Transcript
Brandon Bradshaw (00:00) hey, Ray, how are you? Good to see you?
Rae Tompkins (00:03) Hey, good. How are you?
Connor Morley (00:05) I’m good. I,
Brandon Bradshaw (00:07) just took my first kickoff call today.
Rae Tompkins (00:10) Ooh, yeah, time flies when you’re having fun.
Brandon Bradshaw (00:15) They were totally right when they were like, it just feels like time. How would I put it? I’ve only been here a month but it does feel like it’s been a bit longer already just with all of that gear that you’re having to take in. Yeah, I’m.
Rae Tompkins (00:29) on month seven, and I swear, it feels like I’ve been here at least a year, yeah, but in a good way, it’s just a lot at.
Connor Morley (00:35) Once.
Brandon Bradshaw (00:36) Yeah… I was just on a call with Connor actually, and he said he was gonna like, I guess it’s now one o’clock or one o’clock my time, one o’clock now. Oh,
Rae Tompkins (00:49) that’s crazy. It’s four o’clock my time. My day’s ending, you’re right in the middle of yours.
Brandon Bradshaw (00:54) Are you, is this your last call today?
Rae Tompkins (00:56) Yes, yes, last call until Tuesday, pto, nice.
Brandon Bradshaw (01:01) Are you going somewhere or? Yeah.
Rae Tompkins (01:03) Headed to disney world tomorrow? Heck. Yeah, pretty stoked right? Heading for Easter?
Brandon Bradshaw (01:11) Easter and disneyland or disney world, right? Yes, that’s do.
Rae Tompkins (01:16) They do anything? I’m sure. It’s crazy. Do.
Brandon Bradshaw (01:19) They do anything like special for?
Rae Tompkins (01:20) I’ve never been, I think there’s like a little Easter day parade. I’m sure it’ll be packed.
Michele Izaguirre (01:27) But, yeah.
Rae Tompkins (01:27) We’re just going for the fun of it.
Brandon Bradshaw (01:31) That’s awesome. We’ll enjoy that.
Rae Tompkins (01:33) Yeah, thanks.
Brandon Bradshaw (01:45) And I’ll actually be hopping off camera once they’re on, just to finish my, as you mentioned middle of the day, I have a bowl of lunch here. I’m going to try to eat, so I won’t do it on camera.
Connor Morley (01:57) No worries. Grab some food man.
Janice Laran (02:08) Michelle will be late Connor.
Connor Morley (02:13) Michelle is going to be running a little late yep.
Janice Laran (02:17) Not sure which time… is?
Connor Morley (02:21) Chandra going to be joining because I did have some questions on the group enrollments… and I wanted… to move this call so we could meet with.
Janice Laran (02:33) Her. Yeah, let me check, oh, she’s away.
Connor Morley (02:53) OK. So, I mean, for the, I had some enrollment questions in general because… just looking at what you’ve sent us, you know, we got about like a 1,000 lines that look great. No issues. But then there are about like another.
Connor Morley (03:23) I was going to say 200 lines or so that there’s no, we have like the information that’s needed for the provider and the payer, we have their par status, the effective date revalidation date. I mean, in general, we can kind of, it’s not like we can leave that off for now, but I don’t see… like any practice or group linking information. So, I’m not sure what… to, how to load these highlighted rows. We should actually ignore this one because this one’s fine. That was just a mishighlight… this one’s fine.
Janice Laran (04:14) Okay. Let me check.
Connor Morley (04:17) But yeah, I don’t know what to.
Janice Laran (04:23) For the Mi, those are for ivf, Michigan… the yellow ones?
Connor Morley (04:32) They’re all for ivf Michigan?
Janice Laran (04:35) Yeah. Let me check if you’ll see an Mi, on their email address, that’s all for ivf Michigan.
Connor Morley (04:43) Okay. Because there is this one that says, Ohio too.
Janice Laran (04:48) Yeah, because they have a clinic in Ohio, but they are ivf Michigan.
Connor Morley (04:56) So, ivf Michigan, we are talking about.
Janice Laran (05:06) This one, right? Yeah, ivf.
Connor Morley (05:08) Michigan. And then, so ivf Michigan and the practices for ivf Michigan?
Janice Laran (05:19) We have at least nine, nine or eight. Hi, Michelle.
Connor Morley (05:32) So, okay. So, for these providers, these are all, it sounds like ivf Michigan, right?
Janice Laran (05:45) They are okay.
Connor Morley (05:46) They’re all ivf, Michigan. All one, two, three, four, five, six, seven, eight, nine, but there are only.
Michele Izaguirre (05:57) they have nine locations. I noticed that because we went through all of the practices that were uploaded and I noticed that there was some missing. Grand rapids is missing from this. The city is called grand rapids and Toledo, Ohio is part of the ivf Michigan practice. Those are your missing addresses?
Connor Morley (06:20) Okay. So it is… so Ohio is included?
Michele Izaguirre (06:27) Only one, only Ohio… Sylvania, that very last one row, 38.
Connor Morley (06:38) Oh, there it is.
Michele Izaguirre (06:39) That’s part of ivf Michigan. And then there is a grand rapids, Michigan, but it wasn’t imported. So I wonder if that was missing from your list.
Connor Morley (06:49) Yeah, I think it is okay. So, for these, okay. So there are nine, for these, they’re all I’m… going to ignore the practice right now. I need to go to the group name. So this is all ivf Michigan, right? Okay.
