, like la Rheta, but without the la.
DANA MANNS (01:32) Got it. That’s a good way to put it. That’s a good way to put it. Yes, it is… nice to meet you, Rheta. Yeah, nice to.
Rheta Larson (01:42) Meet you as well. Thanks for sharing a little bit about the role in the background. We can definitely kick this off with kind of just some quick intros.
Rheta Larson (01:50) Yolanda. I can give you some quick background. But as Dana was mentioning, my name is Rheta. I’m one of the engagement managers with medallion. I’ve been with the organization for a little over five years now and my background came from the licensing operations world. So I transitioned over to this side with Hamilton. Oh, gosh. It’s been a while now, but I think we’ve been having internal sync since around December January timeframe. Yes, great. Yeah. So I went through the implementation with them and the handoff with our implementation manager, Naomi, we’re now in a steady state where we have weekly biweekly monthly syncs operationally. And really right now what we have set up for Hamilton is weekly syncs. This space is dedicated for 30 minutes for Hamilton and medallion to kind of cross collaborate and ensure that requests are moving as they’re supposed to. And then just any additional operational items y’all would like to chat through. I work directly with the teams and kind of take this information back if I’m not able to answer them immediately in our syncs. But I do add the agenda to our attached calendar invite. So my suggestion for everyone on these ends is if you do have a burning question that can be withheld until our next sync, add it to the agenda and I’ll take a peek at them prior to us hopping in and then try and get it resolved for you so we can chat on it live. But yeah, that’s really a little bit about my background. I’m also located in Austin Texas. So I’m Central Time if y’all do need to schedule anything ad hoc that’s the only thing is just playing with everyone’s time zones can get complicated. So we’ll send out a few time slots.
DANA MANNS (03:50) Rheta, if you don’t mind, because I want to make sure that Yolanda gets to spend most of this time with you to just, I think I mentioned to you about going through providing an overview. I think that her taking the time with you to go through that will help identify some questions or just make sure that she has a good understanding as far as how to navigate in the system and things like that. But before, because I’m not going to stay on, I’m going to jump off, but I want to ask if you were able to identify if dentists are, if medallion credentials, dentists with the medical on the medical side?
Rheta Larson (04:39) Yes, I have that question out to the team and I believe it is a, yes, I just want to get final confirmation, but yes, from my understanding, we do offer the credentialing for profession dentists.
DANA MANNS (04:53) Okay. I.
Rheta Larson (04:55) will close the loop with you via email as well, just so we can cross that off our list.
DANA MANNS (04:59) That would be great because then that will give us an opportunity to, get the particular dentist that we are needing to have credential loaded in the system, and then start that process because I don’t think that dentist is actually in the system. So I will verify that once you close the loop and then we’ll start the process. The last thing before I get off is in relation to enrollment.
DANA MANNS (05:34) Facility enrollment. So we’re getting ready to open a new site location and we haven’t started any applications. So if you can make sure that you touch base with Yolanda on facility enrollment, fqhc enrollment for medicare and medicaid? You know, I know you went over it with us as far as what is required, what we need to put in the notes, but I want to make sure that we start that process at least next week in getting the new facility enrolled with medicare first. And then with medicaid.
Rheta Larson (06:18) Okay. Gotcha. Okay. And is every single provider that is on platform going through that as well? Are y’all doing provider requests for these also, or is it just the facility and all for the new site location?
DANA MANNS (06:37) It’s provider and facility. So we have some, we haven’t hired any new providers, but we’re in that process of acquiring providers. So when Lisa gets a provider identified and a contract signed, then we know, you know, to go through that process of loading them into the system to start enrollment or credentialing for those providers. Okay?
Rheta Larson (07:05) And y’all, haven’t, added the facility yet to the platform?
DANA MANNS (07:09) No.
Rheta Larson (07:10) Okay. Gotcha. All right. I will definitely take note of that, and we can, if we don’t have enough time today, I can definitely circle back on our next scene, but, we can walk through that as well.
DANA MANNS (07:20) Okay. All right.
