Transcript
Brittany Dees (00:00) hi, Brittany. Hi. How are you?
Amy Barfield (00:02) Can you hear me? Okay? Yeah.
Brittany Dees (00:04) I can perfect.
La Toya Pough (00:06) We can hear you perfectly fine.
Amy Barfield (00:09) Good. I went to it. I ended up switching a couple of my meetings with other clients to zoom or to teams just to see if it would work. And so I was like, okay here’s, the real testers to see if it works with you guys. So I’m glad you can hear me now?
La Toya Pough (00:28) Yes, loud and clear.
Amy Barfield (00:30) I’m sending.
Brittany Dees (00:31) you, the email right now for the spreadsheet… for all turn providers and which enrollment specifically to go ahead and stop?
Amy Barfield (00:41) Oh, perfect. Okay, cool. But good.
Amy Barfield (00:52) Okay. Requested joining? Oh, it says Svetlana is red, is she joining us today or is she still out? I thought she was joining us today? No?
Brittany Dees (01:10) Yeah, I’m sure that she was joining us today. I’m not sure.
Amy Barfield (01:18) And Carrie, maybe they’re tied up on another call.
La Toya Pough (01:21) Carrie definitely said she was going to be here. I’m not sure about Svetlana?
Amy Barfield (01:27) Okay. Oh, there’s Carrie.
Brittany Dees (01:28) There’s, Carrie, did you… receive my email just today recently on Rebecca font for her rejection letter for medicare? I just sent it maybe like an hour ago. I guess we received a task requesting for, I guess someone in medallion sent over to us, well called medicare and probably was like trying to get an update on her application. And then they tasked us because medicare said, hey, I sent, you know, this letter of rejection to Brittany on March second. And so then medallion created a task and requested for us to, you know, upload that rejection letter that we received on March second. However, I already sent that to medallion on March third. So, I think, yeah.
Amy Barfield (02:25) Nicole already escalated it with our medicare team. So, yeah, I just saw it, in our channels where she escalated that. So. Okay.
Brittany Dees (02:37) So, it was just escalated today or it had already been worked on and that some paths got.
Amy Barfield (02:41) Crossed. I just saw it right before a call. So I haven’t been able to really investigate it. Yeah.
Brittany Dees (02:46) Okay. But.
Amy Barfield (02:47) Yeah. So it’s weird when we will call medicare and they’ll say it’s in processing. And I’ve recently talked to our follow up specialists who handles medicare and asked her to ask more in depth questions and not. And then sometimes she’ll look at the portal. So, to call on every single medicare is a lot of work. I get it. But I’ve told her if she doesn’t see an update in the portal within her first follow up, then she needs to make a phone call and then to ask these more in depth questions. So, because the medicare processors are not sending these deficiency letters to everyone on the contact, but then when they close it, they send it to everybody. So it’s like, why aren’t you sending it to me?
Brittany Dees (03:39) Well, can it become a part of her process where she checks support to ensure that nothing was already sent in? That may be, you know, because that letter was sent in on March third. So, prior to her possibly calling or after she calls, if she said, if they say, hey, they sent it to Brittany on March second, you know, she may be maybe a part of the process there’s. I don’t know how your system works or maybe she can like check support. Yeah.
Amy Barfield (04:08) It’s confusing for anyone who’s not in it. Yeah, but yeah, there’s not a way for her to check like support tickets because she’s not in support, but I can check with support and find out what happened with that. March third? Okay, support, do you know the support ticket by chance?
Brittany Dees (04:28) No, but I can find it. I just have the email of where I sent it to support. But I can find the support, the specific ticket and forward it over. Yeah, if you.
Amy Barfield (04:40) Can do that, then I can check with the manager and support and say what happened here? So.
Brittany Dees (04:46) Yeah. Yeah. And you’re just talking about the email that we get after we send it to support, they, the Christina at medallion support or whatever sends us?
Amy Barfield (04:56) Yes. And did you get my email about the updated support email? Yes?
Brittany Dees (05:02) I did. Yes. So going forward, we just need to send everything to help at medallion co, instead of support. Yeah.
Amy Barfield (05:13) And this way, the reason why they changed it is because it creates like certain mail buckets. And so now those support tickets will all go to medallion a like a separate bucket or email box that come from you. So they’re all in one place instead of scattered throughout our support system.
Amy Barfield (05:32) Okay. Yeah. Okay. So it’ll be a little more organized. Yeah. Okay. Awesome. Thank you. Hi, Svetlana. Hi, Amy. Hi, did you have good time off?