Connor Morley (07:13) It’s about 200 lines and then the practices are.
Connor Morley (07:25) So it’s these eight plus.
Michele Izaguirre (07:34) One that’s called, yeah, ivf, Michigan, PC dash, grand rapids… and I can, I mean, I, can you pull that from medallion? Or do you want me to just send it to you in an email because we did upload that practice location into medallion with the grouping I.
Connor Morley (07:54) This is fine because like we can pull that from… medallion, but I just want to, I just want to include this right now. Hey, sorry.
Chandra Palmore (08:08) I joined late. I apologize.
Michele Izaguirre (08:11) That’s okay on.
Chandra Palmore (08:12) The practice name? Like what I’m can you catch me up? Like what are we, is this?
Michele Izaguirre (08:15) The, he was trying to figure out where the Michigan doctors, like, what we were linking them to. So we’re just fixing the linking of the Michigan providers. Okay?
Chandra Palmore (08:24) So… practice name though, I don’t feel like that is the practice name we’re using for.
Michele Izaguirre (08:33) The actual enrollment. So, like when we send claims, yeah.
Chandra Palmore (08:37) We’re using pinnacle fertility? Yeah.
Connor Morley (08:41) That, that’s fine. This is for connecting them with a medallion. So it has to match what’s in medallion. But if you, if you’re still sending them just pinnacle fertility on claims that’s fine.
Chandra Palmore (08:53) So, how does that work from an enrollment perspective? If we’re enrolling with a provider and they’re asking for the practice name, would you give them what you have on this list or would you give them pinnacle fertility?
Connor Morley (09:11) Yeah. So you, we would link them to the group and we would link them to the practice and Ray, maybe you could jump in here as well to see if there’s a better, you know, if we enroll them, if you’ve had any issues with that in the past?
Michele Izaguirre (09:30) The one being any?
Chandra Palmore (09:32) Issues based on what you shared Connor?
Michele Izaguirre (09:38) But what’s uploaded in medallion is the legal name? Yeah. What’s loaded in medallion is the legal name, but then the dbas are set as pinnacle fertility, Arizona, pinnacle fertility, Michigan. So.
Chandra Palmore (09:51) What is this practice name linking to then?
Michele Izaguirre (09:54) How we have them listed in medallion?
Chandra Palmore (09:58) So, the legal name, the legal name?
Michele Izaguirre (10:01) Yeah. With the city? Okay.
Chandra Palmore (10:06) I just, I think from an enrollment, like I’m just, I want to make sure that like, what is going out on any enrollment applications? Like, is it going to say dash Scottsdale at the end? Or is this just from a identification purpose for this spreadsheet?
Michele Izaguirre (10:33) That’s a medallion question. How do the enrollment applications get loaded with practice names when you have a group with multiple practices under, how did they get loaded into the applications?
Connor Morley (10:49) So, don’t.
Michele Izaguirre (10:51) you just list the group name and the dba and then you put the addresses.
Chandra Palmore (10:56) That’s that’s how we do it today. Which is why I’m trying to understand like the difference in column V in the naming conventions that we use today.
Connor Morley (11:08) So, the, what hang on, let me just double check because I don’t want to get this wrong. And I’m just going to pull up one, an application that we have created and sent out because I think… the question is like what is actually going on the application, right? The, the information that I just pulled up and I shared with you in the provider enrollment tab. That is kind of just how we link things within medallion, but it’s not necessarily what is going out in terms of on the, exactly that’s going out on the application… itself. So give me one second.
Connor Morley (12:20) And it sounds like you’re concerned that because you want to use the dba and the practice location or just the practice location on?
Chandra Palmore (12:30) The enrollment applications, it’s legal name and dba. So on your spreadsheet, you have it under practice name and that doesn’t match either the legal name or the dba. So I’m trying to understand.
Michele Izaguirre (12:44) It’s because it’s because Chandra that is used to say advanced fertility care of Arizona has four locations. And so all they’re doing is differentiating the Scottsdale, the Chandler, the Glendale, the Tucson, but in medallion, the group name is advanced fertility care of Arizona with the dba of pinnacle fertility, Arizona.
Chandra Palmore (13:08) That’s that’s what I was asking for. Yeah.
Michele Izaguirre (13:11) Yeah. So the group names like the names of the practice as a whole is correct. These are just differentiating. So like let’s say I’m making this up, but let’s say you have an rgi doctor that’s only enrolled in two specific locations. This is how medallion will know, Jane is only linked to these two locations and not these three locations in Ohio.
Connor Morley (13:38) Yes. And I can confirm that on the application, we focus on the legal name for the group, and then the physical address for the practice location.
Chandra Palmore (13:53) And what about the dba?
Connor Morley (13:57) So within the application, this one doesn’t have a dba that I’m looking at. Sorry, I have to find one with a dba… but there is a space for dba. So we should include it, but I can also just confirm that with our PE team, yeah.
Michele Izaguirre (14:24) Just confirm it. All of the dbas are loaded in and all of the W nines that we attached to the group locations have the dbas also listed on them.
Chandra Palmore (14:32) So, I’m in medallion and I’m looking under practice locations, but the name?
Michele Izaguirre (14:37) No, you have to look at group profiles. Okay. Got it. Okay.