Rheta Larson (07:23) Any other lingering agenda items before we kind of take it here for admin training? Okay… perfect. Well, with that said, I can kind of hop right into it and I kind of just want to start at least on the member side, Yolanda, you’ve already been invited to the platform, correct?
DANA MANNS (07:46) Yes. Okay.
Rheta Larson (07:47) And I’m under the impression you have admin access, is that also correct? No, yes. Oh, yeah, you do.
DANA MANNS (07:58) Okay, great. So.
Rheta Larson (08:00) The difference at least what I’m showing right here, I’m actually in the medallion profile, but I’ll back it all the way up. So we can kind of show you like the platform in general, how the profiles exist and then requests. Hi, Dana. Thank you. So at least what I’m showing right here is the organization members. You are invited as an administrator for the Hamilton community health network group in medallion. So that gives you the ability to see in mass just any provider profile, any of the requests, anything that you need to narrow in on. You should have the ability to review without having to ask the provider for too much details. But really the purpose of the platform is for us to work the service request lines with you all in tandem with the providers. So we’ll kind of start there with the provider profiles. At least for Hamilton, you’ll have a subset of provider professions and provider types. If you go to the providers tab here, you can kind of see the directory tied to Hamilton community. This is going to be every provider that’s been onboarded to medallion. And by onboarded, I mean, invited. So the admins at Hamilton has sent a request out saying, hey, you’ve been invited to medallion. Here are the next steps to get your profile started. I’ll just pick someone that has a green checkmark because this is going to indicate to me that their profile is pretty completed or up to speed with like the most recent requests. But let’s see… let me hop into one as an example. So I’m just pulling this physician assistant Persis, this is narrowing into this specific provider’s profile. So the first thing here is this provider, it will show their first and last name, their profession type. And then the email tied to their invite. This tends to get a little tricky when y’all are inviting providers for the first time. So if y’all are inviting anyone new, we’ll always send the invite out tied to what the account holds. So like just make sure the providers are aware of that. This is kind of like their primary email. This is going to be like the meat of their medallion profile. It is their full medallion info, which is going to be like a repository of their basic info, employment history. Anything you can think of certifications, it’s gonna be a list of their education history. All of this is required for any application requirements. We will tend to collect this information upfront before we even start a request. So that way when we hit the ground running with application submissions, we don’t run into any issues. So the goal and threshold here is to get the profile up. To at least 100 percent at a maximum, but I think on the minimum to start, some of the enrollment requests or licensure requests would be around the 80 percent threshold. There might be some nuance there depending on the provider, but we can chat through those as well. But the goal is to get this as filled up as possible. But each one of these tabs will represent something different. So if you have a provider who’s asking like, hey, like my address is wrong or my contact information is wrong, you can find that in the basic information section, you’ll be able to see all of the relevant info tied to this clinician here. As they work the profile. There’s a next button and it will naturally just take them to the next section which this is going to be professional info. So where they went to undergrad medical school, residency training, all of that will be listed in this area as well as any employment information… primarily y’all’s providers who are working with Hamilton will have the information referenced here. And then any other substantial employers should be listed depending on like what requests y’all have tied to them. Professional history. This is going to be education. Sorry professional will be employment. Professional history will include education. So like medical school, associates, undergrad, all of that will be listed here, training, like I mentioned, work history, hospital, affiliates, military service license. It’s full of everything anything you can think of that an application will have, it will be referenced here. And this is what prompts the provider to go in and add each time… certification. So if they are board certified in something, we need that info. It allows you all to add certifications here into platform. You can edit things by going to the far right editing and then just filling out the necessary information. You can upload files here as well. So, yeah, I know the providers tend to do this, but sometimes admins do this on behalf of their providers. So it’s definitely beneficial to play around in there and I wouldn’t necessarily say something. But if you have a new onboarding provider, maybe helping walk through them and guide. So you can feel it out for the first time.
Yolanda Clark (13:18) Okay. Question. Yes. So you add the certifications in as well as our side who’s the responsibility on the provider, would it be on me or it?
