Transcript
Connor Morley (00:00) how’s it going? You’re on mute?
Jennifer Mikel (00:07) Are you doing no cameras today?
Connor Morley (00:10) I am turning on the camera right now. I thought you were just cursing into the mute button for a second.
Jennifer Mikel (00:19) No, it’s okay. So, like my last call with Naomi yesterday, I wish I would have gotten a heads up from Naomi that I needed to be off camera. These people were so rude, like I was talking and then she interrupted me. And then, so like I gave her a few minutes to like talk and then I started talking and she was asking questions and she was like, excuse me. Can I talk? And I was like, and… I totally had this space and I was like… and then she was like, you can talk now and I was like, can I, is what I was thinking?
Jennifer Mikel (01:00) But Naomi like messaged me she was like go off camera, go off camera and I was like, they.
Alicia Iannece (01:09) were the worst.
Connor Morley (01:11) That’s so funny. Now, these guys are very sweet. They are, they’re very sweet and I.
Alicia Iannece (01:19) think they’re so sweet.
Rheta Larson (01:22) They just have a lot of questions and they get very into the weeds of questions.
Connor Morley (01:28) Okay. I do have to jump at two o’clock for another call but I’m going to let them in because I see Alicia and Jenny waiting right now.
Jennifer Mikel (01:37) Okay, great.
Connor Morley (01:50) Hey, everyone. Hello? Hi there.
Rheta Larson (01:59) How are y’all doing today? Good, good to hear. Thanks for y’all’s flexibility on moving this. I know we had to rearrange this one. So thanks for accommodating there.
Alicia Iannece (02:13) Not a problem.
Connor Morley (02:16) So, I think we can dive on into the tjc cred packets because I think we have some questions on what exactly is needed in order to say tjc compliant. And then we also have Jen on the call right now. She’s our cred expert. So we just want to make sure that we’re following… tjc guidelines and make sure that we’re also following your bylaws. So, I think Jen right now, I think the concern is if we’re waiving work… history as well as claims history that there could be concern. And then Alicia, I know that you brought up that npdb should suffice, but I’m going to pass it over to Jen to explain some of our reasoning and thought process on this.
Jennifer Mikel (03:10) Yeah. So, hello, I’m Jennifer, Michael and I just kind of want to make sure that we’re all on the same page. That way we’re not going back and forth and we have a complete packet when we give it to you guys. So when we went over your bylaws and then the packet that we got from you guys, part of it mentioned that we would be checking the provider’s background, work history and their, which was part of their practice history. And I think there was some misunderstanding if the practice background was like maybe just their hospital affiliation. So was, is that what you guys were doing previously with were y’all, doing that in house or was another cbo doing that for you guys?
Alicia Iannece (04:03) So we had another cbo doing it and, their policy was, and, they were like bare minimum. So, so we’re definitely like I’m just going to explain but they basically would do only hospital affiliation verification. So they would verify privileges only if they listed employments. They would not verify those now if they only had employments and they did not have hospital affiliations, then they would do an employment verification. But otherwise they prioritized it as hospital affiliations. Only. I think what happened, what I’m seeing is our providers like they don’t know or truly understand the difference maybe. And so, and also the so, in the professional history tab where it has work history and then practice affiliations. The practice affiliation specifically calls out admitting privileges, but we have several providers here who they have privileges but not for the purpose of admitting patients to the hospital. So I do have a concern that maybe that language there is a little too specific that maybe they’re like I don’t admit patients. So I’m not going to mark that as a yes. So I think that could be maybe where some of the confusion has happened. So they’re listing their hospitals in their work history even if they’re employed by a separate company, or they might be employed by the hospital also. But the majority, like the majority of our providers are a separate contracted agency. So they’re listing all any hospital affiliations in that work history. And then we’re needing privileges verified and not necessarily employment. So.
Jennifer Mikel (05:47) We can give additional information to them that kind of like breaks down like we can’t change it within the platform just because that’s just standard language, but we can kind of like break, give them kind of like update the email that goes out to them. If I’m correct, in that, right? Rheta and Connor, like their welcome email that goes out that can be like tailored for them, each client, right? And we can actually break down that says like hospital affiliation. This is where the provider holds clinical privileges. And then work history is going to be your employment history, like where you’re actually employed and not a hospital. And one of the reasons why I think we want to get a better understanding is because in your bylaws, it actually says that you want to make sure there’s no disciplinary actions, no sanctions, no issues, those types of things. So that’s why I was kind of unclear why this wasn’t done before. Because the bare minimum packet that you’re describing is kind of like an ncqa packet, not a tjc packet because if you’re tjc accredited and you get audited, you’re not really meeting that full accreditation guidelines if you were to come in and get audited by them.