Connor Morley (14:53) All right. So, for, I… just want to go back to the sorry and Ray is going to follow up to confirm that dba is on the application, but I just want to confirm because I don’t know if there is nine, if there are always nine of these different providers per.
Michele Izaguirre (15:17) Thing? Oh,
Connor Morley (15:20) because it looks like right here, there’s only that’s nine, but here there is nine.
Michele Izaguirre (15:26) Do all of the doctors, so.
Chandra Palmore (15:30) Medical mutual is just for Ohio. We wouldn’t we would just have that.
Michele Izaguirre (15:36) But do all the doctors have it?
Chandra Palmore (15:38) No, because we’re licensed in Ohio. So it’s not going to be consistent. Okay. So all.
Michele Izaguirre (15:49) of the four doctors in Michigan and this is Chandra, I’m sort of asking for confirmation. All of the four doctors in Michigan are all enrolled to the eight locations in Michigan. No. Oh, and only some to Ohio, which is the ninth location.
Chandra Palmore (16:07) Correct. Okay.
Michele Izaguirre (16:08) So, all of them are part of the eight Michigan locations, but.
Chandra Palmore (16:13) But they’re not necessarily attached to every payer at those. Oh, I know. Okay.
Michele Izaguirre (16:19) So, then this list that you gave Connor, we don’t have the practice locations. I don’t know how it got uploaded. So that’s where he’s struggling, all of these Michigan providers. He’s not sure which practice locations.
Chandra Palmore (16:31) So, I think I marked these yellow. Did I do that? Because I think those were the ones that I was going to go back and fix?
Connor Morley (16:39) I don’t think these, so. I think so, I think we marked these yellow because we don’t have, we didn’t have the practice of the.
Chandra Palmore (16:47) I know I marked it yellow at one point. But let me know. Let me look to see if that was before I sent it to you or after… either way, I can fill that piece in and re upload it or just resend that part to you if needed. Either way.
Connor Morley (17:10) Okay. That would be helpful. In the meantime, we can load all of these. I’m assuming you still want non participating or non par providers in here just for source of truth reasons, there’s not.
Chandra Palmore (17:25) Yeah. Well, we’re going to, we’re working on correcting that. So, yes, please. Okay.
Connor Morley (17:31) Working on correcting that as in working on… submitting new applications for them?
Chandra Palmore (17:39) Some, some might require a contract, okay?
Connor Morley (17:45) If you are doing new requests… for them, do you want to load those requests in medallion to… view them?
Michele Izaguirre (18:00) Some medallion can start working at?
Chandra Palmore (18:08) Yeah.
Michele Izaguirre (18:11) Sorry?
Chandra Palmore (18:13) Like I’m in medallion and I’m just looking at like things aren’t just 100 percent done like loaded. So that’s why I’m like I can, but like, is it going?
Michele Izaguirre (18:20) No, but that stuff. Yeah, but this is like, it’s not 100 percent loaded because it’s asking for banking information which we don’t really need for our enrollment. So we didn’t really complete all of that. So there are some missing things, but I think most everything that you would need for enrollment is loaded and if it’s not, they’ll task us for us to update… it.
Chandra Palmore (18:41) Yeah, I mean, we can.
Michele Izaguirre (18:49) If we Connor, if we decide that we want medallion to do it, do we put it in a different tab or are you okay with us just adding a request? So.
Connor Morley (18:58) It’s going to, so it’s going to be essentially, so… you’re in the process? Have you submitted any of these applications currently or are there? I?
Chandra Palmore (19:08) Would have to go through there’s I mean, there’s quite a bit. I would have to go through and figure out which ones we have submitted, but before we get there, I have all the practice information on the thing that I sent you. So I’m not sure why it didn’t come over.
Chandra Palmore (19:28) yeah, because I have it all. I mean, I have it all here and it’s the same template. I can re upload it if that helps. But I mean, it’s all here.
Connor Morley (19:39) Do you mind re uploading that? I’m not sure why.
Chandra Palmore (19:45) Yeah, I don’t either. That’s why I was like, wait, what are we, why don’t you have the practice information, but I’m looking at it. So I will, I’ll re upload that. That’s weird. Okay. And it’s just Michigan.
Connor Morley (20:02) It’s just Michigan and one Ohio… that is so.
Chandra Palmore (20:08) Weird. Okay. Yeah, I’ll re upload it. I can also, I mean.
Connor Morley (20:18) So, so, I want to kind of take a step back as well. And so it sounds like for… these non par providers, you’re in the process of requesting… applications or submitting applications for some. And there’s also some that you, are already in the process of submitting applications and have submitted an application for. Is that correct? That is correct?
Chandra Palmore (20:48) Okay.
Connor Morley (20:49) So, there’s two things that we can do. I think for the ones that are, in the future, what we can do is you can start to create those submissions within medallion, okay? And start making those requests in medallion. For the ones that have already have an application submitted, what is actually needed from us is going to be if we go to this provider enrollment requests tab in the spreadsheet, we’re going to need to know some of the information like what’s been submitted so far and we’ll need to, in terms of this transfer or this request type column, detail it as a transfer. And that medallion owned will be true if you want medallion to work on the follow up and with the payer and reach out to the payer every couple of days to make sure that see what the update is. Okay. The other piece that is helpful as well is if you have any sort of spreadsheet on like tracking numbers with your applications, if you can send that to us, so I can share that with our PE team so that when they do take over the follow up on this, they have all the information that they need to kind of go into. I don’t know Aetna or… whoever to kind of make sure that or first health to make sure that they have the exact right information.