Svetlana Vinokur (05:44) I already forgot about it. I.
Amy Barfield (05:46) Know it fades fast, doesn’t it when you come back to work. Well, I hope you got a little bit of relaxation before jumping back in.
Carrie Reding (05:56) She’s been on every day, I know I.
Amy Barfield (06:00) Know, but it’s less than usual. I hope… so, let’s jump into these. Let’s start with midwest M… for medicaid. We’ve got partial completion for Louisiana, New Hampshire and Wisconsin. We have full completion for North Carolina, Massachusetts for Minnesota. Can you show me something?
Amy Barfield (06:25) Amy? No, I’m just telling you but I can. Oh, okay. Okay. This is just what my team has given back to me on these because we’ve been pushing here. Let me get my shirt. The shirt screen is on the opposite side here.
Svetlana Vinokur (06:44) Yeah. So we’re still at 50 percent. So I just look at it, right? We have 14 completed 13 in progress.
Carrie Reding (06:53) So, these.
Amy Barfield (06:55) Are partially completed, Wisconsin, New Hampshire, Louisiana. We’re just waiting on location ads this one, Texas because it’s a brand new enrollment. It has to go through an oig review, which makes it take a little bit longer. We did tell them the situation and ask them to push it if they could, but they pretty much pass it off to oig review and then wait for them to pass it back so the processor can process it. But they did receive it and it is with oig review. So hopefully we’ll get something moving there. And then for Missouri, we’re still pending a response from them and Minnesota is in process. So of the medicates that we’re still pending that’s what we.
Svetlana Vinokur (07:41) Should do. Kentucky is the issue one as well, right?
Amy Barfield (07:44) Kentucky. Okay. Let’s see. We’ll have a Kentucky medicaid on here?
Svetlana Vinokur (07:51) Yeah. There was an error on application on 319.
Amy Barfield (08:05) Okay. I’ll look into that one. My… teams… can you still see my screen? Yes.
Svetlana Vinokur (08:17) And Amy, it’s interesting. Like I still see on the medicaid, Indiana, like some of the people are still saying pending dependency, a bunch of them submitted, but there’s like three that are saying pending dependency. Okay. So still hasn’t been released fully or hasn’t been worked?
Amy Barfield (08:41) Worked.
Svetlana Vinokur (08:42) yeah.
Svetlana Vinokur (08:47) Yeah, the same on New Hampshire. So, yeah, the same on New Hampshire. Okay. Yeah. So, and it’s not only providers, right? It’s all the other group kind of dependent dependencies, right? On like.
Amy Barfield (09:04) the commercial points related to it,
Svetlana Vinokur (09:08) So.
Svetlana Vinokur (09:14) Carrie, where are we on? Figuring out for us medicaid, Wisconsin, kind of complex care, the same as we did with sewardia… so I.
Carrie Reding (09:27) I honestly, the, I looked at it the other day and what I realized is that we only requested physician groups. And Amy, I noticed it after our ecw call. So I, we did not request any of the nurse practitioner groups. So I’m not sure what happened on that. So I need to go in and do a, either we can take it and do it if you prefer or I can open up a ticket to have it done.
Amy Barfield (09:57) I think it’s the other way around. Is it nurse practitioner group is approved? But, the physician’s not, and, I don’t think so… because.
Carrie Reding (10:07) When I was looking at each of the applications, they were all physician groups for the one that’s completed.
Amy Barfield (10:14) All right. Let me see if I have the application.
Svetlana Vinokur (10:16) For group and really has been nice. I’m looking at the fact is that we are sitting here in April and we are guessing right now what has been done and whatnot for Wisconsin medicaid. Again, we’re going to have the same issue with complex care that we are having with the warrior.
Carrie Reding (10:35) Sorry, I’ve been, I will work on this tomorrow. I will dedicate half the day tomorrow to work on this. I was working on that report for ecw for the entity. So I’m trying to get that squared away so I could get that over to Jackie. But I did glance at a couple of these things today. They did send an email to Lori about a reset for some of the Theoria locations. We just need to go in. I’ll request the pin letters for the ones that we have for the Wisconsin medicaid. I’ll get that done this week so that we can get those started, start getting those set up… but.
Svetlana Vinokur (11:14) Amy, just kind of, I don’t know just to me, it’s completely unacceptable that medallion completely didn’t do that, right? And we’re still in April and it’s not done correctly.
Carrie Reding (11:26) Amy, let me look. Let me pull this again because like I said, when I looked at, it was the one that was completed and I didn’t know.
