Transcript
Betsy Thornabar (00:00) good morning.
Niccole Russell (00:01) How?
Sandhya Kapila (00:01) Are you guys doing?
Sandhya Kapila (00:08) Can you guys hear me? I can’t.
Betsy Thornabar (00:11) hear very well. I don’t know why.
Sandhya Kapila (00:13) I know my,
Betsy Thornabar (00:15) volume’s up all the way, but it seems so low today.
Sandhya Kapila (00:19) Let me see. Can you guys hear me now? Is it better?
Betsy Thornabar (00:23) Maybe a little bit?
Sandhya Kapila (00:25) Okay. I,
Jenny Laurie (00:26) can hear you okay?
Sandhya Kapila (00:28) Okay. You can hear me? Maybe?
Betsy Thornabar (00:29) It’s my computer. I wouldn’t be surprised.
Sandhya Kapila (00:32) Okay. That sounds good. Jenny. I like your earrings, very cute.
Jenny Laurie (00:40) It’s my strawberries, I love it. Love it.
Betsy Thornabar (00:45) Jenny’s always got cute earrings.
Sandhya Kapila (00:47) Oh, really? Oh, my gosh. I,
Betsy Thornabar (00:48) never knew. Yep.
Jenny Laurie (00:50) I love fun earrings.
Sandhya Kapila (00:52) So, fun. Love it. There was this coffee lady back when I lived in San Diego, every time she would have like different coffee themed earrings, I was like, but they’re so.
Jenny Laurie (01:01) Cute, I need to get some coffee earrings.
Sandhya Kapila (01:03) There you go. Cool. All righty. Hey, Nicole. How are you? Hey, I’m.
Niccole Russell (01:12) good. How are you?
Sandhya Kapila (01:13) Good. Thank you. Do you guys know?
Betsy Thornabar (01:19) Jenny, did you know if John was going to be able to join today or did I didn’t invite him? I should have.
Jenny Laurie (01:24) He knew that he was getting invited? He got.
Sandhya Kapila (01:28) I sent him the invite. So, all right.
Betsy Thornabar (01:30) Thank you. It.
Jenny Laurie (01:31) Looks like he may be, it says, is that his iPhone that’s on?
Sandhya Kapila (01:35) Yep. Looks like it?
Betsy Thornabar (01:36) Oh, it might be, he might be on. Yeah, I guess I just didn’t scroll through and see everybody that was in. Yeah, I see him. You’re right?
Jon’s IPhone (01:44) Wonderful. I figured you guys were talking about me?
Sandhya Kapila (01:47) We.
Niccole Russell (01:48) were I asked if anybody had?
Betsy Thornabar (01:50) Invited you? Because I didn’t and I thought, but thank goodness everybody else did, but me, so.
Jon’s IPhone (01:57) How’s everybody doing?
Sandhya Kapila (01:59) Good. How are you? Good.
Jon’s IPhone (02:01) Good. Thank you. Good.
Sandhya Kapila (02:03) Of course. All right. I’m going to go ahead and start sharing my screen, so we can get started.
Sandhya Kapila (02:14) All righty. Cool.
Jon’s IPhone (02:17) I’m sorry, I’m not on camera. I’m on the road. I’m driving at the moment.
Sandhya Kapila (02:21) Oh, no worries. Okay.
Jon’s IPhone (02:22) Apologies no.
Sandhya Kapila (02:23) It’s okay. Please don’t be on camera drive safely.
Betsy Thornabar (02:29) Okay.
Sandhya Kapila (02:29) We’ll just talk through it and if you have questions afterwards, we can totally sync John.
Sandhya Kapila (02:35) Okay. So first, we just want, since Niccole is here, wanted to go through that pair process scoping that we went through last week too. She was able to review the processes but just wanted to get like a final, have a final conversation about it.