Chandra Palmore (22:34) So, first health, we… don’t have an active contract with. So from a process perspective, do I send the request to you? Or do I obtain a contract? And I know commercial payers, they go either way. So what’s the preference of medallion?
Connor Morley (22:55) Ray? Do you know if first health, if they require a contract before we do enrollment or not? Sorry… go ahead.
Michele Izaguirre (23:09) Sorry, I just want to make a, I think Chandra, you should just start it from the beginning. Almost every payer that I’ve worked with does contracting before enrollment, right?
Michele Izaguirre (23:21) And you’re set up as the contract signer. So I would imagine Connor Ray, you tell me, but like if a contract’s needed, then it would then get sent to Chandra to handle that because they have to credential as well. Yeah.
Chandra Palmore (23:34) It’s just some of them require like a like, hey, I want a contract with you and they ask for the doctor, like you have to fill out an application, right? So that’s why I’m like I can start that to get the contract rolling, no let’s.
Michele Izaguirre (23:49) Have medallion started so we can figure out what the process looks like. We can use this as our beta like for our workflow? Okay? That way, it saves you some time too, and they can kind of direct you because I know you’re drowning without Kim… and.
Rae Tompkins (24:04) I’m happy to take this back, reconfirm with the PE team just to, you know, reiterate the expectations and just kind of level set what it will look like going forward.
Connor Morley (24:15) Thanks, Ray and Ray. Yeah… just for like some of these non par questions. Yeah, for some of these non par payers.
Michele Izaguirre (24:30) Oh, there’s a lot.
Chandra Palmore (24:31) There’s a lot because they’re not licensed there. So this spreadsheet, this data, we have an auditor going through and confirming our data. She is not looking based off licensed where the doctor is licensed. So if you go up to the top, you’ll see that there is a lot for there’s a couple for Illinois, there’s a couple for Ohio even though it’s for the same subset and that is because they are not currently licensed in that state. And so participating or not participating, it’s not going to matter if they’re not licensed. So, for sake of time, I took the information that she had worked and is still working and put it into the spreadsheet if I need to go back and put not licensed or not contracted like whatever that is, then I’m happy to do that. I.
Michele Izaguirre (25:20) Think you’re going to have to look at it though because a lot of these people that I see are licensed in the state. So I’m not sure that that’s the reason they’re not participating.
Chandra Palmore (25:31) Which one are you looking at like?
Michele Izaguirre (25:33) This one in front of us is all Arizona doctors.
Chandra Palmore (25:36) Yeah, that one, the one that we’re going to like beta test with like.
Michele Izaguirre (25:39) No, this is not first health. This is banner health.
Chandra Palmore (25:42) Banner, yeah. So there is a, the contract has expired there, so that’s what I’m saying like some of them are going to be, yes, we need to go in and get things done, and some of them are, hey, this is never going to be done because they’re not licensed in that state. So, if I need to differentiate that in column F, I’m happy to do that. So like we have.
Michele Izaguirre (26:05) I think you might have to differentiate them by splitting it out into the other tab and then telling medallion, like, do you want them to continue the follow up? Do you want them to reach out or you’re taking these on internally and they’re just going to load them as non participating?
Chandra Palmore (26:21) Yeah, I can do that. I just didn’t know how to differentiate that for them.
Connor Morley (26:28) Yeah, I think. Okay. So if I understand correctly, so, yeah, Chandra, if you can differentiate the ones that are non participating, but we do like, you do see a future in getting them in either enrolled with.
Chandra Palmore (26:45) Payr. Yeah, it looks like there’s 70 that are listed as non participating. So I can easily go through that just, I know those answers honestly. So I can easily go through that.
Connor Morley (26:55) Perfect. Thank you. Okay. So… do you want us to hold off on importing these non participating or out of network lines? Yes?
Chandra Palmore (27:10) Please?
Connor Morley (27:11) Okay. So… okay.
Connor Morley (27:26) Alright. So we will hold off on importing any of the non participating lines… other than that, I think we can import all these other provider lines. And if there’s a revalidation effective date, you’re okay with that being just na, and empty for now because it’s a pretty silent process. And if you do need to revalidate it, you’ll get an email or some notification from the payer?
Chandra Palmore (27:57) Yeah, that’s I’m.
Connor Morley (27:58) okay. With that. Okay. Alright. I think we’re okay with the provider… enrollments… for the?
Chandra Palmore (28:13) Beta testing on first health, you want me to open up a request? Is that what I gathered?
Michele Izaguirre (28:17) Yes. Okay. You want us to open up a request in the medallion platform?
Connor Morley (28:24) Yep. Okay. We can go ahead and do that,
Michele Izaguirre (28:27) Before we go there, we haven’t had the doctors… attest their profile. So, is that also gonna like you guys won’t be able to start until they attest?
Connor Morley (28:36) We won’t be able to start until they attest. Okay. But we can always, I mean, Ray, I’ll leave it up to you if it’s better to just start making some requests and putting them on hold for now until we get the providers in. Yeah. Okay.
Chandra Palmore (28:54) I think.