Alicia Iannece (07:04) So I, yeah, if you can point me to the joint commission regulation that specifically calls out the claims history. And I know I do know best practices to verify all work and practice affiliations. But as far as what the minimum requirements is, they say it’s up to our bylaws to decide and regarding malpractice, our bylaws really only calls out a current malpractice, like proof of current malpractice. So, it is more on the minimal side and then claiming no disciplinary action, no claims. No sanctions. What I’m understanding from the ncqa requirement is that the like it can be through verification of the malpractice carrier or through the npdb report. Yeah.
Jennifer Mikel (07:47) So, right here is your bylaw. So under section two point four is where it talks about the application of procedure for your appointment, reappointment and branding of clinical privileges. So of course, it talks about your three professional references here. And then of course, about your licenses completing for your hospitals and other institutes at which the applicant had worked and trained to obtain verification of privileges. So this right here is where it talks about getting the verifications. And then the next part.
Alicia Iannece (08:20) These and that’s verification of privileges there for the bylaws.
Jennifer Mikel (08:24) Right. And so right here is your, these are all related to sanctions, this part and this part, again, this part is sanctions and then board certifications. And then my computer decided to freeze. So, sorry. All right. And then… this is where it talks about five years emergency practice graduation. And then there was only one mention of the.
Jennifer Mikel (09:10) Mpdb. So that was the only part that I, that was very unclear in this. And that was actually not in the bylaws that was actually in the other document that I got, which was the.
Jennifer Mikel (09:35) The appointment reappointment and clinical privilege policy which mentioned the mpdb that had to be pulled. And then just one, what was, the Coi when they came on to staff? And so that is fine. If you don’t want to do the clinical history. But when we gave the sop, it just mentioned that we would run five years and that was approved. Connor, I’m not sure who approved that, but that’s the only reason why we went forward with that part because just because that is standard.
Alicia Iannece (10:13) And are you talking for malpractice or for like practice affiliations for the five years?
Jennifer Mikel (10:19) Malpractice? Okay?
Alicia Iannece (10:20) Because, yeah, in the profile, it’s saying it’s requesting all malpractice history. So, I don’t know if that’s confusing. Oh.
Jennifer Mikel (10:28) That’s just the standard in our profile per SE. So, Connor… can we turn that off per client? Do you know that setting that’s an implementation thing? Sorry. Okay.
Connor Morley (10:42) I can turn it to be optional, but I don’t think we have the ability to specify for the past five years… she’s.
Jennifer Mikel (10:56) just saying they just want it to be the current Coi, right?
Connor Morley (11:00) Yeah, I don’t I.
Jennifer Mikel (11:02) would just make it optional then.
Connor Morley (11:04) Yeah. Okay. If that’s as long, okay, we can definitely make it optional. And as long as we can provide tasks just in case someone forgets it or doesn’t include their current Coi, then I don’t have any concerns there all.
Jennifer Mikel (11:21) Right. So we want to. So going forward, you got, we just want to make sure we’re doing so. We’re all on the same page, no work history verification.
Alicia Iannece (11:34) So, okay. So hospital affiliation verifications are our priority would be verification of privileges if they’re stating employment by a hospital. And it fits your standard practice to collect those employment verifications. And you think it’s necessary? Like I think we’re definitely willing to do that. I think the issue is more so on the provider’s side as far as whether they’re putting the information in the right spots. So maybe we need to go and review those in advance prior to submitting an application for appointment or reappointment to verify they’ve filled those out correctly. I don’t know. I mean, because I do totally understand the benefit of employment verification. I think we just had some concerns that it might be duplicative if you’re doing it for both for, you know, every location, which is what happened in our, one example of one of our employed providers, then it was a request for an employment verification and hospital privileges verification. So it initially seemed like too much and that it might, you know, those extra steps might delay a file to get completed. So, I guess that’s where we fall is if these extra steps, you know, if it’s standard for medallion to do those steps. And if that’s considered best practice. And if that’s what we’re saying is going to be the most, you know, opportunity to be compliant with our regulations, then we’re in support of that. But I guess our main question is just whether it’s going to delay a file from making it to completion and whether it’s necessary.
Jennifer Mikel (13:18) So, that is complete. So, our typical rule for tjc is to do work history because sometimes some disciplinary actions are not appropriate… always reportable to mpdb that’s the only thing when it becomes, when it is some things that happen from a employment issue, right? So that’s the only reason why we say do a work history verification if you want to do that. And if you have a form or if you just want us to, you know, have that done? Especially with it saying like they’re not eligible for rehire that kind of thing because there has been some cases where a red flag has popped up that a provider did not disclose. But again, if you haven’t had any issues before and you’ve been following certain, you know, a very mild… file before and haven’t had any issues with tjc based on your bylaws that’s completely up to you because tjc if they’ve approved your bylaws with the way they’ve been written, then that’s what they go by.