Rheta Larson (13:34) Is on the provider. So when the invite comes in, you all will basically invite them as admins, and then they’ll get a request to go in and complete all of these buckets if for whatever reason, they need help, that’s where I don’t know how Hamilton currently handles that if y’all, meet with the providers on an ongoing basis, but it’s just nice to know this information. So you can help push them along because what hinders the request from beginning is usually the providers just dragging their feet on getting their information uploaded?
Yolanda Clark (14:04) Okay. So I will get every email that the providers get. Is that what you’re saying you?
Rheta Larson (14:09) Will get weekly emails. So if they’re pending something, it will flag to admins to say like, hey, we need your support here because we haven’t heard from the provider.
Yolanda Clark (14:20) Okay.
Rheta Larson (14:22) Yep. But yeah, this is typically the provider. I would maybe ask internally. How Hamilton’s currently doing that?
LaShunda Chapman (14:27) Yep. I was going to say Yolanda, that would be just an internal workflow. We would kind of iron out on the side yep.
Yolanda Clark (14:34) Okay. All right. Thank you.
Rheta Larson (14:37) Perfect. This is going to show existing payers, which is a separate section. We’ll check in on for any requests, but it’s also living here in the existing payers. So y’all can hop in at any time and see something that is already existing or linked or par… continuing education. We don’t monitor continuing education on behalf of providers. So we’re not going to tell providers like, hey, this is required for you to stay compliant unless there is some sort of like licensure requirement. But this section is specific to providers to upload their certificates. They can use the repository how they see fit. So if they want to put all their information in here, the better and they can just manage and monitor from here. I just like to pull this out because some admins believe that we’re monitoring this and we’re not… okay. External accounts is big. Anything we create on behalf of the clinician will be listed here. And then we’ll also prompt them to add anything that our team will need to get into these portals. So you can see here we have the fcbs profile, a state licensure board for Michigan. This will also be something that they will add themselves. But if medallion creates anything, we will list it here in platform. And then if y’all, or should y’all ever need to hop into any of the open requests or any of these portals, you can link out directly to those sites and then just use the username and password to log in. So this is another cool section that usually, when providers onboard, we obtain upfront or create on their behalf… I’ll skip credentialing contacts, malpractice pretty straightforward. Any malpractice certificate of insurance information will be listed here, which we typically require for credentialing payer, enrollment, and licensing, any documents you upload to the profile in any one of the sections will populate here in kind of like a mass document section. But then it also does require like driver’s license, passport, marriage certificate, if they’ve had a name change. So anything that’s relevant to the provider’s history will be listed here for them to upload. And you can see and pull up some of these documents just to confirm like, hey, what is this? Or when did this expire y’all have access to view that as well. And then lastly is the disclosure questions and agreement attestations. Really, this is basically just a full synopsis or summary of some of the most common questions we receive on applications for malpractice, criminal history, sanctions, et cetera. So like if any provider has had any. Sort of I like to say, yes, answer or like affirmative on any of those kind of buckets. I highlighted that’s where we’ll kind of capture the information upfront. We always suggest that the provider be honest and forthcoming with information versus like trying to hide it because the boards will find it or any entity will find it and then ask for additional info. So this is a good place to kind of put that information. If they do happen to answer yes, then it prompts them to leave an explanation and upload a file. And that way our team is aware and prepared to like answer the questions from the payers, the licensing boards, whatever, whoever’s asking for it. And then this just gives us the agreement to do business on behalf of the clinician. So they’ll sign the limited power of attorney. We’ll get their signatures and their initials, and this is usually used on applications like for doing licensure or something. And we need to pop on an electronic signature. We’ll use that. But yeah, just giving us authorization and attestation to do things on their behalf. So that’s pretty much the profile in a nutshell. The last section I’ll say is they have a licenses section for any existing licenses that the providers hold. And if y’all are on ongoing monitoring or expiration monitoring, this is something that medallion also will monitor and like automatically verify or manually verify to make sure the licenses are up to date. And if they… are getting close to the renewal or expiration period, our system will check it and, or we’ll flag it to you if y’all need to flag attention to the providers. So this is also pretty useful. But any questions on like the main meat of the medallion profile for providers?
Yolanda Clark (19:11) I guess I’m just, I’m kind of unsure of what you do versus what I would need to do.
