Transcript
Vanessa Persha (00:00) hi, isbath. Good afternoon.
Vanessa Persha (00:08) You’re on mute if you’re talking to me.
Isbath Ligali (00:25) Hi, Vanessa. One moment.
Vanessa Persha (00:26) Okay. No problem.
Vanessa Persha (01:06) Hi, brie. Good afternoon. Hello?
Isbath Ligali (01:13) Okay. Sorry about that. We can get started. We’re going to be off camera. Well, we’re both not feeling well. So we’re going to be off camera.
Vanessa Persha (01:21) Oh, no, no. I got a migraine.
Isbath Ligali (01:23) Crap on. So I look crazy.
Vanessa Persha (01:25) Oh, you’re fine. This is normally not a day that I do customer calls. And so I was getting ready this morning and like didn’t do anything. And then I was like, I forgot, I switched all my customer calls to today. So I look a hot mess too.
Isbath Ligali (01:40) Okay. Oh, okay. So we could jump right in line 68 for Joanna, but geez I see that you said the application was not rejected.
Isbath Ligali (01:52) I’m trying to see what I saw. I see that it not necessarily rejected. So I should have used a better term, but I do see that like.
Vanessa Persha (02:00) A lot, there was a lot of back and forth.
Isbath Ligali (02:02) Yeah. And then it needed to be resubmitted a lot of times. Yep. So.
Vanessa Persha (02:07) I, what I saw was that and I don’t know if you guys are familiar with the Arizona medicaid process. But before we can do any enrollments, there has to be a domain transfer where the provider signs a letter that’s addressed to Arizona medicaid, basically saying, yes, I allow this individual to process, you know, applications on my behalf. And so what it was looking like through the history of all the notes that I was looking through is that domain transfer was never approved. And like they kept, we kept resubmitting a domain transfer letter based on the.
Isbath Ligali (02:45) Sorry, Vanessa Kourtney told me that she’s trying to get in the meeting.
Isbath Ligali (02:56) Okay. Hello? No.
Vanessa Persha (02:59) That’s okay. So, based on what I know about Arizona medicaid and some challenges that I’ve seen from other customers, is we likely were not sending the domain transfer letter in the correct format. It has to be in a very clear format. The email that sent has to have like a very specific subject line in the, or text in the subject line. Otherwise, they will be like, not even looked at. So I know this one goes back quite a while, but does look like the domain transfer was finally approved by the payer on January. The application is in process, but it looks like there was something flagged for needs client attention. So, just wanted to see if you guys had a chance to take a look at that one. They.
Isbath Ligali (03:46) Said they need a current W9, but we already have a W9 up in medallion. You can either send the W9 to us. Hold on. Arizona. Medicare has returned the involvement application regarding the active billing associated association with rhad. If actively need a current, it looks like they, W, I think if I’m interpreting this correctly, they need a W9 from their previous employer. Let’s take a look.
Vanessa Persha (04:47) Yeah. So if she is still employed with this rhad healthcare company, then they need a W9 to upload and attach to the application. Shouldn’t.
Isbath Ligali (04:59) this be assigned to the provider. They made it an admin task?
Vanessa Persha (05:07) Yes, let me double check. Yeah, let me go tell them to flip this.
Isbath Ligali (05:15) So, two things with this one on feedback. I know you were explaining something about the domain access and so I didn’t catch it, but it was something that was being done incorrectly. At first. Was that feedback sent back to the pet so that this doesn’t happen again. And then two, it’s something that I’ve noticed but I don’t usually flag because I was just like writing the task, but things that should be going, tasks that should be going to providers are being assigned to admins like this. Okay? Let.
Vanessa Persha (05:50) Me, take a look at your task. I’ll do a task report and see what’s out there. But I will also flag just internally, like to our team, you know, if it’s provider specific, reiterate it needs to go to the provider. I know sometimes they’ll switch it to the org or admin, if the provider has not been responsive, let me see when this one was originally created.
Vanessa Persha (06:21) I don’t know how to see the history. I’ll dig in and see if I can, if there’s a history log that shows that maybe it was flipped to org at some point… but yeah, I will follow up with them on that and.
Isbath Ligali (06:34) Then, did they update, did you let them know about or do they know about that? I guess access and everything? Yeah.
Vanessa Persha (06:43) And I actually, so it was just flagged to my attention today that they’ve updated the letter again, like we just got an updated letter in January and they’ve created another new template. So somebody from the PE ops team is going to share the template with me so I can get it updated in all the project plans.
Isbath Ligali (07:00) Okay. Thank you. All right. So moving on to Maria Rivera’s, Arizona is the same thing where I saw that it was resubmitted a couple of times. Yep.
Vanessa Persha (07:14) Same situation from what I could see in the notes. They did resubmit the correct application on 313. But what I am still waiting from them on is like it looks like we did her initial enrollment and for whatever reason, she was initially enrolled as an RN instead of NP, which is causing the issues now with her demographic update request or her revalidation, whatever this is Vanessa.
Isbath Ligali (07:43) I think it’s complete now. Oh, is it? Yeah, I’m looking at it now, it looks like it was completed on the thirtieth. Oh.