Alicia Iannece (14:32) Yeah. And that’s the case for us. So, we haven’t had issues in the past with just doing hospital affiliation verifications based on what our bylaws requires. Okay?
Jennifer Mikel (14:42) Well, we’re happy to take them out, but I just want to make sure we’re you know, we’re setting the stage going forward and there’s no confusion that’s why it’s good to have this meeting and kind of that way it’s not all confusing and you’re getting a file that’s halfway completed and it’s not done correctly?
Alicia Iannece (15:00) Yeah, of course. So.
Jennifer Mikel (15:02) I can remove it if you would like. Just let me know because we set an sop that the girls follow and that’s why you’ve been pinged a lot because we set one up and it was approved and I apologize. So if you would like us to remove it, we totally can.
Alicia Iannece (15:18) Well, and I think if you’re saying remove it, so, does that mean anything from the work history section would not be verified, correct? So whatever we would want verified would be in the hospital affiliation section?
Jennifer Mikel (15:35) Yes.
Alicia Iannece (15:35) Correct. Okay.
Elizabeth Baker (15:38) Go ahead. I’m going to step in here. So I think Jennifer we had kind of a minimal on our previous cbo, there was minimal work done on the employment verification side. So it’s just a new process for us. So if we can have those employment verifications done especially on our like contractor providers, the ones that are not employed here, that would be good information we’d like to have. I think what Alicia is just trying to explain is that most of the files that we have are employed rimc providers, so we can do that part.
Alicia Iannece (16:13) But when,
Elizabeth Baker (16:14) depending upon which section the provider puts rimc, if they don’t put the hospital and they put an employee, it kind of goes through a different path. And we definitely want to make sure that we’re getting the privileging checks for sure. So, I think what I’m hearing is that I do want the employment verifications done, Alicia. I think that I want to make sure that we are doing them. The concern we have is, does that, if there’s a delay in that? Does that slow down the application becoming ready? I think we’re really excited to have these files being turned around much quicker than we’ve had before. We just don’t know if this has ever in the history of, you know, you’ve worked with a lot of clients. Does that tend to slow a packet down from being ready for the credentialing committee? And if so, by how many days, no?
Jennifer Mikel (17:00) Not typically, because usually we make an attempt every five days to reach out to them, and then we can, also, you know, if we’re having pushback getting information from the employer, we can just flag it as unable to verify, right? And so that’s how it would come up. Okay? I think we’ll make three attempts. Nobody responds. It’ll be unverified.
Elizabeth Baker (17:28) How do you feel about that Alicia?
Alicia Iannece (17:30) I think that’s fine. I think my initial concerns as far as current state is on the files that are currently in the middle of processing, knowing that they are not filled out correctly. Like their work history section and their hospital affiliation sections are probably not correct. That it’s going to we’re in a tricky spot right now with those files. And then we’ll have a bit of legwork to do to correct the, any other provider files that are complete that will soon be going for those appointments. So, I think once we get that cleaned up and corrected, I think it will make sense to keep it to run both. And then maybe we, you know, if it’s we’re in an instance where we got a hospital affiliation, but maybe not the employment. Like we could waive one of them if we have the other, if that makes sense if we need to. But yeah, I think it makes sense to keep them in. But just, I think we’re in a little tricky spot right now as far as cleaning up what the current issue is for the ones that are processing. So.
Jennifer Mikel (18:39) I can go in and look at the ones that are in there and try to… like look at them a little closer. And then Alicia, do you want to send me? Your Connor can give me your email and I can correspond with you and be like, okay, let’s look at these. These ones look a little wonky that might’ve been filled out incorrectly. How do you want to clean these up? And then me and you can work closely together to get them cleaned up. So we’re not filling them out incorrectly?
Alicia Iannece (19:09) Yeah, I think it might be helpful for us to take a peek at it too, just because we’re familiar with the providers. Like we’re not a new organization. Most 99 percent of these providers are already established with us. And so we can kind of take a look at what their history has been and whether they’ve been affiliate, you know, based on whether they’re contracted or not, we’ll be able to tell if they’re if the list in their work history is going to be the hospitals that they’re affiliated with versus if they were employed by those.
Jennifer Mikel (19:39) Yeah. And then, so I’ll shoot you an email and then you’re able to make corrections to their profile as well. Yeah. Yep. And then, so if you want to do that, we’ll coordinate and if we need to have a call and fix it together, we can do that as well. So we’re not holding up everybody here. So we will keep the five years of work history for initials. What about reappointments? What do you want to, what would you like us to verify for reappointments?
Alicia Iannece (20:12) So, for reappointments, it would be, any new… sorry, any current still current affiliations… where they’re still currently employed or working, and then any new ones since the last appointment cycle?
Elizabeth Baker (20:36) So, is that a three year look back Alicia?
Alicia Iannece (20:39) I think in the past, it’s been a three year look back, yeah.