Niccole Russell (02:53) Yes. Okay. This right here, this is showing you what your payer name is, what the medallion payer name is. And then once you agree, then Sonia will sign off as, yes, the comments that you made regarding the poa, anything like that. Yeah, Poe, there there we go. All of those notes were added to a project plan specifically for your group, so they will follow their process, but they will make sure that those letters are added as well, since that was the only thing that was added there.
Sandhya Kapila (03:26) Okay. So.
Niccole Russell (03:27) Other than that, there were no real call outs for how we should do the payer enrollment. So we’re just going to follow our payer directory. So, Sonia, if you want to scroll back over and talk.
Niccole Russell (03:43) I think we’re missing a few lines there scroll up just a little bit. Nope, go back up to the left. And then, yeah.
Sandhya Kapila (03:51) So,
Niccole Russell (03:51) at a better health of Ohio, we have at a better health of Ohio, would you agree there?
Betsy Thornabar (03:58) Okay.
Niccole Russell (03:59) Sonia, if you want to go ahead and mark, yes on that? Great.
Sandhya Kapila (04:02) And then just to confirm also Niccole, the processes that we’re going to follow is just what we have in the payer directory. So it’s standard, it’s nothing.
Niccole Russell (04:12) Okay. Perfect. Yeah, that’s correct. Yeah, the only thing that I added to the project plan was, were there notes where a certain letter needed to go with whatever they were doing with the project plan. And then Aetna commercial and Aetna medicare. Both of those fall under Aetna just Aetna for us. Are you good with that? Yeah. Okay.
Jenny Laurie (04:36) One question. I don’t know if you would be able to answer this or not right now, Niccole, but when do you guys foresee that you’ll need to have PNM access to be able to manage the medicaid’s.
Sandhya Kapila (04:52) I.
Niccole Russell (04:54) don’t know that because.
Jenny Laurie (04:55) I know like obviously, we have, we would have to let our current credentialing team know that somebody else is taking over. They would have to give you guys admin access to PNM. And there can only be one admin. Okay? And the PNM portal for Ohio medicaid. Okay?
Niccole Russell (05:14) I can say for any… requests that require access that our team does task out for it. So you will see a task or the, you know, if it’s a provider portal, the provider will get a task. If it’s a group portal, then, the admin will get the task. So the payer enrollment team task out for that.
Jenny Laurie (05:38) Okay. So I would get a test like a task set to me and then I would know like, okay, it’s time to alert bhbs that somebody else needs to have admin access. Yes.
Niccole Russell (05:50) Okay. That is correct. All right. And then for ambetter marketplace, we have ambetter from buckeye health plan.
Jenny Laurie (06:01) Yeah, that’s fine. Okay.
Niccole Russell (06:03) Amerihealth medicaid is amerihealth, caritas, Ohio. Yep, anthem. So we’ve got anthem commercial, medicaid, medicare and anthem. So all of those fall under anthem, blue cross, blue shield, Ohio.
Jenny Laurie (06:18) Okay. That’s fine. Okay.
Niccole Russell (06:20) We have antidote which falls under quality care partners. Yes, buckeye medicaid, medicare and mycare, all fall under buckeye health plan. Okay. All right. Let’s see… bureau of workers’ compensation. We have Ohio bureau of workers’ compensation.
Jenny Laurie (06:48) And that’s fine. All right.
Niccole Russell (06:53) Caresource, Ohio marketplace, medicaid, mycare, all of those fall under caresource for us. Okay. All right. CGS medicare, part B is medicare, Ohio. Okay. Cigna commercial is just cigna for us. Okay. Devoted health plan is devoted health on our side. Okay? Ffs, medicaid is medicaid, Ohio. Humana, medicaid and medicare both fall under humana. And then luminaire health. I marked that one red because that is a third party… so.
Jenny Laurie (07:36) Do you know if you guys have trustmark in your system? Because a lot of times it comes in under trustmark, does that sound familiar?
Niccole Russell (07:46) Doesn’t to me, but I, because.
Jenny Laurie (07:49) I think a lot of their insurance cards maybe would say trustmark, if I remember correctly.