Vanessa Persha (07:50) Perfect. Okay. I just flagged this to them this morning to check on it. Okay, great. I still will ask them to kind of dig in and see why she was submitted as an RN, just it’s a training opportunity and make sure that it doesn’t happen again. Thank you. No problem. Line 76 for Iowa medicaid, Bree and I talked about this one briefly last week. So, the payer is telling us that any like development letters or development request letters are being sent to clinicaltn at carebridgehealth. Com. So we’re not receiving the requests for additional information or approval letters or anything like that. Bree went through the email box that you guys have. And she said she wasn’t seeing anything from this rep. So, I don’t know, have you guys had a chance to double check and make sure they weren’t hidden in like a sorted folder or anything? And then do we want to explore updating the correspondence address to the medallion email?
Brianna Humphrey (09:00) I did want to touch on this. I did and is that you can piggyback off it. I did speak to dr Henderson and yeah, she’s confirmed as well before our credentialing email was established, that old email that she did not receive anything from him. And since 20 23, isbath can answer if we’re able to update it to the cred email, isbath. I don’t know if can,
Isbath Ligali (09:29) we, is that something that you guys can do? Can we update the email to our credentialing email? Yeah.
Vanessa Persha (09:35) So, that would be a group demographic update in the platform to request the change because it does, it’s at the group level, and then you guys will just have to monitor like if you receive development requests, forward those to support so that our PE ops team can get those. And then approval letter, same thing you can forward to support and they’ll update the lines.
Isbath Ligali (09:58) So quick. So just to make sure I understand in order for us, so we don’t want it to be that we don’t we no longer want it to be that email. We want to update it to our internal email. We, you guys in order for you guys to do that change for us, we need to submit a demographic update, yes?
Vanessa Persha (10:14) Okay. They’ll have to submit a demographic update to the payer? Okay?
Isbath Ligali (10:19) Can you re, can you submit so that me, and you look at it later on the LNC request form? Can you submit so that we can work on it later together on?
Brianna Humphrey (10:28) It? No, okay.
Isbath Ligali (10:30) Okay. Then what’s the next line? Sorry, give?
Vanessa Persha (10:35) Me, one second. Let me just update my notes here.
Isbath Ligali (10:45) Okay. Perfect.
Vanessa Persha (10:51) Let’s see Washington medicaid. I was just asking if this one can be closed. I think our team confirmed they have all the access they need Rihanna.
Brianna Humphrey (11:02) Sorry, I’m in the middle of that, give me one second and let me get re, which one is this for? Okay? Let me see.
Isbath Ligali (11:10) 70?
Brianna Humphrey (11:10) Seven, give me one second. I can’t see that little.
Vanessa Persha (11:13) Sorry. Let me make, no.
Brianna Humphrey (11:14) No, no, you’re fine. You’re fine. 77 certification needed for Addison. Yep, this is, that can be closed since we already resolved that. Okay. Perfect. Okay. Let me.
Vanessa Persha (11:26) Make this a little bit smaller. Okay? These items need to go to support. These are all, and I do want to call out too. So, I know you guys frequently request for us to contact the board for lines that appear to be on hold anytime that I’ve asked the support team to do that. They are getting responses from the board that they cannot. Like, the board will not talk to them, they will only talk to the provider. So when you guys send those to support, sorry?
Isbath Ligali (11:56) Which line are you referring to it specifically?
Vanessa Persha (11:59) These are what’s the first support line? Sorry, I need you to make this a little bit smaller. Sorry, Bri, no.
Brianna Humphrey (12:05) You’re fine.
Vanessa Persha (12:06) The first one was Deborah Dooley’s, Indiana license?
Isbath Ligali (12:09) So, the ask here was to prior to mark that line priority, right? Yeah.
Vanessa Persha (12:14) That one. So support can update those for you. Okay? And then the other ones were like this next one, Lamari, aranabar, asking to call the board directly. So what you can do is submit those requests to support what our licensing team would do at that point is create a task for the provider to have them call the board.
Brianna Humphrey (12:43) And I guess, can we get clarification on why the provider would instead of medallion? Because.
Vanessa Persha (12:52) the board won’t, talk to medallion. They’ll only provide application updates to the provider directly.
Isbath Ligali (12:57) I called and they provided me with updates.
Vanessa Persha (13:01) For which state?
Isbath Ligali (13:02) Florida? Okay?
Vanessa Persha (13:05) If that’s the case, then, you know, you can submit the request to support and support can flag it for the licensing team. If they have success getting a response, they’ll update support. But any of the other ones you guys have submitted to me in the past, I think New Jersey, there was a couple other ones the licensing team attempted to call and said they won’t talk to us.