Alicia Iannece (20:46) And Jennifer, if there’s a case where we review a provider’s like affiliation history, and maybe they had one seven years ago. That seemed like maybe they were there for the majority of their career or something. Could we request that to be an additional one to be completed beyond outside of the five year minimum? Okay? Yep, sure. Can,
Jennifer Mikel (21:12) Do you still require the cme compliance, for reappointments? Do you require like a 24 40 24 like cme to be turned in? So?
Alicia Iannece (21:24) We didn’t have capabilities in the past, to monitor that well. It was just a attestation by the provider that they had performed the necessary cme, to fulfill their license. Like it’s kind of looped into the Wisconsin state licensure, dr. Baker, am I saying that correctly? So I don’t know if we do anything additional beyond that, okay? Yeah.
Elizabeth Baker (21:49) So, Wisconsin, you know, for an active Wisconsin license, there’s requirements for maintaining C cme credit. So, if their Wisconsin license is active, then we’re assuming that they’ve met the cme requirement, okay?
Jennifer Mikel (22:03) And then for reappointment, we’ll just continue to run the same sanctions because we’re doing the ongoing monitoring that won’t be an issue red flag alerts, right? So, if something does pop up on one of your providers, what will happen is you’re going to get an admin task, right? That says provider smith has a adverse reaction, please advise how you want us to handle this, right? Okay. So that is how you will get alerted when a provider has an adverse notification… it’s called a red flag alert, it’ll be an admin task, okay?
Alicia Iannece (22:43) And that’ll be just during the appointment and reappointment cycle?
Jennifer Mikel (22:48) Yes. Okay. Yeah.
Alicia Iannece (22:50) Because we’re seeing the npdb reports like they’re still showing a flag with like an exclamation point. We don’t have any way to like take those off or say that we’ve reviewed them. Most of them right now that are popping through are ones from the past that we were already aware of. So, if there’s a way to like even put a note on those to say, no concerns like that might help us.
Jennifer Mikel (23:11) So that’s the.
Alicia Iannece (23:12) way.
Jennifer Mikel (23:13) that we alert you during the appointment period is by putting that admin note for compliance. It’s just saying like, you know, you’ve seen this. You’ve addressed this, that kind of thing. Okay. One last thing. Well, two things. Okay? Do we want to stick with the, just the Coi for our AMC? Or do we want to pull a claims history for the last five years?
Alicia Iannece (23:43) Dr. Baker, how do you feel about those?
Elizabeth Baker (23:48) So, for new appointments, I think last five years, if it’s a reappointment, I guess, is it the same for new versus reappointment? Five years? Jennifer, is that the process?
Jennifer Mikel (24:02) So, usually most people only do for a reappointment, the look back period which is two or three years. So I would do three years. So, are we okay with asking for five years of malpractice history?
Elizabeth Baker (24:18) For the initial, yes, I’m okay with that, yes, would.
Jennifer (24:24) That potentially hold up the file at all if you reach out, or do you guys maybe do an attempt like you do with the work history like you tried to get the five year look back on malpractice?
Alicia Iannece (24:38) Are you?
Jennifer (24:39) Able to like if you’re unable to get that, are you able to move forward?
Jennifer Mikel (24:43) Yes, it would be the same thing. But typically providers, if they just send us their cois, we can just add it in there and then because on there, it has where to get that claims history from, and we can get that loss run report from them. So it’s really easy to get that information. And the reason why we recommend doing that is because… the mpdb is just a claims history. It doesn’t always show like dismissed reports, closed claims with no indemnity or demands resolved with, you know, waivers near missed risk events, those types of things. So that’s why we like to say, you know, don’t just trust the mpdb go ahead and get that claims history report as well because it can show things that wasn’t reported or was dismissed or additional things that didn’t have to be reported as well. But again, it’s not going to hold it up.
Jennifer Mikel (25:47) Gotcha. Thank you for explaining. I’m glad we were able to get that resolved. But for you guys, if we’re doing a hospital affiliation and we need to put it in the file, is there a certain email that you guys want us to send that to? Because I noticed that we were faxing them, where would you like us to email that to?
Alicia Iannece (26:06) I’ll put it in the chat. It’s our general inbox.
Jennifer Mikel (26:10) Perfect. Thank you so much for meeting with us. I’m glad we were able to resolve this, but that was all the questions I have. Thank you.
Alicia Iannece (26:20) I have a question. I don’t know if it’s appropriate to discuss it here, but I’ve been looking into the nams pass option. Is that something that medallion uses as a resource for collecting verifications?