Carrie Reding (11:38) It was for, because we’ve only gotten the completion for midwest H, and if you go look at the applications, they’re all for physician groups.
Carrie Reding (11:54) That were sent.
Carrie Reding (11:59) Okay. So I’ll log a ticket and get, yeah, see what we need to get this going.
Amy Barfield (12:10) So, yeah, it’s partially completed, you can say and.
Carrie Reding (12:13) It’s only for what? Five locations now? Because three of them were not in anymore, so.
Svetlana Vinokur (12:20) But,
Carrie Reding (12:21) yeah. Here’s, let’s see provider type on the application says physician group. So I’ll yeah, you’ve got three.
Amy Barfield (12:30) Locations that are termed already on there. Yeah. Okay. Yep. Yeah.
Carrie Reding (12:37) I’ll give you an update in the morning when.
Amy Barfield (12:41) On our call. Yeah. So.
Svetlana Vinokur (12:43) Amy, I mean, I just by accident look at this and look at this on 316. It says at the portal group is showing inactive with the pair. So we’ll call to Laura, to know the reason 316, nothing.
Amy Barfield (13:00) This is for Michigan medicaid. Yeah.
Svetlana Vinokur (13:03) Michigan medicaid. I just look at this random provider.
Svetlana Vinokur (13:11) Like what does that mean group is in inactive?
Svetlana Vinokur (13:19) We have done so provider approved with it. I mean.
Amy Barfield (13:27) I understand. And while we’re not ignoring the providers, the goal over the last two weeks is midwest and four groups to be enrolled. So that’s where our focus is was, yeah. Well.
Svetlana Vinokur (13:38) There has been a lot of like I literally, I looked today midwest and Michigan, right? My biggest kind of, and there was like other than medicare medicaid, nothing is done… literally.
Amy Barfield (13:59) Or midwest? Yeah.
Amy Barfield (14:07) Thank you.
Amy Barfield (14:13) Michigan group is part with traditional, we’re still waiting on the vcm plans, which is submitted. So it’s partially completed right now.
Svetlana Vinokur (14:27) What is him for?
Amy Barfield (14:30) Blue cross blue shield in Michigan blue cross.
Svetlana Vinokur (14:31) Blue shield. Okay? But that has been already like for months and months, I think. Yeah.
Svetlana Vinokur (14:44) So, like I’m looking at the I’m looking at my Michigan, right? Like, so I have tons of Michigan providers. And now I need to enroll, right? And I have three completed and 18 processing and a group level. So basically, I cannot enroll the providers with anything other than medicare medicaid?
Svetlana Vinokur (15:08) But this is the only three that are completed. Let’s see, yeah, medicare medicaid, and Aetna.
Amy Barfield (15:20) You’re saying that’s the only three that’s completed for midwest M.
Svetlana Vinokur (15:24) Yeah, for Michigan. Yeah. I.
Amy Barfield (15:30) mean, you have partial completions. So you’ve got some approved. It’s just we’re waiting on certain locations or lines of business to be added. So there are more completed enrollments.
Svetlana Vinokur (15:41) Okay. So let’s see blue cross blue shield is okay. So let’s see, blue cross blue shield is one, but it’s been kind of.
Svetlana Vinokur (15:53) Says that it’s managed medicaid only. So I don’t… yeah, this one, it says that it’s only medicaid.
Amy Barfield (16:05) Is that the complete line or it?
Svetlana Vinokur (16:08) Says paid enrolled and partially completed, right? They go into the details and that’s what it says that it’s one… facility managed medicaid. Okay. So if we have medicare, like I don’t like why is it not on this one?
Amy Barfield (16:31) That’s part of the BCN network for blue cross blue shield.
Svetlana Vinokur (16:47) So, this was just completed today for two.
Amy Barfield (16:55) When did we get the effective date for that partial completion?
Svetlana Vinokur (17:01) 11, 24, 25.
Amy Barfield (17:04) Well, that’s the effective date that’s not when we received that information. They may have gone back to the date that we submitted that original application.
Svetlana Vinokur (17:14) Yeah. So on four one, they sent us an email saying that, we are not in network with anything other than four one.
Amy Barfield (17:27) So it was still in process prior to that four one mailing according to the note here, or is it saying effective date 1,212 per rep group is a network effective date 1,212 where it verified that one practice location… you know? And so then they sent… the line of businesses. And then there’s a list of locations and providers that are linked to?
Svetlana Vinokur (17:58) Yeah. But do you see like denied does not meet criteria? What the heck was it?