LaShunda Chapman (19:20) So, Yolanda, we do, I apologize for it. We do have a document, what we do, what they do, I think Lisa has that document just you can reach out to her and she’ll share, but we do have something like that on our end that we can share with you. Okay? Thank you. Yep. You’re welcome. I apologize for it for cutting you off.
Rheta Larson (19:48) Sorry, I was trying to unmute. No, you’re fine. Yeah, that’s helpful. I think during implementation, we created a slide for y’all, so that might be helpful just to review. I’m primarily the engagement piece of this. So I will just continue to have operational syncs with y’all on an ongoing basis and then basically give updates on what’s working, what’s not, what can we work together on to maybe push along if there’s any flags that y’all see, flag them in the syncs. And then I’ll get them resolved with the team that’s this primary function, anything operationally that needs to move basically on any of the requests? Okay? Thank you. So I know we have a little bit of time left, but I’ll kind of start getting into… the payr enrollment requests. I think the one thing I would say is definitely explore. I don’t know if they forwarded you the resources I sent, but I have a list of resources that I can share in our agenda that basically just kind of highlight some of these areas that I touched on. I would definitely explore some of those because we have support articles for each of these. So if you ever needed to see like any faqs, you can go here and kind of read up on some of this info.
Yolanda Clark (21:00) Yep. I did that today. I was actually on the understanding the dashboard part.
Rheta Larson (21:06) Awesome. Great. Okay. Yeah, the platform does a lot. So the next piece I’ll take you into is going to be the payers. I think this is a big one for y’all’s team. Is any payer enrollment requests that come in. This is essentially what we’ll work through on a weekly cadence as well if y’all ever need to understand some of these enrollment requests. But this is basically just going to give you an overview on the payer tab of all the payer lists that we have with Hamilton. So this is essentially the ones we’re doing work for. I like to view the enrollment requests because you can kind of see every single enrollment request that has been entered, what’s working, what needs attention, what has already been completed. So this section right here is going to give you some good information. You can see we have 44 completed requests that now are marked as completed. So work has essentially finished with these and their individual requests per provider or for like group enrollments that would be listed here. There’s a ton of columns. So you can filter this how you see fit. But if you ever need reports or something like that, the system can do that as well and you can export some of this information. So if Dana was asking you like, hey, Yolanda, can you pull how many medicare? How many medicare requests medallion has completed in the last 30 days? That’s something you can filter by state, you can filter by provider type. You can filter by so much here and just extract the information from the platform and send it off.
Yolanda Clark (22:47) Okay.
Rheta Larson (22:49) Processing is really what I like to hit on our operational syncs because this is going to give you details as to I’m so sorry I missed sharing my screen. Can y’all, see my screen? Yeah.
Yolanda Clark (23:01) I can see your screen.
Rheta Larson (23:02) Okay, great. I don’t know why I turned to my screen and I don’t see it anymore. So I’m glad you can… processing is going to be the area I like to work through with y’all. So typically, if they’re right now, you can see there’s 65 processing meaning they’re with the payers or our team is working on them in some capacity. There are so many requests tied to a request itself or statuses that are tied to a request itself. So let’s take for instance, you wanted to see any of the open provider enrollment requests. You can see this one was requested for David bush. So what I’m looking at here on this one is the payers, imed, it’s for the state of Michigan. We’re owning it. That’s why it’s labeled as medallion. And then it’s a new provider enrollment specifically for this provider, David bush. So that means somebody added it. You all as admins, can add requests at any time for payers by going to the request button here, adding a new payer enrollment, a demographic update, a bulk demographic update or request, a revalidation, you can put in that information here. Providers cannot do that. That’s only an admin function and, or my function. So if you ever need support to do that, I can do it on your behalf as well.
Yolanda Clark (24:18) Okay.