Niccole Russell (08:01) And this was Ohio, right? Let me see what populates here.
Niccole Russell (08:19) No, we don’t have that. However, when we did research, it does fall under a tpa, so, do they pay provider claims?
Jenny Laurie (08:31) Yes. Okay.
Niccole Russell (08:32) So, at that point, we would need a workflow kind of showing your workflow, and we would have to confirm that with a payer before we add that to our payer directory.
Jenny Laurie (08:43) Okay. And,
Niccole Russell (08:44) I will say if it is specific to your group and they don’t enroll across the board, then I was just advised the other day, we will not add those to the payer directory because what happens is if it’s group specific, then the rest of the clients will be able to see that name and they will want to choose that as a payer for Ohio, if they’re doing Ohio enrollments.
Jenny Laurie (09:11) Okay. So what do I need to do for? Is there more than just luminaire that you were unable to find that’s the?
Niccole Russell (09:19) Only one that’s a tpa for us. So we’re showing that it’s oh, no one more. I’m sorry, trustmark.
Jenny Laurie (09:25) Trustmark, which they, yeah, those go hand in hand?
Niccole Russell (09:28) Okay.
Jenny Laurie (09:32) Thanks, Sonia. I have to go back and look though because I almost feel like it might fall under quality care partners. I’m going to have to go back and look at some patients that are tied to those payers in our system, so I can look at their insurance card.
Niccole Russell (09:47) Okay. Yeah. And if you have a workflow, like I said, we can look at that and determine if it’s a true payer across the board and we can have that added to our payer directory. Okay? So we’ll skip those for now until you get some information, Sonia on the comments on the client side, if you’ll just put pending workflow or pending information, something like that, just so we know what we’re waiting on there. Yep. And then we have medical mutual commercial and medicare. So those both fall under medical mutual for us. Okay?
Jenny Laurie (10:23) That’s fine. Okay?
Niccole Russell (10:24) We have medigold medicare, which is mount Carmel health plan. Yeah, meritan health under Aetna.
Niccole Russell (10:34) Melina, dsnp marketplace, medicaid, medicare, and mycare, but all fall under Melina healthcare.
Jenny Laurie (10:42) Okay. All.
Niccole Russell (10:44) Right. Ohio, ffs, medicaid falls under medicaid, Ohio. Okay. Optum, behavioral health, we have as optum… quality care partners, same quality care partners for us. Tricare east is the same tricare for life. So, for us, that one is tricare for you? Okay?
Jenny Laurie (11:10) Okay. And we don’t have to change anything in our system. This is just.
Niccole Russell (11:14) For you guys. No. So what this is for you’re? Going to keep a copy of this as well. So, whenever you request enrollment, you would request under our medallion payment?
Jenny Laurie (11:23) Under your name. Okay? Yeah.
Niccole Russell (11:25) Yeah. So this is just for reference for your team. Okay? And then trustmark, we’re going to get information on that one. So unitedhealthcare commercial medicaid, medicare and dsnp, we all have as unitedhealthcare.
Niccole Russell (11:43) Okay. Alrighty. So, it looks like we’re set here, Sonia, except for the two which she’s going to provide some sort of workflow for us. Perfect. That sounds great. Thank you. Yeah, you’re welcome.
Jenny Laurie (12:00) All right. Okay. I.
Sandhya Kapila (12:02) Think Niccole, do you have anything else? Oh, actually, we did have one thing for you. Were you able Jenny to get confirmation on which payers have rosters from bhps?
Jenny Laurie (12:13) Bhps said all of the managed cares would use rosters. I mean, I was not able to get copies of those, but they’ve said that all the managed care plans would require a roster.
Niccole Russell (12:26) Okay. The only thing I would say to that one, our roster request eligible is column H, so you would have to mark that, but we do need a link to that roster. So, if our normal workflow follows a roster, we would be able to do it, but if we didn’t have a roster template from you, then we would not be able to do that one, we would just follow our normal payer directory.