Amy Barfield (18:03) That’s the BCN network that we have to apply for, but your traditional is active as of 1,212?
Svetlana Vinokur (18:09) Yeah. And why we are sitting here in April first and we haven’t done that… wasn’t this requested back in the summer. Amy, I just don’t know. I don’t know what to do. We are again creating huge holes for me because I will have right now 20 new providers I need to add in Michigan… and I can’t even build blue cross. What do I do?
Svetlana Vinokur (18:55) I don’t know, you tell me how else to communicate to medallion the priorities. I don’t know what to do. It’s been outstanding for nine months now and we just submitted today something.
Amy Barfield (19:17) I’ll have to look back at the notes. I don’t know if something was submitted at the time and it just didn’t get approved or why we’re submitting it today, but it was communicated a few months ago that they should be submitted at the same time.
Amy Barfield (19:41) So, I don’t know if this is a resubmission of the BCN because they’re not finding it or you’re on mute. I’m sorry?
Svetlana Vinokur (19:54) Like, I mean, we like, I like… this is a pain, like we feel like I have like we just acquired a company in Michigan. I have 20 Michigan providers. I need to enroll. I can’t enroll them with anything other than medicare and medicaid.
Svetlana Vinokur (20:22) And we know that blue cross commercial does nothing for me because I don’t have blue cross commercial people, right?
Amy Barfield (20:36) I’ll get you some better answers on that. I’ll speak with Nicole on it.
Svetlana Vinokur (20:43) I’m going to send an email to Derek like I’m just really fed up. I’m so fed up like I just don’t know kind of how to… and like nothing like not a single like.
Amy Barfield (21:02) I know you’re upset about this and I understand why, but to say that nothing has been done is incorrect. So, I mean, we have made movement in the last two weeks with at least partial completions. And we’re working to get the additional locations or whatever is missed on those lines. We have been focusing on midwest to M, for the last two weeks. For the groups, we do have approvals… providers are being submitted where we do have approvals, we’ve released the majority of providers that we could. And while I know you see a few stragglers here and there of pending dependencies, they should flip here soon. If they’re worked. I’ve requested all the medicates to be released. If you still see some of those. Let me know. I will ask them to at least release those so that they’re showing released for your visual. I understand.
Svetlana Vinokur (22:07) I just don’t know how to go back to my CEO and say, I’ve been working on the project for a year now. And in my biggest market, I cannot even enroll providers with bluecourse. Blueshield. I just don’t know how to say that and not to lose my job, yeah.
Svetlana Vinokur (22:29) Like this is like, I mean… and how medallion can just sit there and say that they’re making improvements when the basic stuff is not done like and I’m not directing it to you Amy, I know.
Amy Barfield (22:50) And I share your frustration. I really do and I’m pushing what I can on my end.
Amy Barfield (23:11) Do you want to continue reviewing the rest of these things? I?
Svetlana Vinokur (23:15) Don’t know what to review, like, I see kind of like, right? Like, and I see like that stuff is not moving. Like, the only thing that was done is medicare, my medicaid in the last two weeks, no medicaid got approved and my bluecourse blueshield, no bluecourse blueshield got approved… and my united, no united got approved. So, I had, very few… group enrollments actually done. I.
Amy Barfield (23:49) have united, Indiana, Illinois, and New Hampshire that are approved with commercial medicare and medicaid for complex care midwest. But.
Svetlana Vinokur (23:56) Again, commercials do nothing to us commercials.
Amy Barfield (23:59) Are they have medicare and medicaid lines of business? They have medicare and medicaid lines of business. Those three are approved.
Svetlana Vinokur (24:06) So… I.
Amy Barfield (24:09) understand, not all unitedhealthcare is not approved, but those three are… with those lines of business. And I submitted several network participation requests for those medicare and medicaid. I haven’t heard anything back Brittany. Our team lead reached back out earlier this week. She hasn’t had a response back. We sent a letter I think to humana as well because you have a national contract.
Svetlana Vinokur (24:38) Yeah, I have seen that, and I appreciate you doing those things like, you know, like I appreciate you doing those things. My frustration was because we’re short right now.
Amy Barfield (24:46) Yeah, right. No, I, yes, like.
Svetlana Vinokur (24:49) Because we’re from Michigan. It’s unacceptable. Like, it’s unacceptable. What’s happening with Theoria? It’s unacceptable what’s happening with complex care? And I don’t know how to get through that to medallion. I’m going to send an email to Derek again. Like, I don’t know how to get through. Like, I just, I don’t know. And then, and then Mitch gets on the phone and starts telling me kind of how much money they’re spending like, well, I want to tell how much money I’m writing off. So Theoria and Kari, do you have access logins that you need, or are we still waiting? And what do we need? Ame’s, help with on that?