Rae Tompkins (28:56) It’s kind of up to you. If you want to start, you know, playing a platform, getting used to it, putting those requests in just to kind of see what the expectation will look like. They’ll be there whenever we start adding in providers or if you want to wait, we can add providers and just kind of start everything at one time.
Michele Izaguirre (29:12) No, I like your idea, play around with the system, start getting it added. Yeah.
Rae Tompkins (29:18) Let’s do it.
Connor Morley (29:30) Okay. So just to do you want me to kind of walk you through how to start making some of these requests again? I.
Chandra Palmore (29:39) Was actually playing around with it last week, so I don’t have questions. I didn’t hit submit clearly.
Michele Izaguirre (29:47) But I.
Chandra Palmore (29:48) don’t have questions yet. Okay. All right. So to answer your question, you’re happy more than welcome to walk through it, but it’s totally up to you for time’s sake. I don’t know if there’s something else on the agenda or not.
Connor Morley (30:07) Okay. No worries. All right. So, we’re going to turn around tomorrow and we’re going to have 30 or 70 new requests in place… but, yeah, if that was the biggest thing was kind of like looking at the provider enrollment data, we’ve created the entities for the facilities in order to start requesting credentialing… pieces for them. I have a completed.
Connor Morley (30:42) Tjc credentialing or credentialing sop that I’ll send out to you and I just would like that confirmed. There was, I think I had sent out an email last week. I think around… a few questions I had.
Connor Morley (31:10) For the credentialing?
Michele Izaguirre (31:16) Yes, you did. And I left everything in a draft so that’s fun. Let me just run through these. There is no dop.
Michele Izaguirre (31:38) Existing an internal and external appointment. Oh, okay. So you’re saying that providers who were loading in that have existing appointments, we don’t have the dops for them.
Connor Morley (31:47) So, yeah, for the, it’s those for the external hospitals, we.
Michele Izaguirre (31:56) don’t have any of those? Oh, yeah, I don’t have any. I have nothing for any external facility. Okay?
Connor Morley (32:03) I don’t think we can load those specifically in, but we can load in the connections to those external hospitals.
Michele Izaguirre (32:12) Yeah. Okay.
Connor Morley (32:16) For the.
Michele Izaguirre (32:25) I’m not sure. Go ahead.
Connor Morley (32:29) For the like the credentialing checklist didn’t have any requirement for peer references?
Michele Izaguirre (32:35) We require two you.
Connor Morley (32:36) Require two. Okay. Do.
Michele Izaguirre (32:39) you have a peer reference form or something? Or do you want ours?
Connor Morley (32:43) We do have a peer reference form, but if you’d like us to use yours, we can.
Michele Izaguirre (32:49) It doesn’t matter if you guys have one that you send to the peer references directly, that’s fine. Okay?
Connor Morley (32:57) All right. Sorry, one second, while I just make… some notes. Yeah.
Michele Izaguirre (33:05) And I’ll get back to you on this email and write it out too. But it’s two peer references for both initial and recredentialing.
Connor Morley (33:14) Okay. And then just wanted to confirm all of the verifications that you want in the credentialing packet because we have Sam, oig, NPD, medicare opt out, state licenses, Dea licenses, CSR licenses, medicaid exclusion, death, master ofac and CMS preclusions that are available. But on the checklist, I think you just had npdb.
Michele Izaguirre (33:44) Npdb. We do need Sam, we do need oig, and I think we need medicare opt out. Can we just do all of them? Yeah. Okay. Let’s just do all of them?
Connor Morley (33:56) Yeah, we can do all of them.
Michele Izaguirre (33:57) I think I just listed out npdb specifically or separately because some of them have to be self queries. And so, I wanted you to be able to see that like for some clinics, some facilities, you’re going to have to ask the provider to give a self query? Where some of them, we have the entity set up so you can query npdb. Remember, not all of our facilities are set up with npdb as an entity?
Connor Morley (34:28) Got it. Okay.
Rae Tompkins (34:32) Just to confirm if they are not continuous queries, would the facility provide the npdb report as we outreach to collect them? If?
Michele Izaguirre (34:43) They’re not continuous query, then we ask the provider to give us a self query at initial and reappointment applications. And then we don’t do any monitoring in the timeframe.
Rae Tompkins (34:58) Yeah. Let me run that by our product team, Connor only because I know automation kicks off as soon as we have enough information and platform to try to, you know, enroll the provider in npdb. But if they’re going to be self queried, we… would need to figure out a way to configure that to stop from the auto enrolling it.
Michele Izaguirre (35:16) Would only be some clinics and they don’t have a bid… whatever it’s called. Like they don’t have an npdb id.
Rae Tompkins (35:24) Okay. Are we talking about provider credentialing or facility credentialing? We’re.
Michele Izaguirre (35:30) talking about internal privileging for our provider credentialing, but it has nothing to do with enrollment because we’re not, we don’t have delegated, we’re talking about like the… internal privileging primary source verification side. So, yeah, credentialing. Okay. This is only a short term thing. We’re working on getting all of our entities into npdb but it probably will take another two months or so.
Connor Morley (36:06) Rave if we’re but if we’re set up as a registered agent for pinnacle can’t… we pull in on the npdb.
Rae Tompkins (36:19) We can’t use existing enrollments. We’re pulling new enrollments.
Michele Izaguirre (36:25) That’s not even the problem is that there are some facilities that we don’t even have npdb. So you’re not even set up as a registered agent because one doesn’t even exist for those facilities.