Jennifer Mikel (26:32) Yes. So we actually have a intake process. So one thing that you’ll see is like when a provider’s profile is incomplete, first thing we do is we, if they have a caqh, we’ll do a caqh data import and then we’ll go to nams pass and look and see if they have any hospital affiliations that way, grab all their verification letters there through there. And then we’ll also run the veridoc and see if they’ve held any license anywhere else and had any like license actions through there that they didn’t disclose because we found some actual providers that didn’t disclose licenses through veridoc that they didn’t want us to know about, which was kind of funny. Well, it’s not funny, but you,
Alicia Iannece (27:16) know, you know what I mean? It happened. Yeah, it happened to us once we had a provider list that they like had an Indiana license, but then they didn’t list any of their Indiana hospitals that they were affiliated with. So then that caused us to go back and look again.
Jennifer Mikel (27:30) Yeah. So we actually checked all the resources available to us to try to help the doctor complete their profile with our intake process.
Alicia Iannece (27:43) I think one question we had that maybe it was a follow up from yesterday, Connor and Rheta, and I don’t know if maybe Jennifer or no, but wondering if the documents posted in the provider’s profile, if all documents are visible to the provider or not. Yeah.
Rheta Larson (28:00) I know we ran through quite a few things, but the two outstanding things we have is the document section. So do the providers have access to view those items? I’m having the engineering team take a look at this just to ensure we have confirmation if that is the case for providers or not. And I will get back to you there’s a few outstanding items we don’t have confirmation on. So I’ll send that email of everything we discussed with the answers outlined, kind of highlighted. So you see what medallion proposed, that is outstanding. But just to recap the malpractice and work history validation, we’ve worked through that with Jen. I think we have a good action plan there, work history, and hospital affiliations. We’ve worked through that. With Jen. We have a good action plan there. The employment verification sent via fax. We have the new email address. So we’ll update our internal records and make sure we’re sending it to that email medicalstaffoffice at ramchealth. Org instead of via fax, Jen, also, can you confirm if we don’t hear back via email? Does the team then after X amount of tips, then fax, I’m just trying to understand the workflow there in case we don’t hear back via email. So.
Jennifer Mikel (29:11) We do three attempts and two attempts is one way. And then the third attempt is another away. It’s just based on what we can find. So.
Rheta Larson (29:21) That way, Alicia, if you see that it’s just because we have most likely have not heard back. And that’s something we’ll discuss on the operational syncs. Like why we went a different route and you’ll have a loop in platform as well, yeah, Connor.
Alicia Iannece (29:36) I just,
Rheta Larson (29:37) want to let you know. I’m going to take it from here and work through any additional items we have with Jen’s support she has been with as well, but happy to let you go. Connor. Thanks.
Alicia Iannece (29:48) Connor. Sorry, everyone. Thank you all. Yeah. So, with the contacts, so basically, you need a contact in those lists in the list of the work history and hospital affiliations for it to go directly, to… those locations, right? Because if you haven’t worked with them in the past, like medallion won’t have a contact for them. Like does medallion keep a master list anywhere of who the contacts are? We do, yeah, because our providers, most of them are not going to know, you know, who to reach out to for that information. So it’s a matter of Jenny and I, you know, going back into the profiles to look at, adding those. If we know who they are, who the contacts are. Okay?
Rheta Larson (30:39) Great. Yeah, definitely flag those as you see them. If you see our team is asking directly for the providers and we can correct that pretty quickly. Okay? So the employment verification via email, we’ll update that, the document section that’s the outstanding item we have engineering working on just to determine if that is something the system or like what level of security is there. So the providers don’t see the sensitive information. And then I think there was two more at least from the privileging side. The privileging contact, medallion emails, y’all had sent me three emails for your previous cvo that was on the caqh profiles. And you were just questioning which email you all should use when you’re updating their profiles, correct? Was it one of three?
Alicia Iannece (31:26) Well, the two privileging ones were what Jenny had received through the fax, one fax. And then one of the emails had a different email. So those were the two privileging ones. And then the really long one that starts with like reedsburg area medical center, that was the one in the caqh that we were seeing… Jen.
Rheta Larson (31:47) I don’t know if there’s a, I know there’s three different ones that we’re using. So we just want to ensure we have the correct email on the caqh profiles moving forward. Should reedsburg decide to update it, we have the privileging at medallion co, privileging at medallion. Com. And then the reedsburg area medical center at medallionteam. Com that’s the one that you’re seeing on the profiles.
Alicia Iannece (32:09) And I’m sorry, one of those was privileging medallion at Gmail. Com, and we were questioning that one why it would be a Gmail account.
Jennifer Mikel (32:20) I think I grabbed.
Rheta Larson (32:22) That wrong… privileging at medallion co, and then privileging at medallion at Gmail. Com. Yeah.
Jennifer Mikel (32:30) That one shouldn’t be used anymore. That one was set to sell a long time ago. It would be privileging at medallion co.
Alicia Iannece (32:38) Okay. Jenny, do you want to take a peek and try to find what document we saw that on? And forward that to Rheta… that?