Isbath Ligali (13:28) Okay. I have a I’m going to be quite Frank. This is extremely frustrating for me for Florida and New Jersey. Specifically you, if I’m correct or if I’m incorrect, please correct me. I believe that you guys have an ongoing QA going on for those two states because we’ve sent emails and complaints about these. The complaints we have with these two states have been going over for over a month now. And we have two different thread email threads especially for Florida. So, and you told us that there was a cap that was going on that gave us a whole powerpoint about how you guys would make improvements and whatnot this earlier this week, Brianna went into medallion and she saw that there’s still issues going on with Florida. At that point. I no longer want to speak to support. I want to speak to you as my engagement specialist because you promised us that changes would be made and a month and a half after again, we’re still back to square one where we’re not seeing any improvements. And now you’re redirecting us back to support when we have ongoing threads especially about Florida with you. And at that point, I don’t want to speak to support, you know, the issue. And that’s why we’re bringing it to this. That’s why we’re bringing it to this agenda. We are escalating it to you. At that point. We’ve already, we’re past support. And I went in and I wrote that in this agenda and you’re again redirecting us back to support. We’ve already escalated it. We have Steven on, we have Steven on that thread. We have one of our district managers on that thread especially with Florida because they’ve been pending for nine months. At that point, I no longer want to speak to support because we’ve already escalated to you. Previously. That goes for New Jersey as well. That’s why we’re bringing these certain like that’s why we’re bringing certain, we don’t bring everything to this agenda most of the time we go to support. But if we see that it’s a pattern and things have been pending for over nine months. I don’t want to speak to support because they’re not as quick as you would be to get these issues resolved and to flag them, it’s not my responsibility to go to support so that they can do their workflows and notify medallion operations. No, if I see a pattern. And there’s been stuff sitting down for like nine months. I’m going to bring it to you. Because I believe that’s what this form is for. So.
Vanessa Persha (15:45) I just want to be clear that the escalation and the cap and the email threads as it pertains to Florida is specifically related to Florida medicaid enrollments. This corrective action plan is not in relation to any licensing issues. So there is not a cap or any QA going on for Florida licenses. It is specifically around Florida medicaid applications. The, and in the cap, we discussed and agreed that we were going to allocate dedicated onshore staff specialists for your support tickets to be handled promptly so that they didn’t need to come to this agenda. This agenda is for items that one have already been sent to support and have not been resolved, or two are out of scope for something that support would handle. So, while I understand your frustration and you feel that I would respond to these items much faster than support, we need to be following the process and submitting them to support. Initially. If you feel that the responses from support are not adequate or not resolving your issue, they can then be added to this tracker. But I don’t have the capacity to manage general inquiries to the ops team on things like, can I get an update? Can a phone call be made? Those are items that the support team is equipped to handle most timely? And I know Mitch was going to bring that back to Stephen as well just so that it’s clear what the expectations are on sending items to support. And I think he has time scheduled with him this week to talk about that.
Brianna Humphrey (17:34) So I do have clarification like, I do have something like with that, like to kind of piggyback off though. And I do understand for multiple, like for majority of like general. But like isbath was saying, kind of is like if something is pending for like nine months, right? And then like generally an application for like a medicaid shouldn’t take that long. Should we not flag that for like immediate updates from like these medicaid like?
Vanessa Persha (18:01) These are not medicaid. These are Florida licenses. And that’s what I’m trying to like make sure we’re talking about the same thing here.
Vanessa Persha (18:09) Florida medicaid is under a full review where like we’re monitoring the progress it’s going through a QA thing that is different than the licenses. The cap and the go forward process that I talked about in that cap was that you guys would no longer need to escalate those things to us because I am monitoring it on a weekly basis with the operations team to make sure your applications no longer get to the point where it’s been in process for over 90 to 120 days and we’re still just following up with the payer.
Vanessa Persha (18:45) And that was why we added the additional time to this call so that I could review with you the progress that we’re making on any of those aging lines and give you updates where we are with those.
Isbath Ligali (18:56) Okay. So for, I understand, so the cap is for Florida medicaid. So you guys are putting all your focus on Florida medicaid. So we’ve noticed now that there’s issues with Florida, the Florida license and that’s what Brianna has brought to, she has brought to the agenda, right? And at this point, you’re saying we should go like if we notice, and Brianna correct me if I’m wrong. She noticed that there, for example, lemary, she’s… had the last the same last three updates for what I want to say the last month and a half that’s a pattern that we’ve noticed and it’s a red flag for us and it’s not just one provider. It’s you’ll see that it’s like on four or five providers. At that point, I feel like we should, we bring it to you because we feel like it’s probably a process issue, but you’re saying we shouldn’t bring it to the agenda. We should go straight to support for these specific kind of issues. If.
Vanessa Persha (19:54) Your ask is for the team to call the board, which is what the ask is in the agenda. Then yes, that needs to go to support. If the issue is that you need you’re requesting like an audit or a cap or something related to licensing and you can share the breakdown like this is the trend that we’re seeing. And we want you to look into this, that’s something that we can address on the call. But if you’re asking me to just create a flag for licensing to call the board that needs to go to support.
Isbath Ligali (20:26) So, I think it’s both. So it’s a trend that we’ve noticed and a recommendation is that the board needs to be called because if follow up is being done three times and we keep getting the same message that we checked the portal, nothing, we’ve checked the portal. Nothing, we’ve checked the portal, nothing that’s a process issue. And that is why it was brought to this agenda. Maybe re, education needs to happen.