Carrie Reding (25:38) We still are pinning some, let me tell you what we do have. How about we start there? We have Texas. I know that for medicaid and let me pull up my login sheet, Texas.
Amy Barfield (25:54) That you still need or Texas?
Carrie Reding (25:56) That we don’t oh, no, no, that we have it. Yeah, we have Texas. Yeah. Let’s.
Amy Barfield (26:02) see, I.
Carrie Reding (26:04) Have Ohio, medicaid, Texas, medicaid… I think we’re still working on Illinois because that was a big one. They.
Svetlana Vinokur (26:14) That.
Carrie Reding (26:15) was one that.
Amy Barfield (26:15) we were still working on.
Carrie Reding (26:20) Minnesota… Tennessee.
Carrie Reding (26:31) Let’s see. I have Michigan… and we set up Vermont, the other day.
Amy Barfield (26:37) So, we’re.
Carrie Reding (26:39) working our way through them, we’ve gotten quite a few. I think we have another call.
Amy Barfield (26:45) You need Illinois, Minnesota and Tennessee.
La Toya Pough (26:47) Illinois?
Carrie Reding (26:48) I think they said was kind of, it’s going to take some work on Illinois. I think if I remember, right? It’s I think you can only have like one administrator or something like that. So, okay.
Amy Barfield (27:01) And did you say you need Minnesota, Tennessee or you have Minnesota and Tennessee? I?
Carrie Reding (27:06) Have Minnesota, I think it was set up by medallion. I have a Minnesota login.
Amy Barfield (27:11) Okay. So, yeah, we are meeting bi weekly for portal setup, and there’s been communication in between those two weeks or bi monthly, I should say, and there’s communication in between those meetings with our team. So that is open and moving for the portal setups, Lori.
Carrie Reding (27:34) Has access to Florida. We decided to leave that with her since she had all nine locations since it’s nine logins. It’s not necessary for all of us to have the same thing, if we can just use hers. And then I think Latoya, you were asked, you got access to Georgia, right? Because you already had a Georgia login. So you just needed access to Theoria. So you got that. So we’re moving. I think, yeah, we’re probably about halfway through. I guess.
La Toya Pough (28:03) Okay. Amy, I do want to bring up. I just noticed that for midwest M, for complex care midwest. M, there are Illinois… Indiana, and also the… Michigan. The group has been… I don’t know if someone is trying to.
Amy Barfield (28:32) Submit a.
La Toya Pough (28:35) Change of information for the group, but the application is like in a pending state and I can’t add any providers to it.
Amy Barfield (28:47) What payer is this in reference to medicare? Oh… okay. So you’re trying to do what with medicare?
La Toya Pough (29:03) I was trying to add to it and I cannot add providers to it because the group application is stating that it’s waiting for process and it looks like someone has put a change of information. So either you guys need to submit it or delete it, and I don’t know where you guys are in those three states. So I don’t want to delete it if you guys were, if.
Amy Barfield (29:31) it’s in process, it’s something that we’re updating that there’s a request and we usually have reassignments that go through those applications as well. So if we can’t just delete it, we have to call and withdraw the whole application. And then it stops everything. And then we’re not able to proceed with whatever requests we had in the system. So there are a couple where we did do change of information so that we could add Svetlana as a managing and so that’s probably what you’re seeing and you’re saying this is for complex care. It’s.
La Toya Pough (30:06) for complex care, it’s for Michigan, Indiana, and Illinois… for.
Amy Barfield (30:14) midwestn. Yes. Okay. I’ll have to look at them individually to see exactly what it is. But if it’s I will.
La Toya Pough (30:26) Send an email after this meeting. So at least you can see what I’m speaking about.
Amy Barfield (30:32) Okay. Yeah, that would be great. Okay?
Brittany Dees (30:39) Okay. A couple things for me, Amy, I sent you over that ticket for Rebecca fond. The ticket shows that it was resolved on March third, the same day that I sent it. So not sure what kind of happened there.
Svetlana Vinokur (30:55) That’s really, Amy. Like this is like, I mean, I’m beyond myself right? 30 days, we lost time… and now they’re asking us to find that email when we sent it 30 days ago.
Amy Barfield (31:14) Okay. I’ll have to ask support how it was resolved and get you an update on what happened with that ticket. But now that I have the full context, I can do that. Okay? I.