Sandhya Kapila (12:53) So, it would be, excuse me all the managed medicare medicaid.
Jenny Laurie (12:58) Okay. Yeah.
Jenny Laurie (13:04) And I do know a lot of the managed care advantage plans… like because I’ll get emails like I just got an email the other day from devoted. So I believe that they would use them as well because they wanted me to verify the roster.
Sandhya Kapila (13:33) Okay. Because that’s medicare advantage. So then they would need a roster too. It sounds like.
Niccole Russell (13:39) So devoted does have.
Jenny Laurie (13:41) A roster, do you have more? Yeah. Do you have more information on that? Niccole? So.
Niccole Russell (13:44) The devoted, we do have rosters for that specific payer in our payer directory.
Niccole Russell (13:53) So, that one does follow a roster. Okay? So, yeah, some of these, like I said, they may follow a roster. I didn’t go through each specific payer, looking at the workflow… there, I would say if you have any rosters that are specific to you, those are the ones we need if it’s.
Jenny Laurie (14:15) other than that, and maybe what will need to happen is like once bhbs knows that we are switching over, I will ask them at that point to send me any rosters that they have. Yeah.
Niccole Russell (14:29) That’s fine. And we can update your project plan and have those mapped.
Niccole Russell (14:55) Okay. So, Sonia, we’re going to pin on that until they’re finished with their other vendor.
Sandhya Kapila (15:00) Yep, that sounds good. Yeah.
Niccole Russell (15:03) All right. Well, I’m going to hop. I think that’s all I was here for. Perfect. Thanks, Nicole. Yeah, no problem. Have a great day.
Jenny Laurie (15:10) Thank, you too.
Niccole Russell (15:12) Thanks.
Sandhya Kapila (15:15) All righty. Okay. Cool. Thank you. So we can continue on with the next piece of things. Congratulations on being approved for npdb. You know, it was a process… Betsy, did you, have you said you had? Oh,
Betsy Thornabar (15:31) well, I have been extremely busy and I saw that they gave me some directions to follow. So, I hope to get to that today or first thing in the morning. So I will go through that email and follow any steps. You know what I mean? That they have further, but yes, thank God. Thank you for the examples because they were literally the saving grace for us. We were at a question mark as to what they wanted. And so thank you so much for providing that.
Sandhya Kapila (16:00) Of course, you’re so welcome. I’m so glad. I’m glad it helped so.
Betsy Thornabar (16:04) Now, is there any, I mean beyond following the instructions on the email? Is there anything else that I have to do that you all know of a heads up or anything? Or what the next steps are with that? Because, you know, obviously we’ve never done this before. So I.
Jenny Laurie (16:21) think probably Sondra, I don’t know if like Betsy and I will need to like have another meeting where we walk through or if that’s what we’re planning on doing today because I haven’t done any. I’ve just got logged into the portal, but I haven’t.
Betsy Thornabar (16:36) done anything. Yeah, I’ve not even logged into the portal. Jenny’s ahead of me. So, yeah, we were just going to wait to ask today. Do we need like an instructional, a… one on one or a suggestion?
Sandhya Kapila (16:50) Yeah, absolutely. I was actually going to ask you guys today to set up a training session, so.
Jenny Laurie (16:56) We could do that next week or we.
Sandhya Kapila (16:58) Can schedule time outside of our weekly meeting, a one hour training session where we can walk through the platform, okay? And give you kind of steps on your next steps on what to do, what works for you guys in terms of timeline or, you know, availability rather…
Jenny Laurie (17:20) Betsy’s probably the one, I know her schedule’s a lot crazier. So, Betsy, I’ll let you answer that.
Betsy Thornabar (17:27) Good luck. No, I’m just kidding. I’m just kidding. Next week looks good so far because I haven’t started scheduling interviews yet for next week, which is wild to me. So, what do you… what about Tuesday? What time in like, do we have any morning time on Tuesday? The seventh? And John, I don’t know if you want to be a part of that or not or if you want me and Jenny just to do it and show you later or no?