Isbath Ligali (20:54) At what point does medallion specialists actually pick up the phone and call when they don’t notice an update within the portal? And that’s why we brought these licenses, these Florida licenses to this agenda?
Vanessa Persha (21:15) So, it looks like… they did a couple follow ups, they’re doing bi weekly follow ups here. I mean… this has only been in process since the beginning of January. I understand that you’re saying there are other providers that have been in process for nine months, but I mean, this to me doesn’t seem alarming that we’ve had an application in process since the end of January and that the notes are stating it’s still in process. The final note that was made on 326 prior to the approval states that they’ll call the board if no response is received on the next with this follow up. So, in this particular instance, I guess I’m just trying to understand like, what is your expectation of what we should have done differently? With this? We picked.
Isbath Ligali (22:06) up the phone and called Florida medicaid after the second portal check. And there was no update there. We.
Vanessa Persha (22:12) Check the portal every two weeks.
Isbath Ligali (22:14) That’s not enough, that’s what we’re saying that’s not enough. If, after the second time you, these lines don’t get checked weekly. So it’s they only get checked twice a month. They.
Vanessa Persha (22:27) Get checked more than that. There’s a web scraper that does these checks outside of our agents actually going in and checking the website, sure.
Isbath Ligali (22:37) So, but what we’re saying is that, how many times are you going to check the portal? If you don’t see an update and then like actually pick up the phone and call like, hey, is there anything that needs to be done? It, it’s not only me and Brianna that are going into these lines and seeing we have our district managers and VPS going and seeing the same updates and like check portal. And we’re it’s being brought to our attention. So, and I thought help.
Vanessa Persha (23:06) me understand like, what is your expectation of turnaround time for a board to process a license?
Isbath Ligali (23:28) Okay. Wait, maybe I can come in just a little bit here. So.
Kourtney Mankowski (23:33) Vanessa for you, isbath is it is coming to you out of a place of frustration because she is getting the back end of, the doctors and the nurse practitioners that are reaching out to her asking her, why has this not been completed? Why has this not been completed? And for us, there is nothing else we can do on our end. It now fully falls onto you and your shoulders. And so that’s where the frustration lies, it just lies because having it start in January and then now it’s April. I mean, that’s four months. What, what should our expectation be? Like that we wait five months for things to happen? Like, what should our expectation be? Because we don’t know where we’re supposed to come in and say, hey, it’s not, it’s now over the time now we can’t constantly go to support because support isn’t helping us and you kind of, are like in between to support every person that we’ve had before you. We’ve gone through that person and that person then escalates it to support to their manager to whatever the case may be. And you are our like middle piece now. But changing the document and saying, like push us to support that’s not really helpful for us. We need you to be that helping hand for us. So.
Vanessa Persha (24:38) Again… throughout the like, what was it? Two weeks ago, we delivered a corrective action plan with Stephen on when we talked and addressed support issues. Stephen was on board with having a dedicated support team to address these kind of issues. These are administrative asks that are supposed to be handled by our support team. I can’t speak to how previous engagement managers operated and what their capacity was when they were your engagement manager. I can only speak to the scope of what I can do and what my responsibilities are. And, you know, my question come, you know about like what is your expectation of turnaround time on an application is, so that I can help level set what is occurring internally to what your expectations are? So application was originally submitted here at the end of January. There were additional items that were needed to complete the application which you’ll see documented throughout the notes in medallion. And there were, there was bi weekly follow up being done. So if this is not sufficient to your expectations, help me understand what is sufficient, so that I can take that back to our operational team and try to bridge the gap there if possible, bi.
Kourtney Mankowski (26:06) Weekly follow up is the gap like that’s too long for us. We need like every other day follow up or every other like it needs to be at least weekly, bi weekly for us. Is too long. We don’t have bi weekly, so.
Vanessa Persha (26:19) As I mentioned before, we have scrapers that are scanning these websites regularly for the updates and we’ll flip those lines to completed if the website is showing that it’s been completed and issued. So it’s not that there’s no action being taken at all until every two weeks. It’s just that a physical human being is checking the portal, checking to see if anything’s been rejected or additional information is needed, so they can action it at that time. But the web scrapers are checking on a regular basis.
Kourtney Mankowski (26:56) Is the web scraper a physical person or an AI bot that is like going through and trying to fix this for us? No?
Vanessa Persha (27:04) It’s a tool. It’s an automated tool that goes through the websites and scans for approvals. So.
Kourtney Mankowski (27:09) Maybe what I’m asking for is a physical person bi weekly instead of or weekly instead of bi weekly. Okay. I.
Vanessa Persha (27:17) can take that back to our ops team. I’ll have to take that back to Mitch as well because I can’t make any commitments in terms of what operations does, but I’ll have to take that back and will likely need to be something that he discusses with Stephen.
Isbath Ligali (27:37) Okay. Can we skip down to line 84? No, yeah, line 84.