Brittany Dees (31:27) also received an email from santendra Yadav. The email was sent directly to me to RCM. However it’s an email like it’s they’re requesting information like information regarding a provider enrollment status. But the way that they’re requesting it is like they think that they’re emailing the payer directly. I already emailed back and said like you’re emailing Theoria and not the payer, but this is like the third time I’ve received something like that. So I thought maybe we can bring it up with the team to double check. Yeah, I think.
Amy Barfield (32:09) What happens is we’re our teams are told to like reply back to and they’re just not seeing like you’re with you like seeing your domain. And so they just automatically reply to the last person who emailed. So, if you flagged the medallion team email for enrollments, then they’re just responding. But yeah, if you wanna, did you send that to me so I can flag it for you? Yeah.
Brittany Dees (32:35) I guess what happened was the payer requested a copy of the W9. I sent the payer a copy of the W9 and then they responded back to that email. So I’ll forward that to you right now.
Amy Barfield (32:47) Okay. Thank you.
Carrie Reding (33:09) All right.
Svetlana Vinokur (33:18) So, my favorite friend Cyndia Boswell in Louisiana. So, looks like they just rejected the application because they didn’t like that. We sent it on double. Sided. So, the good news is that I actually have a second application that I kept. It was her signatures already and everything. So I’m ready to send it. I need the shipping label. Yeah. And I asked on the test today for that, okay?
Amy Barfield (33:59) I will try to get it to you today. It’s depending on because it’s coming to the end of the day. If not that’s fine.
Svetlana Vinokur (34:06) I don’t need it today because I’m not going to ship it today, but if you send it to me tomorrow, I can try to get it out tomorrow… okay?
Svetlana Vinokur (34:20) All right. Okay. But I’m very displeased with the progress. Like given kind of Nicole involved. There are two new people and everything. I am very displeased because like I don’t even have basics again, like I have 20 Michigan providers right now that I need to enroll and I can’t even enroll them other than with medicare and medicaid and Aetna that’s.
Amy Barfield (34:45) it? Okay.
Carrie Reding (34:58) Amy, there’s a task out here and I’ve reached out to the provider rep, it’s for anthem, blue cross, blue shield, New Hampshire. And I think what it appears is happening is that we tried to send in the same provider for midwest M and then maybe northeast H.
Svetlana Vinokur (35:18) So,
Carrie Reding (35:18) there are payers like one we’re enrolled with one entity but not with the other. I’ll let you know tomorrow. I was going to try to call her back today. I.
Amy Barfield (35:30) Think I sent an email to you Svetlana about that there’s so anthem doesn’t want to honor a contract for the other location and I wanted to know. I was going to reply back.
Svetlana Vinokur (35:44) So, basically, Kerry, we need to find out if there will be explain to them why we need two separate legal entities. Yeah.
Carrie Reding (35:52) I started today and she had a meeting she had to jump off for too. So I told her I would try to give her a call back. So, I was explaining that we’re there are two different tax ids and mpis and we need two groups. So.
Amy Barfield (36:05) Yeah. I wanted to relay to her the whole aco, reach part of it, the reason for the two separate tax ids at the same location. So, yeah… let me know if you want me to communicate something via email, but it sounds like you have her directly.
Carrie Reding (36:23) Yeah. I called her number off the task in there. Okay? I’ll let you know tomorrow. I’ll see if I can get a hold of her in the morning. Okay? I think she said she was in meetings this afternoon, so it’ll probably be in the morning.
Svetlana Vinokur (36:42) Okay. So we got the priority house rosters for midwestm… and midwestah, right? I forwarded to you guys. So, who is going to go through and update that in the medallion… to make sure that we don’t miss anyone who should be enrolled?
Amy Barfield (37:12) Specifically, I don’t know who, but I will get it assigned to the team. Well.
Svetlana Vinokur (37:16) We haven’t forwarded, I don’t know. Did I forwarded that to you? Amy? I don’t know because I might have sent it internally.
Amy Barfield (37:24) Yeah. I saw communication where you were asking, but I don’t know that I actually got the, I don’t see it in my email right now. Hold on, let me look. No. The most recent email I have about priority health is like the thirtieth?
Svetlana Vinokur (37:47) So, there are rosters for complex H, M and H.
Svetlana Vinokur (37:59) And is it client owned right now or?
Amy Barfield (38:05) I believe, so, it’s either client owned or on hold. Either way, we should be able to update it. Okay?
Svetlana Vinokur (38:12) So, so Amy here, is the hold on, let me forward you this email. Maybe I didn’t forward because it was, so I just forwarded you this email. So basically, they honored her for one? They.