Rheta Larson (24:19) But just using David as the example, if I wanted to like kill the noise and not see anything else, you can filter specifically by him and just pull up whatever lines we have associated with David. You can filter by first and last name, just by first name. The system kind of works to pull that information appropriately. And then you’ll see what group it’s tied to, which in this case, it’s the Hamilton community group profile that we have set up request status is basically going to give you a breakdown of currently like where we’re at in the process. If you click on this here, it will pull up this second view and kind of show you what this means. So, following up on submitted application means that medallion is following up on the submitted application to inquire about any other updates or processing regarding the current payer enrollment status.
Rheta Larson (25:10) So the application has already been completed, it’s already been submitted. As of the 20 third. You can kind of see the request timestamps here. And then if you go to the right even further is our team is trained and like contracted to follow up on these on a ongoing basis, we follow up every two weeks or every 14 business days. If it’s a priority file, then we’ll follow a 10 date cadence versus 14. So we’ll do like a week essentially or not yeah a week versus the 14 day cadence. So in this case, our last note was just left yesterday, and then you’ll be able to see who posted the note. It’s a medallion side. So y’all can put notes in here as well. I will caution you however, Yolanda that we do not communicate via notes. So just be mindful of that. If you’re asking a question, the team won’t see that until they go back into the file. So I always encourage admins like filter any questions my way or go to support and we can get it answered.
Yolanda Clark (26:21) Okay, a.
Rheta Larson (26:22) Lot of admins tend to put notes in here and they just expect us to see it, but we won’t until we go in that normal follow up cadence if that makes sense. Okay? So you can see here, our last note here kind of just indicates how our team has been reaching out to this payer, we reached out via email, what email we’re using to reach out and get contact through. And it gives you a pretty robust idea kind of synopsis of what is outstanding, what’s pending, what’s tracking, what our next steps are. So if you ever are questioning any of the requests, I always ask y’all to turn to the internal notes and just see what our last note was on the file. Our team will also input any attachments that we received from these email correspondence or from the portals. So that would be something to look at and just like get familiar with and understand like what’s going on with the request… are?
Yolanda Clark (27:17) They all 14 days?
Rheta Larson (27:21) Yeah, unless it’s a priority, this one’s actually marked as a priority. So this one’s every five every 10. Well, not 10. Sorry, it’s 10 business days. Wait, it’s a week. So it’s five business days. It’s weekly. So five business days versus the 10 business days for priority. Not counting weekends. I’m counting weekends. So don’t count the weekends. So either two weeks or one week depending on the priority status, most of these are not priority that’s where I ask you all during our operational syncs, like let’s say y’all are doing a big initiative and push on a specific payer that you need by a certain deadline that’s where I’m just going to ask y’all to be very transparent with me.
Rheta Larson (28:04) So that way I can work with the teams to ensure we’re getting these done in a timely manner for your organization. But yeah, like this one will be every two weeks. So if you pop into the note, you’ll see the last note was done on the 20 fifth. So our team will put a new note in on April the eighth. And then the last one they put was the eleventh which was two weeks prior to the 20 fifth. But that’s kind of like a quick rundown of the enrollment requests. A few other things I didn’t highlight here is this little button to the left actually expands the record. Should we need anything from you. All our team does end up tasking these items out to the provider. So these are you’ll be able to see the existing tasks here. If you go to, needs attention. Usually that would be a good rule that like something is pending the provider or the admin from completing in order for our team to proceed. So there’s two ways you can look at this. I know we’re out of time. So I want to be mindful of y’all’s time. Do y’all have to hop or I have a bit of a cushion so I can stay on a?
Yolanda Clark (29:16) Little bit. I just need to use the restroom real quick? Yeah.
Rheta Larson (29:19) No worries. Take your time. I can hang here. Okay?
Yolanda Clark (31:37) Thank you for being patient.