Isbath Ligali (27:49) So… all right. So in the past, we’ve asked similar questions like this for other states and, they went to like the PE chat and they asked and they either provided us the information or they didn’t… yeah.
Vanessa Persha (28:07) So, I have a note here that I sent a message out to the team just to see if anybody who’s really experienced with this payer has like an average tat, but just want you to know, that would not be based off of any data we have in medallion.
Vanessa Persha (28:29) So, as soon as I have a response, if somebody is able to advise, I’ll update here, what their experience is?
Isbath Ligali (28:36) Okay. I don’t have anything else Brianna?
Kourtney Mankowski (28:43) I do not either.
Vanessa Persha (28:46) Okay. On line 92, I sent an inquiry to Kourtney to check on the help at medallion co, email. So I’m still waiting for her to respond on that one, lines 94 and 95. These are two items I added. The Arizona medicaid website has two new questions on it that we just want your confirmation on before we move forward. One is for who bills your services? Is it in house biller, or outside biller? And then the second one is who is completing this application, and we just want to make sure you’re fine with us using outside credentialing agent.
Isbath Ligali (29:32) Okay. I’ll ask, and then we’ll get back to you.
Vanessa Persha (29:35) Okay. And then the next one is for provider, shirkara Irvine. She has a Washington medicaid PE request, but when our team went to go link her to your group, her individual npi is affiliated with a practice name. So, our ops team is contacting the payer to see what the provider needs to do to correct that with Washington medicaid. And they’ll create a provider task with those steps, but just wanted to put it on your radar so that if you guys need to nudge the provider along and, that doesn’t delay the enrollments any further.
Isbath Ligali (30:18) Rihanna, is she still here? I thought she left.
Brianna Humphrey (30:22) Please hold. It. Sounds like she did, but let me check.
Brianna Humphrey (30:34) She has left. Okay?
Isbath Ligali (30:44) Oh, you’re waiting for enrollments to close? That’s why… this is about one?
Brianna Humphrey (30:51) Yeah, yeah, I couldn’t deactivate her until completed?
Vanessa Persha (30:56) Oh, that’s not her. How do you spell her name? SHI.
Vanessa Persha (31:30) You want me to go ahead and stop this line?
Isbath Ligali (31:33) I’m double checking. We’ll let you know. I’ll write a note. Okay… Kourtney and Brianna, do you have anything else?
Brianna Humphrey (31:41) I am good.
Vanessa Persha (31:42) Nothing for me.
Isbath Ligali (31:45) Okay.
Vanessa Persha (31:48) Right. And then… still have a little bit of time left here. So I just wanted to provide you all with a quick update on how we’re moving through your top priority payers. So Florida medicaid, I’ve identified that I’ve seen a slowdown in items being completed. So again, these are all going through QA to make sure that they have everything they need. And if anything needs correction, those are being sent back to the agents for resubmission. Your Texas medicaid, there’s quite a bit that are still processing. And I believe about 18 that are aged over 90 days. So those are in the process of being escalated with the payer… your New Jersey medicaid, we still have seven processing anything that’s aging over 90 days. I’ve flagged for the team to escalate, and I think there’s like onesies twosies here where we’re over the 90 day mark. And the account specialist and team leader are going to audit those manually… Iowa medicaid. This one’s not one of your priority payers if I’m not mistaken, but I think I noticed a delay. We had a lot of aging lines for your Iowa medicaid. So you can see since I’ve started escalating that with the team, we’re seeing some movement on completed lines there. Same thing. Anything aging over 90 days is going through an audit… mass medicaid. I don’t really see any concerns there. We have one in process one in hold… Virginia medicaid. We have three in process, not really a whole lot of new requests or movement on those. I don’t have any concerns there, Tennessee medicaid. Same thing, low volume processing and Indiana medicaid. We have 14 of those processing anything over 90 days is getting an audit and, or escalation.
Isbath Ligali (33:57) Thank you. I have a question. Yeah. Is it possible to get another like an additional engagement specialist? Because what I’m hearing from your explanation, you don’t have the bandwidth to go line by line when it comes to us adding things to the agenda, is it possible to get an additional engagement specialist?
Vanessa Persha (34:19) So just to be clear, it’s not that I don’t have the bandwidth to go line by line because as you can tell, we made additional time to go through your items. What I had said was I don’t have the bandwidth to address items that need to go to support things that you’re just asking for an update on the line or you’re asking for a phone call to the board, those need to go to support so that my time can be focused on the more meaningful things that your team needs from me like monitoring these aging lines, the escalations, things that are in a corrective action plan. If your request is still to have an alternate engagement manager, I will definitely flag that for our account management team and our leadership team and have them advised. Okay? Maybe.
Isbath Ligali (35:08) I wasn’t clear. What did I say? I said that? So, you say that for meaning like for things that mean, these are, these lines are meaning meaningly for us, they’re meaningful for us. And I’m not looking for an alternative. It’s just an additional because… they’re.