Svetlana Vinokur (38:35) They, they attached the providers for each and for each and we just need to kind of mark that and see who is not.
Amy Barfield (38:46) Who’s not on the roster?
Svetlana Vinokur (38:48) Right. And, and locations really don’t matter for priority. Like they say they matter, but they matter only because for their… internal search, but it doesn’t matter for paying claims. So I wouldn’t worry about the locations?
Carrie Reding (39:11) They just use it for their directory, yeah.
Svetlana Vinokur (39:14) And is.
Amy Barfield (39:15) this for Michigan or Ohio?
Svetlana Vinokur (39:18) Michigan. That’s not paramount. He was thinking about paramount, Ohio probably.
Amy Barfield (39:23) Okay. I have priority health lines for Ohio… no?
Svetlana Vinokur (39:28) We are not using that line because we don’t have right now the business in Ohio for priority health. So we decided we’re not going to engage until we have more.
Amy Barfield (39:39) Okay. They’re client owned right now anyways, do you want me to stop them no?
Svetlana Vinokur (39:43) You can keep them client owned because if we decide to have it, then we’ll work on it, but we decided we don’t need it right now.
Carrie Reding (39:51) Okay. And it looks like there’s some medallion owned in here too. Amy, I don’t think they’ve all been moved to client owned.
Amy Barfield (39:59) Okay. So I’ll move all the Ohio’s.
Svetlana Vinokur (40:02) yeah. My.
Carrie Reding (40:04) Paper path. That might have been my bad because I don’t think I updated on the spreadsheet until the other day. So, if.
Amy Barfield (40:10) we.
Svetlana Vinokur (40:15) can update the Michigan one to?
Amy Barfield (40:21) Because.
Svetlana Vinokur (40:21) we got enrollments and everything. And then did… I forward you the email for blue cross, blue shield of North Carolina? I think I did, right? That we are also done with them on four one and four, four. But what’s concerning to me is that healthy blue was never even requested. So, how was that missed? So, healthy blue for North Carolina was never requested?
Amy Barfield (40:55) Requested on our side or on your side?
Svetlana Vinokur (40:57) I think on our side, okay?
Svetlana Vinokur (41:08) Do we have an hour of payr, masterpayr, healthy blue? North Carolina?
Svetlana Vinokur (41:32) I see it for Theoria. We have, I,
Amy Barfield (41:35) see it for Theoria. I don’t have anything for complex cares. Yeah.
Svetlana Vinokur (41:41) I know.
Carrie Reding (41:43) You said healthy?
Amy Barfield (41:44) Blue? Yeah.
Svetlana Vinokur (41:45) North Carolina?
Carrie Reding (41:47) It just says blue cross blue shield of North Carolina. So.
Svetlana Vinokur (41:51) No, we need to have healthy blue for… North Carolina. And in the email I forwarded there’s, the email and there’s a phone number. So I think Latoya, if you can call tomorrow and figure out how we can get that application up and running.
Carrie Reding (42:10) Okay. And I’m updating the masterpayr list right now?
Amy Barfield (42:15) Okay. Healthy blue? Yeah.
Svetlana Vinokur (42:18) It’s in the email that I forwarded for from Tia, North Carolina. So there’s a phone number in the email for North Carolina, healthy blue that’s the medicaid plan. We need to enroll as soon as possible.
Carrie Reding (42:31) You said medicaid?
Svetlana Vinokur (42:33) Yeah, it’s a medicaid line. Okay?
Svetlana Vinokur (42:43) I did sign the blue cross blue shield Texas contract. Amy, I think you were copying on it. So I don’t know if this is Brittany spelled differently.
Carrie Reding (42:54) Yeah.
Amy Barfield (42:55) Yeah. With an, I always have to catch myself when I’m emailing. Yes. I did see that. Okay?
Svetlana Vinokur (43:10) I don’t know how like Amy is to like what language to, in what language to say we need to get blue cross blue shield of Michigan done as soon as possible, like we have to… like, I can’t operate without blue cross blue shield of Michigan. Yeah.
Amy Barfield (43:35) It is submitted. I’ll have them do follow up weekly on it… does.
Svetlana Vinokur (43:41) The fact that it was submitted today was just like I’m just like I want to scream, you know?