Rheta Larson (31:41) Yeah, of course. Okay. So what I was saying or where I left off was the needs attention portion is where I would focus admin energy on because that’s going to kind of indicate what is pending… on the provider admin side in order for our team to proceed. So a lot of this is going to live in the overview section. They’re kind of just mirrors. But if you ever needed to like narrow on a specific request, like let’s say you needed to pull up Nicole stromberg medicare. You can view this by clicking the little button to the left. And then you’ll see the same tasks that are in the overview section. So you’ll see here there’s several tasks that have been assigned, several that have been completed. But there’s two that are outstanding. It looks like they’re both org admin tasks. So we need her group demographic update… basically just needs to follow these instructions to get this completed. And then same thing with the other open tasks… admin and provider tasks are I’ll… tell the team on this because it looks like they weren’t able to open it. But admin and provider tasks live in the overview section. So as an admin, you can see a mix of all tasks. So you can see provider and administrator tasks on this all tasks section. So it looks like right now there’s currently 12 that are outstanding. I like to say for admins, I don’t know how your day to day will function. But usually like first thing when I log on in the mornings is I check to see if there’s any outstanding tasks that have been assigned to me. So I’ll go to my specific tasks. You can filter here, like for admin tasks. And that will be the ones that we need action on from you. All, it looks like there’s 10. You can filter this how you see fit. So if you need to pull up someone in particular, you can do that. I like to tell admins to filter by the created date because that’s going to give you an idea of like what’s been outstanding for the longest. So like this one was created in December and we haven’t had any response back or we still are blocked by something because we haven’t received this information, whatever they’re asking for… you can place an opinion. So it looks like you just need to know how to add a line for BCN. But yeah, that’s some good feedback here is just making sure that if you have a task, what you can do is you can open it. And then from here, it’s going to give you a description on what is outstanding from our team for you all to complete?
Yolanda Clark (34:25) Once.
Rheta Larson (34:25) you actually action the request, there’s two things that we need you to do to like make it known that you’ve completed this, either mark it completed. That will give you a timestamp that says, hey, this was done by the provider or by the admin. When you mark, it timestamps here. And then it forces our team to check those within 24 hours. It goes to back to their queue. I like to say put two things in like mark it and then add a note saying like completed or here’s the attachment or whatever the case is. Sometimes providers just mark it and they don’t actually satisfy the request because they’re tired of seeing the like email reminders. So then when that happens, our team will move it back to a not started status and then just say, like, hey, by the way we asked for X, y and Z, you didn’t attach it here, please let us know. So that’s kind of like this communication and you can add any attachments here. So if they’re asking for something in particular, you can upload those. You can write your notes here. And then you would just post it. And then that pings our team as well to check within 24 hours for the update response, we’ll get back to y’all within 24 hours if necessary. If everything’s good, and y’all got us what we needed, then what we’ll do is we’ll just mark it as reviewed by staff, and then it moves out of the queue and it’s done. And then that prompts our team to move the request line forward. But you can always see what this request line is tied to. So this is for Erica Gonzalez’s blue cross Michigan. So, like if you ever need to see like what is this tied to it’s? Tied to this related request in the description?
Yolanda Clark (36:00) So, what is the blue circle where it says done by provider? Was that actually done by the provider? Yeah.
Rheta Larson (36:06) This is the activity of what occurred. So like sometimes tasks sit for a long time and then admins will escalate and say like what’s going on with this request? So this is helpful for us because we can see our team created it on the.
Rheta Larson (36:30) Whatever they were asking her to do wasn’t actually completed. So upon reviewing the medallion, it appears that there are no lines for BCN. Consequently we were unable to add the pending dependencies. Could you please create the line for BCN? Once that is done, we can proceed to place this line in the pending section. So she just needs a specific, I guess request tied to this in order for us to proceed. But, yeah, if it’s not truly done, our team will open it back up. And then we check the notes to see like what happened? Like why did it open back up? Was it because the provider didn’t get us what we need, are we pending something… so.
Yolanda Clark (37:06) Is that on us to do now?
Rheta Larson (37:10) Because, yeah. So this is an admin task. So we’re just asking to submit the request, add a line for BCN. What?
Yolanda Clark (37:18) Do they mean? Add a line? So.
Rheta Larson (37:21) They’re just, they’re asking to add the request for this provider for that. I’m assuming payr new payr, enrollment. So you all can add requests as well. Here. We just don’t know if that’s something you want us to proceed with. Like if you want us to do enrollment requests for specific payrs, I just need verbal confirmation from y’all, or like y’all, can input the request and then we can proceed with them as well, right?