Jon’s IPhone (17:57) I’ll participate in whatever calls are scheduled. You know, I’ll do my best.
Betsy Thornabar (18:01) To make them all, does Tuesday morning work for you at all or no?
Jon’s IPhone (18:04) Tuesday mornings? Yeah, Tuesday mornings are generally good.
Betsy Thornabar (18:07) Okay. Jenny, are you okay with Tuesday morning? If they have anything I think.
Jenny Laurie (18:13) So, let me just look because the only thing I’ve really done, I’ve been all over the place, covering for the best.
Betsy Thornabar (18:18) I know my Tuesday afternoon is full, but I’ve got some free in the morning.
Jenny Laurie (18:21) Yeah, I can do the seventh in the morning, yes.
Sandhya Kapila (18:27) Okay. The seventh in the morning… what time are you thinking?
Jenny Laurie (18:34) Oh, because we’re aren’t you like four hours?
Sandhya Kapila (18:37) I’m three, are, you guys are east coast, right? We?
Jenny Laurie (18:40) Can do 11 since 11 is 11, okay?
Sandhya Kapila (18:44) Yep. Are you guys east coast?
Jenny Laurie (18:46) We are Eastern Time eastern?
Betsy Thornabar (18:48) Time?
Sandhya Kapila (18:50) Yeah, 11 works. Yep. I can do that. Okay. All right. Schedule time. Okay?
Sandhya Kapila (19:03) Okay. I will send this over Tuesday… four… at… a, M, eastern. Okay. I’ll send that over to you guys right after this meeting. So we will have an hour blocked to go through training. Perfect. And then just on the npdb side of things, what we would need from you as you go through it is the DB id, and then I’m actually going to shoot it over to Connor just to give a little bit more insight, into how you get that and, yeah.
Connor Morley (19:44) Connor, so you should just, I mean, your npdb DB id, you should just be able to have that. I think it’s just your DB id that’s on your?
Betsy Thornabar (19:58) Npdb profile. Yeah, we already do have that, I think, you know what I mean? But you want me to email it to you or? Yeah.
Connor Morley (20:05) You can, you can send it to us like right now, okay? And we can put it into our system like right now before you even set us up as a registered agent that way. Once you do set us up as a registered agent, then we’ll get essentially like an email notification with all locations that are associated with your account. And then we’ll be all set from there. So if you just want to send this, send that over.
Jon’s IPhone (20:34) That’s what you?
Connor Morley (20:34) Need let.
Betsy Thornabar (20:36) Me search for it because I don’t have it wrote down anywhere, I’ve got it in email. So as soon as I get it, I will send it over an email.
Connor Morley (20:44) No problem. And then we can just put it, Sandhya. We can just put it in Django on the back end in the organization field. Okay? There’s no harm to.
Betsy Thornabar (20:55) Putting it in there. Is it the data bank identification number that you’re looking for? Yep?
Connor Morley (20:59) Dbid data bank identification… it should be a decently long number.
Betsy Thornabar (21:08) Yes, I’m just going to send you. All right. Yep.
Connor Morley (21:15) And Sandhya, there’s no problems. If we start to, if we just put that in Django, now, okay? While they work on setting up the registered agent status, okay?
Sandhya Kapila (21:27) Perfect. So we can do that right away. Yeah, great. All right.
Betsy Thornabar (21:31) I’m getting ready to send it to you right now, you can make sure Connor, that it is the number that you’re looking for sure.
Sandhya Kapila (21:43) And then we’re confirming on our end, if we can use that same number for New York and Pittsburgh, John?
Connor Morley (21:55) Yes, cool.
Jon’s IPhone (21:57) Yeah, everybody in one bucket.
Sandhya Kapila (21:59) Perfect. Yeah, yeah… great. Okay. And then, John, did you want to be set up as an admin within medallion too? So you have access to medallion?