Connor Morley (36:38) Okay. So.
Michele Izaguirre (36:40) Each, so pinnacle as a whole does not have one organizational npdb account. Each of our facilities have their own npdb, each of our surgery centers… surgery. Anyways, that’s why I differentiated it. So for, on that checklist for the clinics who you do not have npdb for like you’re not a registered agent on the npdb. It’s because we don’t have an npdb for that organization. So we ask the providers to provide us a self query. They have to query themselves and provide it as part of the credentialing packet. Okay?
Connor Morley (37:26) All right, Ray, I’ll take this back to Jen to make sure that she has that information. And then,
Connor Morley (37:40) Michelle, are there any bylaws that you could send in addition for each facility?
Michele Izaguirre (37:51) The entire bylaws or like our credentialing policy for each facility?
Connor Morley (37:58) I think we’d actually like both.
Michele Izaguirre (38:03) That’s not, I can give you the credentialing policies. The bylaws is going to be really difficult for me to get and we don’t provide it to like our providers when they’re credentialing, we don’t give them the bylaws they have to request them from us directly.
Connor Morley (38:21) Yeah, we don’t share bylaws or that kind of information with providers. This is an ask just for our operations team to review and make sure that all of our, what… we’re putting together in the packet like follows all of your bylaws?
Michele Izaguirre (38:48) Let me get you at least the credentialing policies which I think is what the same thing that you’re referring to as a bylaw? Yeah. But not a lot of our surgery centers have just the medical staff bylaws separated. So that’s my problem like some of them included all the medical staff information with all of their like clinical bylaws and protocols and it’s.
Connor Morley (39:16) a little, yeah.
Michele Izaguirre (39:17) But I’ll try to get you the medical staff information. Okay?
Connor Morley (39:22) No, that should be good enough. Okay. I think… that covers… all the questions I had. So we can do, I have,
Michele Izaguirre (39:40) a few questions just playing around with medallion. If you guys could help us help me? Yeah. Okay. I’m going to share my screen and real.
Rae Tompkins (39:51) Quick, in regards to the verifications that we were just discussing, I did reach out to the team to clarify. I know we spoke last time if we pull amas or go directly to the board. So we go directly to the board or utilize avms, but the ama is not usually our first place to go to verify a board certification.
Michele Izaguirre (40:09) Yeah. Okay. That’s fine. We just have to adjust some of our own bylaws.
Rae Tompkins (40:13) Yeah. And then in regards to the education proxies, the list is kind of just an internal document that we follow, but just kind of a quick glance. There are 22 states that we utilize for education proxies. And there’s 55 different credentialing types across behavioral health, MD, advanced practice, and kind of specialized certifications. So as we start to process more files, you can kind of get a little bit more visibility into those ones that we’re utilizing education proxy for. Okay?
Michele Izaguirre (40:45) I’m sharing my screen really quick with medallion. And I did notice that we already have two tasks and so we… can just start working this. So it says like this caqh management, this person needs a consent form completed. So theoretically we would connect with that provider and get them to sign the consent form and upload it. I just wasn’t sure what we should be doing with these two tasks.
Connor Morley (41:12) Yeah. So right now, we don’t have to do a whole lot with these tasks. This was created because we turned on caqh management.
Michele Izaguirre (41:21) Okay.
Connor Morley (41:23) For all your providers, okay? It would be once we invite all of them just to connect with them and make sure that they have loaded this, but these tasks specifically… are provider tasks. So they would actually just go directly to the provider to have them sign the release form.
Michele Izaguirre (41:48) Oh, I see that. But since they’re not invited into the system, they don’t have their tasks. Okay? That makes sense. Yep. Okay. My other question is about provider licenses. So when I was looking at some of our providers, you have the ability to notate it as a compact. And none of, we only have a few compact licenses, but none of the providers that we know have compact are loaded in here. How do I edit that? Because it didn’t shit. It didn’t appear to be something that I can edit.
Connor Morley (42:24) Oh, yes. It is something I can edit. Yeah. So, so wait, sorry. Yeah, there’s I think there was a, is this a compact license or not down there?
Michele Izaguirre (42:38) Yeah. I must have been in a different screen when I was looking at this. I wonder if I was in the, no here’s one. Oh, is it because it’s a Dea? Yeah, maybe that’s what it was.
Connor Morley (42:50) So, I think as well.
Michele Izaguirre (42:53) Yeah, like here, this is Illinois… but I don’t I know, I don’t have that ability to state that it’s compact.
Janice Laran (43:09) Try to choose the state first if there’s an option. So state and then, yeah.
Michele Izaguirre (43:16) Oh, state is missing from these. Okay. Yeah. Okay. Got it… with imlc. If I do have their username and account information, I am loading it in external accounts. Is that the correct place for me to be doing that?
Connor Morley (43:37) For their imlc. Yes.
Michele Izaguirre (43:38) Yeah. In here, imlc. Okay. Yeah. The other? Okay. So we’re going to go through it’s. Only a few. So we’ll just manually update the imlc licenses. The other thing is that Janice noticed that there were some licenses where there were issues with verification. And when we looked at the verification, they’re different names, they’re not the correct provider. Okay? So this says Krista bosch and it’s for, Jeffrey tack is the one that we looked at. So I’m not sure how we can help Jacob reifer, I’m not sure how we can help fix these. Okay?