Amy Barfield (43:46) Yeah, it is. It is owned by our team lead now because when we started this, I asked her to start taking over a few of your priority pairs like your blues and medicates with. Kelsey is not with medallion anymore. So now Brittany has taken over her workload. But I think you’ll be pretty pleased with Brittany. She’s been here for four years and, she seems to be pushing things through in the right way the way, that I would want to see that. So, yeah… I will ask her to make sure that’s followed up on and that it’s top priority and that she’s following up weekly on that.
Svetlana Vinokur (44:30) I just sent an email to Derek and Nicole on this. I think I copied you as well. So, but this is where… we are not even close to where we need to be. Yeah. Okay.
Amy Barfield (44:48) Is there anything else you’d like to review for complex care today?
Svetlana Vinokur (44:52) No. Okay.
Amy Barfield (44:56) Tomorrow we are meeting… we’ll check same time as usual. Yeah. And.
Svetlana Vinokur (45:07) I think we don’t have any meetings going forward. Like I don’t see them on the calendar going forward on the Tuesday one. Oh, that next week? Are you out next week? Because that might, yes.
Amy Barfield (45:20) I’m out. So we, so we adjusted, so we’re meeting. Yes. Yeah. Okay. But we’ll resume normal when I return to the.
Svetlana Vinokur (45:28) Phone. Yeah, I know. And I now, I see it. Yeah. Okay. Yeah, yeah. And, I think Amy, what we maybe should do also, all of these denials, we probably should discuss them on this call kind of right? Because medallion just closed hop, I don’t remember like kind of even being notified that it was denied, right? And I was just looking at something else and I was like, what? And, you know, because… that’s a really big one for us. Okay?
Amy Barfield (46:04) Let me make a note and I’ll look to see why that was closed.
Carrie Reding (46:08) What state was that for?
Amy Barfield (46:10) Michigan? Oh, gosh.
Amy Barfield (46:18) And is that connected with another payer that I recall? Like we have to be enrolled with that to be enrolled with something else or anything?
Svetlana Vinokur (46:26) I don’t think so. I don’t know. I don’t think so well, we.
Carrie Reding (46:31) Put a note on the master payer list that the health alliance plan was closing on. So, maybe, no.
Svetlana Vinokur (46:39) That’s a different, that was like one line that was closing. And so, then they stopped, oh, I might have been remember, like, yeah.
Carrie Reding (46:48) That might be where the confusion is. We probably need to look at that then.
Amy Barfield (46:53) Well, we just need to reopen it and then investigate while they get it moving. They.
Svetlana Vinokur (46:58) Denied it, right? They said, yeah… okay.
Svetlana Vinokur (47:11) Only one network? Yeah, I don’t.
Amy Barfield (47:13) know what network that was. They were closing. Only one network was closing. I guess it doesn’t matter. We’re just going to request medicare and financial?
Carrie Reding (47:24) Was this a market one or whatever it was?
Amy Barfield (47:28) Yeah, I was trying to look, see if I can look back at… I see.
Svetlana Vinokur (47:41) Oh, hop, a care source. Yeah.
Amy Barfield (47:47) So, I have a note to remove dependency. Yeah.
Svetlana Vinokur (47:51) But this hop, medicare, right? And hop, medicare that’s where it’s like really important for us. This is really big for us, so.
Carrie Reding (48:07) Can we have doms go back and review all of those and make sure our provider’s enrolled?
Svetlana Vinokur (48:15) Carrie, our group was denied.
Amy Barfield (48:18) Did we have a, this is for complex care that we’re talking about? Does the Aurea have an active enrollment? Yes. Okay. We need to just transfer?
Svetlana Vinokur (48:38) Okay.
Svetlana Vinokur (48:43) Okay. All right.
Amy Barfield (48:49) I’ll work on those.
Svetlana Vinokur (48:50) Things. Okay. Talk to you tomorrow, like tomorrow, I would like to like if there are any updates on the medicare’s that we’re appealing to our special person in CMS? Yeah.
Amy Barfield (49:06) I’ll try to get an update. Since we kind of start first thing in the morning. I’ll work to see if I can get an update before a call from what I understand we haven’t got one. He’s pretty good about responding to me immediately when he gets an update, but I’ll check with Nicole and Brandon… so far haven’t had much success, but I’m hoping those name changes will at least approve.
Svetlana Vinokur (49:33) And then the medicaid, blue cross, blue shield, sorry, blue cross, blue shield of Michigan again, medicare medicaid, lines, right? But the warrior, like I have 700 K still sitting on it.
Amy Barfield (49:51) And medicare… petro.
Amy Barfield (50:00) Okay.
Amy Barfield (50:04) All right. And I have those ready for you tomorrow. Okay? Thank you. Bye.