Jon’s IPhone (22:15) Yeah. Just in the event I need it, that would be good.
Sandhya Kapila (22:18) Okay. Great. Cool. I will add you as well. All.
Betsy Thornabar (22:22) Right. Connor, I just sent that over, you can check it and make sure that that’s the number you’re looking for?
Connor Morley (22:29) Okay, cool. I’ll take a look. It should be like a 15 digit number.
Betsy Thornabar (22:34) Yeah, it’s a pretty long one.
Sandhya Kapila (22:35) Yeah.
Sandhya Kapila (22:41) All right. While he’s doing that, we’ll just go through the data import or how we’re going, how we’re doing with that? The one thing, so I ran the caqh bulk import that’s completed. There are still 27 providers that are missing caqh numbers.
Jenny Laurie (22:58) Is this providers that actually have one or the ones that like did not have one? Like the qnhs? No, they.
Sandhya Kapila (23:04) don’t have one correct? They don’t have, well, let’s just go through it.
Jenny Laurie (23:08) So, they might not be missing. They just,
Sandhya Kapila (23:10) well, they’re missing, on the data sheet. Yeah. And so, yeah, like these folks here and maybe, yeah.
Betsy Thornabar (23:20) All the case managers.
Jenny Laurie (23:21) Should not have one. All the case managers. I’m nursing would not have one. Yeah, it.
Betsy Thornabar (23:25) Looks like that’s who it is too. If I’m correct, I can’t see everybody but, yeah.
Sandhya Kapila (23:31) Do you?
Jon’s IPhone (23:31) Think that, I’m sorry to interrupt, do you think?
Betsy Thornabar (23:34) That, although I see that Michelle doesn’t have one Jenny. Sorry, John, I didn’t mean to interrupt you. I’m so sorry. Oh,
Jon’s IPhone (23:43) that’s okay. I was just asking if the case managers and the nurses are going to present any problems as we, you know, try to get everything set up. Like does everybody feel comfortable that, you know, setting that up is going to go as smoothly as prescribers?
Jenny Laurie (24:03) Well, that’s kind of been my one concern from the start. But they, we have talked about this in other meetings and they assured me that they would be able to handle the credentialing for the case managers, you know, the qmh staff and the nurses as well.
Connor Morley (24:25) Okay. Good. Just want to make sure. Thank you. Yeah.
Betsy Thornabar (24:29) Do we have access to this report right here? Because I do see a couple of therapists?
Jenny Laurie (24:35) Yeah, yeah, because I would have provided them this information, Betsy from, yes, that’s what I thought. Yes, yeah.
Sandhya Kapila (24:44) And the link is actually in the meeting notes, which is in the invite, but I will actually let me just link it to our, I feel.
Betsy Thornabar (24:53) like the only ones we didn’t turn in would have been case management and nursing. I feel like we had everybody else.
Jenny Laurie (24:59) Right. And like I said, I pulled this directly from bhbs and I know I had even emailed them and asked them about some of the therapists and why they didn’t have it. Let me see if I can remember what their response was on that.
Sandhya Kapila (25:14) So, I just copied the link in the chat in the zoom chat, so you should be able to access it.
Betsy Thornabar (25:19) Yes, I see.
Sandhya Kapila (25:20) It got it. Yeah, if you have that info, that would be great if you want to fill it out.
Sandhya Kapila (25:35) Or alternatively, you can go ahead into medallion and fill it out directly in medallion versus doing it in the spreadsheet, which probably would be better because then you guys have control over that.
Jenny Laurie (25:48) So, for the ones that, okay, let’s say for the ones that don’t have a caqh, is that something that you guys would be… would you guys be applying for them or setting them up with a caqh?
Sandhya Kapila (26:06) Sorry, you cut out?
Jenny Laurie (26:07) If it’s needed?
Jenny Laurie (26:11) For those staff, like the lsws, if they don’t have a caqh, and they need one, is that something that you guys would get them set up with a caqh?