Connor Morley (44:23) So, if you go to that provider’s profile, click on his name, go to the verifications tab right? All the way up there. And then if we can scroll down to the state… license, and can you actually hover on the issue right there? Let’s see what pulled in. So the source name is that and the license number is zero two four.
Michele Izaguirre (44:51) Seven, it’s not pulling in the G.
Connor Morley (44:54) Oh, that’s why? Okay. So.
Rae Tompkins (44:57) With.
Connor Morley (44:58) this, let me take that back and put in a ticket to make sure that this is being corrected, but we can also go in and manually verify these. Okay?
Michele Izaguirre (45:09) Yeah, I just wasn’t sure. Like when we were cleaning it up, if we were supposed to flag medallion somehow or, you know, if we click on it, do we re, verify, it seemed to be a few californias with the G specifically. And then, there was some other ones we noticed, but it kind of had to do with the letters weren’t getting added into the verification?
Connor Morley (45:31) Yeah. For, for that, what I would want to do because this does seem like it’s not just a one off is create a ticket within medallion. So, if you go to support center in the bot over to the left side?
Michele Izaguirre (45:45) Yeah. There’s a bunch of a bunch of them. Yeah. And it’s kind of same deal. Okay. So support center?
Connor Morley (45:51) Yep. And then here just go to messages and you can just type in. I had essentially did.
Michele Izaguirre (45:58) You do this, Janice, yesterday, you did do this? No, I.
Janice Laran (46:02) Haven’t tried. Okay?
Michele Izaguirre (46:04) Okay, cool. So then yes, we can start using this. That’s what we were thinking but we weren’t sure if it was like ready to go.
Connor Morley (46:10) No, no. It’s it’s ready. So you can start, you can type in the, you can type in the issue. It will create a ticket for you. And then once you go back to support center, you’ll be able to see the progress and the update on that ticket and it’ll pop up. Like if you click on support center again instead of like messages at the kind of the top of that chat window, you’ll be able to go back to your old tickets.
Michele Izaguirre (46:37) Okay. That makes sense. I think… the.
Janice Laran (46:43) Missing two doctors Michelle.
Michele Izaguirre (46:45) Oh, yeah. Maybe message. But Janice noticed there were two doctors missing and when she tried to add him, it said that their email addresses were already in the system, but they weren’t under the inactive provider list. We couldn’t figure it out at all. So maybe just use the message function.
Connor Morley (47:04) What are the provider’s names?
Michele Izaguirre (47:08) Barrett, cohen, Barrett? Okay.
Janice Laran (47:11) And.
Connor Morley (47:15) couldn’t.
Michele Izaguirre (47:17) search by email? Yeah.
Connor Morley (47:19) This is an issue within medallion. Most likely, you said Barrett cohen?
Janice Laran (47:30) C o W.
Michele Izaguirre (47:32) A N, I think the last name is Barrett. I don’t know.
Janice Laran (47:40) They’re both from posterity health. So I’m not sure if they’re a client of yours or they’re already in the system most.
Connor Morley (47:49) Likely, they’re already in the system somewhere else and they are going to have an issue because right now, we can only use a single email address even if in… general, but what we can do in order to kind of get around that is create what’s called an alias. So within medallion, give me one second while I go through this, I can walk you through this… where, yeah, and it looks like those providers are in another organization’s instance. So, what we do is we create an alias for those providers. So hang on while I share my screen, I’ll show you what that means.
Connor Morley (48:46) So if you run into that where the provider is not in medallion at all, and it’s showing you that issue. Apologies, my computer’s a little slow today. We can still invite them into the system. We would still go to invite providers and in the email address instead of Barrett cohen… at whatever we would do plus pinnacle at… Gmail. Com. And this will create what’s called. This will create the alias. And essentially, it will, all the information will still go to this provider’s, normal email address minus the plus pinnacle and it will separate them out and they’ll have to log into pinnacle and they’ll be given the same invitation. Okay?
Michele Izaguirre (49:39) So, if provider’s real email address is Barrett at posterityhealth. Com, we would put Barrett plus pinnacle at posterityhealth. Com. Correct? Is that correct? Like we’re putting the exact email we’re just putting plus pinnacle before the at sign. Correct? Okay.
Connor Morley (50:04) And this is a known and truth be told, very frustrating issue. It is going away and we are creating kind of like, a drop down that users who are available in multiple organizations can pick the environment that they want to go through. So they only have to, so we can use the same email address across organizations, but that’s not scheduled until Q2.
Michele Izaguirre (50:34) Okay. That’s okay. I mean, it’s only two providers. So, yeah, the other quick question that I have is half of the providers that we have loaded in, we aren’t are not employed providers. They’re contractors that we only do internal privileging for, right? The other half is we do everything for, we noticed in the provider profiles, you can differentiate their status, so we can differentiate by full time employed or by contractor, which is really helpful. Does medallion have the ability for us to add a custom column? So that way we can use that information to filter or view providers?
Michele Izaguirre (51:20) Employee type, maybe we can do that or employment status, which?
Connor Morley (51:25) Which one did you? I think it would be employment type most likely because this one usually has either full time or, yeah… this one has full time part time contractor etc.