LaShunda Chapman (37:46) And that’s how we’ve been doing it yep.
Rheta Larson (37:48) Okay, great. Do you think that’s something you all can add for this one? Or do y’all, need my support here to add it?
LaShunda Chapman (37:57) Tip for Erica Gonzalez. For blue cross. What is this blue cross complete?
Yolanda Clark (38:02) Blue care network?
Rheta Larson (38:04) Yeah, blue care, let me see.
Rheta Larson (38:15) I think so. Oh.
LaShunda Chapman (38:28) Yeah. The provider for the enrollment, just talking about the provider’s non enrolled BCN which is necessitates a separate enrollment procedure desired for a provider being enrolled BCN. So we just need to add a pay a payer request for BCN, correct?
Rheta Larson (38:44) If you all want us to proceed with that, yes?
LaShunda Chapman (38:47) Yes, that’s fine. We can do that. That’s yep, that’s okay?
Rheta Larson (38:52) I can add that here too. If y’all, don’t input, it, let me know and I can input it or if y’all, need help.
LaShunda Chapman (38:57) And who’s that provider, Erica Gonzalez? Yep?
Rheta Larson (39:04) But that’s kind of just like the overview of the tasks and how we work them. Again. I always encourage the admins to go to the provider tasks and just take a look at to see like who sometimes the repeat offenders are. Some providers are better than others at getting these done. And then admin tasks, take a look at these and then open them up to see what is required. This one’s basically just saying that we need the provider Nicole to go into pcos and sign. So, yeah, we’ll just ask if we can get support on some of these items… and then mark them accordingly once y’all satisfied the request. Okay? But any questions on the tasks, the admin or provider tasks?
LaShunda Chapman (39:49) Let me log in. I want to make sure I am following where that is located.
LaShunda Chapman (40:04) Oh, overview admin tasks? Okay. Oh, there’s a lot there wow.
Rheta Larson (40:10) Yep. Yeah. This is, it’s actually dwindled down. I don’t know who’s been actioning them, but they’ve been doing, they’ve been doing some cleanup. So, it looks good. But this is where admins tend to get a little backlogged. So again, I like to encourage y’all to filter by the oldest to newest. I.
LaShunda Chapman (40:28) Was I just did that? I was going to say it’s probably smart to filter oldest to newest, right? How do I add a line for BCN? So this is the one right here we need to do because this is affecting her blue cross complete, which is medicaid. So we need to.
Rheta Larson (40:49) And then just so on and so forth. We’ll just ask like this one’s asking for a group demographic update for the group’s medicare enrollment in Alabama. I didn’t want to do that.
Rheta Larson (41:07) But are there any other questions on this section?
LaShunda Chapman (41:12) Yes, I just did something. Who was that provider that Nakia said she couldn’t she asked, how do you, Erica Gonzalez? Okay. Thank you.
Yolanda Clark (41:22) Gonzalez?
LaShunda Chapman (41:24) And it was for BCN. I don’t have any questions, do you, Yolanda,
Yolanda Clark (41:31) No, I’m going to work through it and then, am I able to reach out to you personally by email or? Yes? Yeah. How do I get my questions answered? Reach out to you? Yeah.
Rheta Larson (41:43) So, the team does have my email. I think you’re on copy on some of the emails that have been going back and forth. I know we didn’t cover everything extensively in this session, but I do have to hop to another sync in a moment. So I’d at least like to pick up a next, I think Dana mentioned like in our next sync, we’ll continue this kind of chat and working through how to request items, any additional items y’all want to cover, but you can go ahead it.
Yolanda Clark (42:11) Was one thing that Dana wanted me to ask you when you go to groups and… you… go to the practices, you got 10 practices. Some of them had different percentages. Yeah. And she was asking, how do you determine a percentage? How do we update the facility to get 100 percent? No.
LaShunda Chapman (42:36) We’re all set on that. I think, yeah, we’re all set on that. Okay?
Rheta Larson (42:42) I did cover that with you all.
LaShunda Chapman (42:44) Yes. So let.