Rheta Larson (32:48) Would be so helpful if you have any examples shoot in my way, and then I can pull up the file and work with Jen’s team to either correct it, and then just ensure we’re not repeating that behavior on any other files? Yeah.
Jennifer Mikel (32:59) I just wonder if they pulled an old verification document and didn’t like.
Alicia Iannece (33:02) Update it. Yeah, I’m thinking so, too. Yeah. Does that question?
Rheta Larson (33:07) For the email portion for the privilege contact?
Alicia Iannece (33:13) So, for the contact, for caqh, are we thinking the reedsburg area medical center one?
Jennifer Mikel (33:20) I would do everything for, do you guys, pardon me? I’m so sorry. Do they have PE or any other services or just privileging we?
Alicia Iannece (33:28) Have both? Okay.
Jennifer Mikel (33:30) So, yes, it would probably be the, actually, I don’t know because caqh management has their own email. I would ask them. Okay. So, because the way that they update it is completely different. So I would ask them, it would not be a privileging email for caqh management, for them to update it.
Rheta Larson (33:53) Okay. Alicia. Yeah. So if you’re seeing the reedsburg that should be the correct one. But I’ll confirm before we get final sign off. Sorry?
Alicia Iannece (33:59) Okay. Yeah, because I’ve also been seeing the like the pay your enrollment at medallion co. So I didn’t know if that one should be, you know, a contact one, but, yeah, yeah.
Jennifer Mikel (34:10) Not for PE. I mean, not for caqh management. I know they have one.
Rheta Larson (34:16) Yeah, I.
Jennifer Mikel (34:18) came for PE. So, I know they have their own like management email, okay?
Alicia Iannece (34:24) Sounds good. Sorry. So I’ll just if I get into caqh profiles before medallion, I will update it to the reedsburg area medical center one because that’s the one that medallion put in for that provider. So I’ll just replicate that.
Jennifer Mikel (34:41) Yeah, it probably is that one then. Okay. I’ll.
Rheta Larson (34:44) take that as an action item just to be sure. And I’ll include that in the email. And then lastly, for the, I think there was the Paula Hobson privileging her mpdb flag there.
Jennifer Mikel (34:56) I know.
Rheta Larson (34:57) That file was flagging an issue that was flagged and you were just questioning if you needed to resolve anything. But I don’t think there was an outstanding admin task. So, Jen, correct me if I’m wrong, there’s nothing tasked out to the admins. There’s no action for reedsburg to take there for the flag, correct?
Jennifer Mikel (35:11) Not yet. She hasn’t got to it yet.
Alicia Iannece (35:15) And that’s a perfect example of like those are old ones that mpdb report. So we already are well aware of that one. So, yeah… you’ll.
Jennifer Mikel (35:24) still get one here soon. When she gets done with that. When she gets through the file, you’ll still get one as an acknowledgement because it’s just part of our procedure just to make sure it’s through the she’s following everything on our checklist yep.
Alicia Iannece (35:40) And that pulls into the committee packet, right? Like it will, when the committee gets the packet, all those notes are going to show or am I thinking something else the?
Jennifer Mikel (35:54) Admin tasks do not, but the mpdb will pull in there.
Rheta Larson (35:58) Okay.
Jennifer Mikel (35:59) Yeah. A checklist does not run in there like that. You’re thinking of that shows like that it was reviewed. Yeah. But I can, if you want, I can try to get like a red flag checklist to go in there.
Alicia Iannece (36:19) That would be great. Okay.
Jennifer Mikel (36:21) I can see what we can do for that or.
Alicia Iannece (36:23) Even some sort of, I think we talked about this with Eunice last week, Rheta, where we were talking about the committee packet. And maybe even if there was like a button for like reviewed or acknowledged like for a certain section or something like… either for the red flags or for every section. I’m not sure, but, you know, that might be something that would be meaningful to have regarding like, those really important elements, to verify that somebody’s laid their eyes on them, yeah.
Rheta Larson (36:57) You just want like a very like some sort of check on y’all’s end to say like we’ve reviewed it. It’s good move on with the file,
Alicia Iannece (37:05) I think.
Rheta Larson (37:06) It’s good product feedback as well. But I don’t know Jen, anything that you put together. Definitely, we can take this offline. And, yeah.
Jennifer Mikel (37:15) Have you seen what your packets are going to look like when it comes through? Okay. Yeah. So right now, it’s just going to have like your primary source and your checks, but that’s definitely something that we can work at like creating like a red flag checklist to put at the top. So like kind of, move it up so you can see it. But, yeah, that’s definitely something we can use for feedback because we’re trying to improve the way our packets look for sure.
Alicia Iannece (37:42) Yeah, that’d be great.
Jennifer Mikel (37:43) Okay. Perfect. Well, I look forward to working with you guys. And if you need anything additional, please let us know.