Michele Izaguirre (51:39) Okay. That’s employment type. So we could use that. Yes, I see it now. I do see it on the thing. I just didn’t scroll all the way. My bad, I’m getting used to the system. Sorry. Okay. Now that’s perfect. Then actually, I think that’s going to be really helpful for us. So we’ll do that. We’ll use employment type and differentiate full time or contractor yep.
Connor Morley (52:05) No problem. The other option is if you have like different contracting agencies that you have as well, we can create teams for those contracting agencies and assign the providers to that team. And it would create another column. So you would be able to filter a little further. Okay?
Michele Izaguirre (52:24) Probably not needed for us, I think just more like if we have somebody new coming in, we can see like which providers licenses are about to expire for which ones we would actually want to request a new one versus it’s up to them to do it. So I think this will be fine for now. Okay. That’s helpful. Was there anything else Janice you can remember? I think, that was most of what we went through. I have.
Chandra Palmore (52:49) A question, can you go to payers real fast? Connor? I forgot who was sharing their screen? Thank you and then under enrollments there’s… medicaid and medicare in there. Do we, is that just because they have an active provider id and you guys found it and pulled that in? Yes.
Connor Morley (53:11) Usually, we were able to pull this in through caqh.
Chandra Palmore (53:16) If we need to, so we don’t accept it, we don’t accept government right now. So, how do we make sure that this isn’t part of like reattesting or anything else? So from a contracting per, like we don’t even accept it to manage millions. So, how do we, how do I fix that in here? Like are.
Connor Morley (53:42) you worried that we might automatically do like a revalidation for medicare medicaid and you would be charged for it? Yeah. So we do not automatically revalidate any of these because one typically for the commercial payers, it’s a pretty silent process and we don’t want to charge you otherwise. So we would not auto revalidate any of these medicaid or medicare enrollments for the provider.
Chandra Palmore (54:09) So, will the billing status once it expires just go from active to inactive? Or will it always active?
Connor Morley (54:19) If the provider and Ray, correct me if I’m wrong, but if the provider keeps up with their direct enrollment to medicaid, like for example, is Scott Hutchinson, if he keeps up with medicaid outside of pinnacle, I think it wouldn’t stay as active, but it sounds like you’d want that to be, I.
Chandra Palmore (54:39) Just don’t want to attach to pinnacle because we don’t accept it, just.
Rae Tompkins (54:43) Be able to just delete it completely. Yeah… just delete the line if it’s not applicable to pinnacle and doesn’t need to be captured in platform. You should be able to just utilize those three dots.
Chandra Palmore (54:53) And then just, and,
Rae Tompkins (54:54) just delete the line. Okay?
Michele Izaguirre (54:56) So, since these are all there, yeah, let’s just bulk delete. Perfect. And then in, the group information, we put commercial only for line of business. So, yeah.
Connor Morley (55:11) There’s no, like.
Michele Izaguirre (55:13) In the group profiles there?
Rae Tompkins (55:15) May not be a way to bulk delete Connor, we might have to just do it individually.
Michele Izaguirre (55:20) I do.
Connor Morley (55:21) Not have a way to bulk delete right now, I.
Chandra Palmore (55:23) Think you’re gonna do it that’s fine. I’m in here. I can do it. Okay? Thank you. Yeah, no problem.
Connor Morley (55:34) All right. Any other questions for us?
Michele Izaguirre (55:43) No. So next steps, Chandra’s gonna get you that the list of non participating and how she wants that to be. She’ll, put in the new enrollment request for our first health Arizona people, so we can see how all that plays out. You’ll import all the participatings and hopefully we can have all the non participating ones. Chandra. Do you think you can get that sent over this week? So they can import that by Friday? Yeah. And then, because, I still want to invite the providers on Monday?
Connor Morley (56:21) Okay. So you want to invite the providers on Monday? And then let me just set some time aside. Does it matter what time to?
Michele Izaguirre (56:31) Invite them. We’re no, maybe just a little bit like in late afternoon. So, if people are on the, you know, pacific coast, it’s not super early. They’re getting the email, but probably by, I don’t know by 11 a M noon, eastern latest.
Connor Morley (56:50) Okay. Yeah, no problem. Yeah… I can do that. Okay? That’s.
Michele Izaguirre (56:55) scary, but let’s do it. Let’s just.
Chandra Palmore (56:56) Do it. Yeah. I mean, it’s scary. Yeah, it’s scary. Do they know what’s coming? Yeah.
Michele Izaguirre (57:02) I’ve sent two to three communications already. In fact, like I’m afraid if we keep waiting, they’ll forget, I’ve sent so many communications about it.
Michele Izaguirre (57:11) So once we do a bulk invite on Monday, then I’ll send like a follow up communication, letting people know like, hey, this should be in your email. Does that come from? Medallion? Like, do we know how it will show in their inbox or what email? Yeah.
Connor Morley (57:28) It comes from noreply, at medallion. Com. No.
Michele Izaguirre (57:33) Reply at medallion. Com. Okay. That’s good. So I can let them know actually, it’s technically.
Connor Morley (57:38) Medallion co, if you are trying to whitelist it, but, yeah. So that’s where it would come from? Okay?
Michele Izaguirre (57:51) Yeah. Let’s just do it. Okay. Cool. And then I’ll review your email and get you all of the stuff for the credentialing that you needed. Okay, perfect. Okay. We’re moving along. It’s so exciting. Okay. Guys have a good one. All right. Thanks.