Vanessa Persha (35:33) meaningful for us. They’re meaningful for us. Okay. Yeah. So like I said, I could take that back to Mitch and share that sentiment with him and my leadership team and just share full transparency. I don’t think that that’s something they’d be willing to do. But I, the best I can do is take it back, and let you know, cuz I,
Isbath Ligali (35:52) just feel like we’re in a we’re stuck between a rock and a hard place where, we are trying to express our concerns and we’re being told to go to support and then going to support. I’m waiting three weeks a month on some tickets. And I’m not getting responses online that I’m concerned about that they’ve been sitting for long periods of time without either no update or not any kind of proper meaningful update. And I thought that this… from since I was hired, I thought that this is what this agenda was used for when I was working with Lee that’s what we used this for. So being redirected back to support on things that we were worried about is concerning to me. So I don’t like that. We don’t know. I just feel like now, I just feel like I don’t know who to go to if I have an issue with medani.
Vanessa Persha (36:48) Yeah, no, I understand. And, you know, like I said, I can’t speak to how, what capacity other engagement managers had prior to, I will share, candidly, Lee was working 12 to 13 hours a day in order to manage this, which is not feasible for any one person to do. And so that’s why we’re redirecting to support. We need to be able to manage a meaningful workload across the engagement managers. And what our focus needs to be is on your high priority items, your overall like operational strategy and things like that, which is why you’re being redirected to support for those items.
Isbath Ligali (37:30) Florida is Florida medicaid and licenses are, let me before I speak, yeah, Florida medicaid and the licenses are priorities for us. That is why I brought it to the agenda. I don’t bring everything to the agenda because when you first started, I understand that your job is, I know that it’s a lot and I know that we’re not your only client. I don’t and that’s why I purposely don’t bombard you with a lot of things. But I feel like you’re telling me the same thing. And I’m telling you the same thing. You’re saying that we should only address things that are high priority or things that have already been escalated. Florida medicaid and licensing is a priority. If you go to the priority tab in our agenda, it’s a priority for us. That is why I brought it there. But now you’re telling me to go to support and I’m like I’ve worked in the support department and I just know what that looks like. And I feel like I’m wasting my time, so.
Vanessa Persha (38:21) I want to be clear. A lot of things have changed since you left support isbath, they do things very differently than they did when you were here. And I do want to add again like there is no question that Florida medicaid is part of the escalation, but that is referring to Florida medicaid. There’s not been any.
Isbath Ligali (38:41) Can I share my screen? Sure?
Vanessa Persha (38:48) And if I can just finish that thought, no.
Isbath Ligali (38:50) That’s.
Vanessa Persha (38:51) okay. So, you know, there is no discrepancy that Florida medicaid is escalated. I don’t have as far as I’m aware, anything that there’s an issue, an ongoing issue specifically with Florida licenses being an issue, this tab that you’re sharing here. My understanding is that these are your PE enrollment, your PE priority states, which is how I have been focused in monitoring… things with our operations team.
Isbath Ligali (39:29) Brianna, was that your understanding?
Vanessa Persha (39:32) I just.
Isbath Ligali (39:35) Took it as priority states in general. Yeah, this was for both licensing and medicaid. It wasn’t just for medicaid. Okay? And I understand… that I don’t work at medallion anymore, and I’m not in the support team, but I speak to the support team every day and the patterns that I saw when I was working there still continue. Yeah.
Vanessa Persha (40:02) So, a couple of things there, one, thanks for clarifying that the priority states is for licenses and PE. I can… add licensing into my operational tracking like for these priority states just to make sure that those are being monitored without you needing to escalate them. And then I wanted to address your concern. You know, you’re sharing that you have open tickets from support that have been open for weeks months that are not being resolved. So I want to understand like this is new since we gave you dedicated onshore specialists to working your tickets… no.
Isbath Ligali (40:45) This is just, this is, that was just overall like I don’t I just don’t I still from, that incident, it was probably like what? Three weeks old, three weeks ago and I was out last week, on leave. I was out for whatever. So I haven’t built that confidence back up where I fully like trust support and I mind you, but I still do go to them for certain things. For mostly everything. I only come to you when I feel like things have been sitting for too long or if it’s a priority state or something that we’ve already discussed with you and we have a, we already have like some kind of, you know, communication and that’s why I brought it to the agenda but we don’t bring everything to the agenda because why you’re also a busy person, we’re not your only client. We’re just flagging things that we know for a fact is a priority state. I didn’t know that you did. I didn’t know that you didn’t know that this was, this applied to licensing and medicaid. But now we’re on the same page. And that is why we brought that’s why we flagged the Florida licenses in that other tab because, and like for, and I’ll just use the lemary example. I know that you said that it was just submitted back in January. This is now month four.
Vanessa Persha (41:59) She’s approved, her license has been issued.
Isbath Ligali (42:02) When it.
Vanessa Persha (42:03) Was issued today, yeah.
Isbath Ligali (42:06) But that’s like granted, they didn’t you know, it was just issued today, yeah. And they didn’t really, but like we just need more like substance when it comes to our, the notes that are being left.
Vanessa Persha (42:21) And.
Isbath Ligali (42:22) and, that’s a concern that’s coming from people within our organization, not even not like not even me and Bree, yeah, like our Florida dcl is just like, hey, this is just like why they just keep checking? They’re not as aggressive. They’re really passive with the updates that’s literally her word verbatim.