Alicia Iannece (37:49) Yeah. One quick question. The, when we initiate the appointment or the reappointment process, does the provider get an email like that? They’re starting the appointment or reappointment process or is it not, unless they need some, we need something from them or medelia needs something from them?
Rheta Larson (38:13) So are you saying, are they going to get noticed that the reappointment was requested?
Alicia Iannece (38:18) Yeah, or initiated or anything like that? The?
Rheta Larson (38:20) Only thing they’ll get on, their email preferences is anything that’s tasked to them. So they won’t receive some sort of like notice that it’s big like work has begun, on the admin side, however, like you all can see all of that in flight progress. And that’s what we’ll continue to chat through on our operational syncs. Okay. But hopefully that answers your question there. Yes, it does. Okay. Great. So, for the privileging side, Jen’s, expertise, I know we have limited time, but those were some of the outstanding items we had while we have her. And before I move on to pay your enrollment, is there anything else you want to address with her before? I don’t know Jen, if you have to hop or?
Alicia Iannece (39:08) I will just say one more little bit of feedback on the packet, any notes that we’re putting in during the privileging packet process that’s pulling into the packet right now? Is that going to be visible to the committee or does that kind of like clear once it goes into the committee status… I just don’t know because we’re not that far.
Jennifer Mikel (39:31) Are you talking about?
Alicia Iannece (39:36) Yeah. Like if you click on a provider’s yeah. And it, yes. Yep. All those notes show up right now? Okay. No. Okay. So when.
Jennifer Mikel (39:46) you, so, can you actually generate a packet from here and look at it? Yep? Yeah. So when you click this generate packet, that’s what it’ll look like. None of that will be here.
Alicia Iannece (39:57) Okay, perfect. Yeah. Well, the notes don’t aren’t right there. No. Yeah. I think that’s it.
Alicia Iannece (40:05) I’m sure as soon as you hop off, we’ll have we’ll think of 10 other questions to ask you? But I really appreciate your time being able to meet with us and chat through that a little bit more. And we were able to talk with dr baker before the call today to kind of like, you know, think about it and knowing we came from a very antiquated process with our old cvo and they were very rigid and impossible to work with. And that’s why we’re with a new cvo. So appreciate you guys, you know, chatting through it and talking through what’s best practice and all that too. Well.
Jennifer Mikel (40:33) Feel free to email me if you have any questions. I’m happy to help you especially, you know, while we work out this process. So anything you need, so I can help you, I’m here for you. Okay?
Alicia Iannece (40:46) Awesome. Thank you so much. All right. Bye.
Jennifer Mikel (40:48) Guys. Bye. Yeah.
Rheta Larson (40:52) Jen is the expert there and that’s what if I can’t answer things on the fly for you all definitely loop her into the conversations. She might not be able to join every sync, but if she needs to, we can definitely invite her.
Rheta Larson (41:05) But with that said, I think we have a good running agenda there. The other piece of this for, I think there’s three other questions from yesterday, the payer enrollment for tricare. I know we were looking into the in flight requests for Tenzin Shaw and smith and you all had asked just to approve them as they are. So y’all can proceed. I’ve sent these to the payer enrollment team so they can action. And they have not been actioned yet. Usually it takes around 24 to 48 hours, but I’m monitoring with them and just making sure we’re aligned there before I flip them and I’ll just email you with next steps once they’re changed, but anything else with tricare, you want to flag before I move on to some of the other two questions?
Alicia Iannece (41:45) Just if it’s meaningful to note that we will kind of process those on our end more. So like that, it’s more likely we’ll do that. If it’s meaningful to know that, I think just take that note otherwise. Yeah, I don’t think we need to worry about it anymore. Yeah.
Rheta Larson (42:03) I have the note that y’all, don’t have a formal contract with them. So you’re treating them as non network providers. Yes, you need to bill for those services. Yeah.
Alicia Iannece (42:16) I just do what I’m told and they said add… it as a payer and then, but then they were like, yeah, we only, they only enroll providers when we bill for their services and they pay it out anyways, like, but just as non network. So, you know, a lot of that doesn’t make sense until we’re trying to go through the enrollment process and finding the glitches, right?
Rheta Larson (42:38) There is very nuanced. And I briefly flagged yesterday, they’re like BCB BCBS providers cascading effect. So I was trying to dig in to see if that applies to all, like if it’s nationwide, but, I will get back to you if I hear anything different. Okay, security health plan for Angela sorg, that has also been flagged to the team. I know you were asking for clarity on the credentials or like if the login is required and if medallion can just create that. So once I get an answer there, I’ll respond to you via email on that and then just close and mark the task to date. It’s still open. So just be aware of that. We are working on it. Okay? And then lastly, the medicaid par linked to the group versus par not linked to the group. And then just to determine how you can decipher those, I have the examples for mark Mayer and then Benjamin neesom, mark Mayer should be linked. And then Benjamin neesom, or wait, mark Mayer shouldn’t.