Rheta Larson (42:45) me know if you still, but essentially just for your knowledge because it is kind of funky when you go and add the facility officials ownership, you have to list for each one direct and indirect owner. And then the option populates for the percentage. And then you can just work through the percentage totals. It just needs to equate to, the 100 percent. But yeah, let me know if y’all are still experiencing issues, if y’all have any questions there. Let me show you if you go to Hamilton. Okay. I’m just using Hamilton too as the example. Okay. It’s now at 100 percent. So that’s good. Okay. But the facility officials, it’s listed here. Essentially, what was happening? Is there, Dana was just a citizen director officer, Michael was just medical director. So it wasn’t populating that percentage threshold. So just make sure direct and direct owner is added to every single official type plus whatever their title is.
LaShunda Chapman (43:48) Well, actually how I got that to get to 100 percent that top line that you have there, I had to add Hamilton as a facility and direct at 100 percent and that’s how we got it to at 100 percent ownership. And so that’s how we got the facility itself at 100 percent because otherwise, it would not populate to that 100 percent even with the three of them listed because they don’t have ownership as individual, you know, W, to employees.
LaShunda Chapman (44:21) Yep. So once we listed Hamilton, I do have some questions about Erica, but let me look at her profile because I think she’s already pending with blue care network. And so, I think she’s already pending. So I don’t think I need to add a line for her. Like what Nakia was asking. Okay, blue care network. So blue care network is going to, it’s going to be under blue cross. So if she’s pending for blue cross shouldn’t that include all lines of business that should be blue care network too, right? It says needs attention. Oh, why does it need attention? Okay? I need to look into that.
Rheta Larson (45:03) Yeah, because I only see the blue cross, the Michigan and the blue cross complete.
LaShunda Chapman (45:09) This is tied.
Rheta Larson (45:10) To that request, I think, right?
LaShunda Chapman (45:14) But, you know, how when you select a payer like blue cross blue shield, it usually selects all lines of business. So that blue care network is typically should… include blue, should include, I.
Yolanda Clark (45:30) Said a document was needed. Once signed, something needs to be signed, it’s a document that’s needed. Yeah.
LaShunda Chapman (45:42) We need to look into this one a little bit more. Okay? I need to dig into that combined participation.
Rheta Larson (45:50) Agreement. So if this is something you all can get, we can push it.
LaShunda Chapman (45:58) Gotcha. Okay. Yep. That’s what it is. Okay. But I’m.
Rheta Larson (46:02) glad y’all, are chatting through these and working through them because that’s essentially like what these syncs are for. So again, I would encourage you buy our next syncs as y’all, play through this, add any of y’all’s questions here for our next sync. You can just like insert the date for our next chat, which would be next week. And then I think we meet on Tuesdays actually, and then you can just start jotting those down and I can take a look at them prior to our sync, but we’ll continue our session of kind of training platform overview. We didn’t have a chance to go through like requests, but I know some of y’all, on the admin side, know how to do that. So, feel free to share that knowledge as well, but I’ll definitely cover it in our next sync. And then we’ll hit on some of the things that Dana also suggested for facility enrollment. Okay? Sounds.
LaShunda Chapman (46:49) Good. Thank you. Thank.
Yolanda Clark (46:51) You. I appreciate your time. I’ll be reaching out to you.
Rheta Larson (46:54) Yeah. Oh, yeah. That’s what I was going to say. You have my email. So feel free to send me emails on any questions. We do also have our support team. They’re very responsive as well. So, feel free to filter anything through support and then loop me in if you’re not getting responses back as well.
Yolanda Clark (47:09) She, froze.
Rheta Larson (47:11) oh, can you hear me?
Yolanda Clark (47:14) Yep. Now, I can’t okay?
Rheta Larson (47:16) Yeah, just loop me into anything you don’t hear back from support because support is also a good function. So, if y’all, need questions on anything, support will be the first kind of line of defense. And then if you don’t hear back, just loop me in so I can get them going on that.
LaShunda Chapman (47:32) Okay. Sounds good. Thank you for.
Yolanda Clark (47:34) Meeting you, Yolanda, have a good one. All right, you too.
LaShunda Chapman (47:37) Yep. Bye, bye, bye bye.