Vanessa Persha (42:40) Yeah. So I think like I said, one thing I can do moving forward is pulling in like the licensing data into my dashboard where I’m monitoring your PE stuff and just create separate for the priority license states as well where it gets complicated in tracking like movement of the application is that we can submit the application without necessarily having all of the required documents needed. So like continuing education credits, you know, things like that where like the portal allows us to submit the application without it and we continue to follow up with the provider to get the information we need. So, for that one provider, just as an example, like we still had outstanding items we needed from the provider in mid February that we sent to the board when we received it from the provider. So it technically wasn’t even a complete application at the end of January. The completed application wasn’t fully with the payer. I’m sorry, with the board until it looks like mid to end of February. So, yeah. So, you know, that I just want to be fully transparent like even with me monitoring the high level statuses and how long they’re sitting exactly?
Isbath Ligali (44:05) Yeah, that I get. So before we drop, I just want to, I want to just make sure we’re on the same page because I feel like we’re repeating this when it comes to the priority states and we have issues, for example, Florida license. If it’s just one missed update, I wouldn’t add it, but for like instances like this where we notice like I don’t know two months, no update or like the same kind of update. Is it okay for us to add it to this agenda? Again? I’m not adding random stuff. It’s just priority states. I need to be able to come to you about it. I know it’s tedious seeing line by line but like they’re literally knocking at my door, Vanessa and I’m about to give them your address.
Vanessa Persha (44:43) No, I understand. My hope is that you don’t even need to add them to this tracker with me pulling it into that operational dashboard that I have. So our licensing team just rolled out a weekly like optional meeting for the ems to join, where we have questions about things related to licensing. I will pull in all of your priority states into my dashboard. I will look through and see what’s been sitting or looks like it’s been sitting for. I don’t know what. And again, I guess every state is different, but what do you feel, what would you feel comfortable with in terms of a processing timeline for me to escalate it to the licensing team? What?
Isbath Ligali (45:26) Do you mean like.
Vanessa Persha (45:28) Like if.
Isbath Ligali (45:30) it’s been sitting for that long? Yeah. Oh, like without an update? No, no.
Vanessa Persha (45:36) No, not without an update, but that it’s been, actually, it shows that it’s in process with the board… because again, we do have like the scrapers are going, we have the bi weekly check ins of the actual portal. But when does it become a red flag for you? If it’s been?
Isbath Ligali (45:52) I think it’s a yellow flag, at 60 days, but that’s still kind of that’s still kind of odd, but red flag is definitely 90 days. Okay. All right.
Vanessa Persha (46:00) That’s helpful. So, what I can do is like on the 60 day mark, I will address it on those calls. Just say like, hey, keep your eye out for this. Can we start calling if possible? And if the payer says they won’t talk to the provider or they won’t talk to anybody but the provider, I will ask them to submit a task to the provider to call. And then at the 90 day mark, we need regular, like there needs to be some kind of activity on that that’s escalated. So.
Isbath Ligali (46:31) Earlier, you did say that same thing and I apologize. I said I was talking about Florida medicaid. So you’re saying Florida, the nursing board will not talk to anybody but the provider.
Vanessa Persha (46:42) I’ll have to go back and check on Florida specifically. I was just saying like every other request that you guys have flagged for me before we had your dedicated support onshore support team. When I was flagging them for licensing, they kept coming back and saying, sorry, like the board won’t talk to us. We called, we’re just going to send a task to the provider and ask them to call.
Isbath Ligali (47:07) Okay. And I,
Brianna Humphrey (47:09) do have one thing I need to bring up whenever you guys are done. Sorry, just.
Isbath Ligali (47:12) Wanted to make sure.
Vanessa Persha (47:13) okay. No, I was just going to say if memory serves me correct, those were for the New Jersey, I think.
Isbath Ligali (47:20) Also for Massachusetts, I think don’t I could be wrong. I think also for Massachusetts that’s the case. I’m not sure about Florida, but I mean, if that’s the case, that’s what we’ll need to do. Yeah. And we just have to figure something out because their schedules here are so crazy. But if that’s what we need to do, we’ll figure it out. But.
Vanessa Persha (47:36) Like again?
Isbath Ligali (47:39) When, if, after like two after two portal checks and there’s no real update if they can just like either call or tell the provider to call because they are not allowed to speak to the board. They just, we need to see more aggressive outreaches instead of just having like two months go by check portal, nothing or send email, no reply because once they send an email and again, I might be wrong because processes might have changed. They’ll send an email then wait two weeks to check for an update. Again, I might be wrong but we just need to see more aggressive. And I really appreciate you being so receptive to that. Yeah. And then, for these, all of these portal licenses and this one, New Jersey, can we flip it back to medallion? Can you go to the licensing team about these?
Vanessa Persha (48:28) Yeah. So like I said, I’ll spend some time either today or tomorrow. I’ll you know, consolidate all of your licensing stuff and then let me just see when that licensing call is. It might be tomorrow. Yeah, it’s actually tomorrow. So I will… add that to the agenda for them. All of these ones that you flagged and ask for either one, a phone call to be made. And then if they don’t won’t talk to medallion, ask them to task the provider to make the phone call.