Alicia Iannece (43:36) be linked.
Rheta Larson (43:37) Yeah. And Benjamin should, so they have eyes on it. They’re working on it once I get resolutions there. I will definitely let you know, but yeah, we have a lot of notes. So I’m going to just make this nice and pretty in email format kind of like I did last time and then cross them off our list. So they don’t trickle to repeat scenes.
Alicia Iannece (43:57) Sounds good. Thank you so much if I’m seeing dops… come in that don’t quite look correct? Like I just realized I hadn’t looked at my tasks, our tasks yet today. And the dops coming in like for Violet laucant, they tasked her with a family practice dop, but she’s actually just a generic nurse practitioner dop. I’ll just put that in the medallion notes and complete it, right? And then they’ll switch it to the correct one. Yes.
Rheta Larson (44:31) If you can, I know Connor is working on that with the implementation team before end of week. So I think we should have hopefully you won’t see too much of that moving forward, but put the note in and then I can give the feedback to the team as well. Okay?
Alicia Iannece (44:45) Yeah, it hasn’t been too often and it’s I feel like it’s been on the apps where it’s a little bit nuanced or whatnot. So. Okay.
Rheta Larson (44:55) I’m just gonna grab that one because it was for.
Alicia Iannece (44:57) And I just completed it. It was for Violet laukant. Got it. Okay.
Rheta Larson (45:03) Perfect. Anything else that I can add or dig into for you before we let you go? Any?
Alicia Iannece (45:12) Thoughts… just a question and I’m sure you probably don’t have much of an answer, but I wanted to just throw it out there because we are having our external contacts are concerned, but the quarter, is it still a quarter two goal for combining provider profiles? Like if a provider has a profile at two locations, yes, that.
Rheta Larson (45:36) Is a goal of ours? I know it’s a pain point for many of our clients. So we’ll definitely send out marketing communication from our team. Once that is completed. I can get an updated for you. I don’t have the exact date yet, but that is still on our radar and it’s like a P0 for us. Okay?
Alicia Iannece (45:54) Yeah. We’ve got a couple providers… with the southwest location, you know, that the southwest health organization who’s who also decided to go with medallion at the same time as us. We have several of several similar providers. I.
Rheta Larson (46:12) Really lack those to support or has a provider reached out to support by chance? Not?
Alicia Iannece (46:19) Yet, I did forget about you guys mentioning that to have them reach out. We.
Rheta Larson (46:24) Can help support. It’s. Not super easy. But what support will do is they can typically duplicate the files and extract info to like mirror you.
Alicia Iannece (46:34) Know what? That would be actually incredible. Would… it make sense for me to put you in contact with our direct contact who she man manages? Like she’s our credentialing contacts at that organization? Would that be the easiest thing? Or should we do it if?
Rheta Larson (46:52) You want to give me the list of providers, I can have the team on the back end. And then if y’all want to just give that credentialing contact a heads up that we’ll be reaching out to the clinicians because I don’t think there’s any support tickets currently for them. No. But first, let me ask the team if this is, I don’t know how big the list is. So that might, we might need a scope like how long that will take because, it’s not a real easy fix, but I know they can do it sure.
Alicia Iannece (47:16) I think our like I think it’s going to match more so on our credential by proxy list. So the ones that don’t need a complete profile, but then we have probably 10 or so that might need… a full complete profile. And then we are contracting with them to actually switch our radiologist group to be that to be uw university of Wisconsin. And currently, we’re with a different group. So by next year, we’re going to have several more rate like providers that we have to have a full profile on. And.
Rheta Larson (47:51) By then we should, this should have resolved. But, okay, if you want to send me the list of those providers, and then I will scope work with the support team first like the technical team there. And then if we need to have the intro with the credentialing contact, I’ll just give you like the yes or no, if it’s something we can easily accomplish before I commit to it. Okay?
Alicia Iannece (48:11) Sounds good.
Rheta Larson (48:13) But yeah, I’ll keep an eye out for that email as well. And then hopefully, by tomorrow, I’ll have some more of these things answered for you. If I still have something outstanding, I’ll just list it in the emails like pending for our next inc. Okay? But… thanks so much for being patient through all of this.
Alicia Iannece (48:30) Thank you always.
Rheta Larson (48:31) Feel free to send questions our way and then just include me on CC. If you do reach out to Jennifer, I like to stay like the loop with things. So that way I’m not like blindsided if I hear of.
Alicia Iannece (48:39) Course. Yeah. Okay. Thank you.
Rheta Larson (48:42) So much. I hope you all enjoy your weekend. Thank.
Alicia Iannece (48:44) you Rheta, you too. Happy Easter. Happy.
Rheta Larson (48:46) Easter. Bye bye.