Sandhya Kapila (26:22) I don’t think so. I think that they would have to go and set themselves up with a caqh number?
Connor Morley (26:28) Yeah, Cindy, our caqh management team does not do initial setups because.
Jenny Laurie (26:34) I know bhbs, like they did that process. So that’s why I’m just kind of wondering if they need it. So that’s something that the individual staff would have to set up and then share the information. Yeah. Yep.
Connor Morley (26:49) So they’re in medallion, I do want to call out a couple of things because you do only have caqh management for 10 providers, it looks like. So your staff would have to go in and create caqh profiles for any individuals who don’t have it. And then we would mark what individuals you want us to manage their caqh profiles for as well. And in the system… you can pick certain providers that you choose, who you want to manage. And we can also change that. It doesn’t have to be the same provider year over year. But once you do click caqh management for a provider, if you do want to change it, you do have to let us know you don’t have the ability to toggle it on and off. Once you toggle it on in order to change it or turn it off, you would have to contact either Sandhya or your account… manager… okay?
Connor Morley (28:04) And for those individuals who don’t have caqh accounts, it’s not the end of the world, if they just want to use medallion as their source of truth for all their profile information. We do also offer.
Jenny Laurie (28:19) Well, so like I’m sorry. So like the qmhs and the nurses, like they’re ones that don’t have a caqh and there’s really no need for them because they’re just billing medicaid. So that’s where the PNM is the source of truth for any of our medicaid providers.
Connor Morley (28:40) Yeah. So with those, we can do a resume scan. So if they have a resume, we can pull in a lot of their information in medallion. And when they’re invited into the platform, the system will prompt them. Do they want to load from caqh? If they don’t have a caqh, they can do a resume scan, and we can pull in that information and auto populate their profile. Now, if their source.
Betsy Thornabar (29:04) Of truth is, Jenny, we can go through those and I can turn the resumes in for the people that I already have. Sure. Okay.
Connor Morley (29:12) And then for the source of truth is the PNM, like, it sounds like we’ll just coordinate our payer enrollment team to make sure that we do a nice clean handoff of when we can switch over the admin for that. Okay.
Jenny Laurie (29:32) This, I’m going to read what bhbs sent me about caqhs. He said all cmps will have the caqh accounts since they’re eligible for commercial payers and independent license, RNS, and lpns, like case managers do not have a need for one.
Connor Morley (29:53) Hold.
Jenny Laurie (29:54) on, I was telling them, I told him that there was some.
Jenny Laurie (30:02) Lsws that I’ve seen that was on their list that did not have any. Let me see what he said. What.
Connor Morley (30:12) You said does make sense because typically commercial payers, they rely on caqh to do their validations, if it’s just medicare medicaid. And if you have providers that are only medicare medicaid, it’s not required to have a caqh profile in medallion. It just helps us pull in some of their profile information. So.
Jenny Laurie (30:36) And I think, okay, so he said the reason why some lsws and lpcs have caqh accounts is because they’re eligible to be credentialed with medical mutual and bwc. So, I don’t know if maybe they got those accounts once they were working on their credentialing with like med mutual or bwc. And some of them, maybe they did have their own account set up because I noticed Michelle earnfield. I know for a fact she has one because she sent me an email a couple weeks ago where she got a reattestation that I forwarded on to bhbs. So I’ll see if I can get anybody that’s not on the list. I’ll see if I can find out any information about what their login, things are. Okay?
Connor Morley (31:24) That sounds good. And when we do get to the point where we’re inviting providers into the platform, if they know they have a caqh account, they can link it and the system will prompt them to link it if they have it as soon as they log.
Jenny Laurie (31:36) in. So.
Connor Morley (31:38) We do have like, if you,
Jenny Laurie (31:41) and some of them may have one, and we don’t even know because we’ve never managed it.
Connor Morley (31:45) Yeah. And if that’s the case, then they’re welcome to link it to their medallion profile or if they don’t have one, it’s not needed, then we should be fine. Okay. That makes sense. I know we’re a little over on time, Cindy.