Isbath Ligali (49:00) Thank you so much. That is so perfect. And then going forward just to reiterate, I’m only, we’re only bringing escalations here or priority states, everything else I’ll go to support unless like support is like they haven’t got, they can’t get a result in like a week or three. I mean, two or three weeks, then I’ll bring it here. But priority states they’re priority for a reason. So unfortunately, I will have to bring them here. But I do appreciate y’all, yeah.
Vanessa Persha (49:24) And like I said, my hope is that you don’t even need to because we’re monitoring it closely. So, yeah, no.
Isbath Ligali (49:30) Problem. Thank you so much, Vanessa. Yeah.
Vanessa Persha (49:32) No problem. I appreciate you guys and I’m glad we were able to get through that and, you know, like there are so many times where things are just, it’s a miscommunication. So, I appreciate that you guys are always so professional and we’re able to get to a common goal here. So I appreciate that.
Isbath Ligali (49:49) Thank you so much. I do have one.
Brianna Humphrey (49:50) Thing?
Vanessa Persha (49:50) Oh, yeah. Sorry.
Brianna Humphrey (49:53) Can you bring up? I know this is one you said to send to support this was sent to support, but it’s regarding eight line 93. I already reached out to support regarding this and the license has been issued since February per nurses.
Isbath Ligali (50:08) Oh, yeah. Oh.
Brianna Humphrey (50:10) The manager pinged me today a little frustrated because she was like what’s going on, but I did just pull it up on nurses and it has been, but it looks like on the line as of yesterday, they’re still putting updates on there. So I’m not. Yeah.
Vanessa Persha (50:24) I think this was one you flagged for me before, and I marked it complete because it’s only her temp license that has been issued.
Brianna Humphrey (50:34) I’m showing her full license is issued.
Vanessa Persha (50:38) Let me go. See. Let me go.
Brianna Humphrey (50:40) Check because I think, from what I’ve seen in the past, it would show temp on nurses.
Vanessa Persha (50:48) What was her name again? Margarita, Gomez Margarita?
Brianna Humphrey (50:51) Gomez, yes, but it’s showing on nurses and what I feel like I’ve known on there is it always would show temp or some like or conditional or something.
Vanessa Persha (51:02) Mass, right? Yes.
Isbath Ligali (51:04) It’s better to check the board website, but I’m bleeding.
Vanessa Persha (51:11) Yeah. Her limited RN license is marked active in her existing licenses. Yeah.
Brianna Humphrey (51:17) It’s not showing a limit. It’s not showing like any type of it’s showing.
Isbath Ligali (51:21) It’s not even coming up in nurses for me.
Brianna Humphrey (51:23) It’s showing up on my end. I can share my screen if needed.
Isbath Ligali (51:27) Yeah, you can take it.
Vanessa Persha (51:29) Yeah. Let me see what you’re seeing because we pulled it from the board, no worries. And it says conditional.
Brianna Humphrey (51:38) Here’s my end.
Isbath Ligali (51:43) I think we’d have to go with what the Massachusetts website has. Well?
Brianna Humphrey (51:48) Massachusetts goes through nurses for verifications.
Isbath Ligali (51:51) Vanessa, it’ll be directed to nurses. Yep. So.
Brianna Humphrey (51:55) See right here?
Isbath Ligali (51:57) Vanessa, are you on, are you on the mass website?
Vanessa Persha (52:01) I’m looking at the verification that was done, commonwealth of Massachusetts office of health and human services license verification site.
Brianna Humphrey (52:13) Well, because I just was on mass and it says it to, it rerouted me to nurses for verifications, let me see. But then still, why, would, it would show some type of thing… right here? From what I’ve seen previously.
Isbath Ligali (52:30) So,
Vanessa Persha (52:31) I just dropped the link in the chat. That is where we ran the verification from.
Isbath Ligali (52:43) Let me see. Let me.
Brianna Humphrey (52:50) pull up the license number I have. Okay, for some reason, I just want to see because.
Isbath Ligali (52:55) that’s weird. Let me see.
Isbath Ligali (53:08) That’s conditional. What?
Brianna Humphrey (53:11) License number. Are you looking at that’s interesting? Because I feel like on the past, I’ve seen that on nurses. Yeah, it’s conditional if there’s limitations.
Isbath Ligali (53:22) Brianna, can you let the manager know, that is conditional and we can’t we,
Vanessa Persha (53:30) can’t do anything?
Brianna Humphrey (53:31) I’m already on it then. I’m gonna let her know too.
Isbath Ligali (53:35) But that’s really neat. It is. Thank you so much, ladies. No.
Vanessa Persha (53:39) Problem. Thanks everyone. And we will, I’ll let you know if I have updates from licensing on those before end of day tomorrow appreciate.
Isbath Ligali (53:47) You have a great day.
Vanessa Persha (53:48) All right, you too. Ladies. Bye bye.