Jenny Laurie (32:03) Sorry?
Connor Morley (32:04) No worries. I’m.
Jenny Laurie (32:06) sorry, I.
Connor Morley (32:07) don’t want to dive too much into the caqh management, but did we want to talk about the, did we cover updating the population for the New York and Pittsburgh group? Not?
Sandhya Kapila (32:18) Yet. Yeah. So that was next up on the list and I think we’re good on the mid Ohio side of things. So, yeah, John just wanted to chat with you to see if you had any updates on the New York and Pittsburgh groups, so.
Jon’s IPhone (32:32) Nothing really updating as far as you all would be involved. Yet we met with the two nurse practitioners for New York that would be coming on. They’re both brand new. So, you know, I’m anticipating this is going to be a little more involved than it normally would. So they’re going to sign off on their contracts, probably… Tuesday realistically. And then once they sign off on those, then I can have someone at the office, the practice manager at the office in New York, start on that Pittsburgh I think is going to be much easier. The physician there is, you know, in network with everybody… you know, again, we’re just trying to get the va, community care and tricare there… but she would be, you know, she would be kind of managing her own because that’s a small de novo clinic. So, yeah, probably… mid next week realistically before, you know, anything can really be built out or, you know, start the process with them.
Jon’s IPhone (33:45) But, you know, I really need to have that at least running by… mid next week, you know, like working towards, you know, everything getting set up and getting you guys everything you need?
Sandhya Kapila (34:02) Okay. That sounds good. Did you have questions on like the data that you needed to enter? I know you’re not able to see my screen that’s fine. Oh.
Jon’s IPhone (34:11) My gosh. I’m going to have, yeah, I’m going to have probably a couple 1,000 questions but, you know, I’ll cross that bridge when I get to it.
Sandhya Kapila (34:19) Perfect. Okay. That sounds great. Yeah, keep us posted and yeah, we’ll be ready to get that set up once we have the info from you.
Jon’s IPhone (34:28) Okay. I sure will. Thank you. Great.
Sandhya Kapila (34:30) Thank you. All right. Okay.
Jenny Laurie (34:34) We are out of time and I have a super quick question like how do we need to handle new staff? Because like we’ve already had new staff start. So how does that need to be handled?
Sandhya Kapila (34:43) So, for new staff, I’ve got to just let me, you can actually add them right into medallion. I’m going to,
Jenny Laurie (34:50) stop. So maybe we’ll do that in our training meeting then.
Sandhya Kapila (34:53) Or I can actually, I can create like a loom video for you after this and just show you exactly how you can do that so you can get started actually even today or tomorrow. Okay? So I’ll send you a loom video after this to show you how you can start adding new staff. Okay. Yeah. Would you want them to go directly into medallion right now to do that? So, would you invite them or would you, Jenny or Betsy go in on their behalf and add their info into medallion?
Jenny Laurie (35:27) On their, yeah, I’ll let Betsy answer that. I’m not sure, so.
Betsy Thornabar (35:31) I would say new people coming forth once we get everything established, I want them to do it, but until we’re established, I would almost prefer, you know what I mean? Handling it until then, but that is the goal that once we get in and medallion up and running, the new providers, do everything, submit everything themselves.
Sandhya Kapila (35:58) Okay. That sounds good. I’ll send you. Yeah, I’ll send you a video so you can see exactly how to get both flows done. Thank you. Of course.
Jon’s IPhone (36:11) Cool. Can you copy me on that? Can I get that as well? Yeah, of.
Sandhya Kapila (36:15) course. I’ll send it in my follow up email to everybody. And so it’ll be in there. Thank you. Great. Okay. Cool. Well, thank you guys. I’ll send a follow up email and I will send an invite to the training session.
Jon’s IPhone (36:29) Great. Have a good day. Thank.
Jenny Laurie (36:31) you. Bye.
Jon’s IPhone (36:32) Bye.