Transcript
Connor Morley (00:00) hello, everyone. I’m so sorry about that. I’m running a little late today. Welcome to our medallion weekly implementation call for today. We did want to go over some of the credentialing workflow and just kind of walk you through how that works. So, I don’t see… Renee. Are we all set to get started?
Rasencio (00:36) Hey, Connor, just scrolling through to see who’s here. Yeah, I think we’re good to get started. Okay?
Connor Morley (00:43) Perfect. And then I did want to check to see if everyone had access. I was looking through and did notice a lot of folks had team viewer roles and I wasn’t sure if that was the correct role for everybody.
Rasencio (01:04) I haven’t looked to see who has team viewer roles. I did let Greg… know when he’d set it up to set them up with admin access. But if, during it, if you can show me how to change that access… or update it to admin. So I’ll let you decide which would be the best. I know we’ve gone through this before. We are going to set up teams just so it’s easier for the credentialing specialists when they log in to be able to see their specific provider information, but they still need to be able to submit requests as far as credentialing provider, enrollment, stuff like that and sending out requests to providers when we have new ones. So, I’m not sure if only one of those will allow that access.
Brittany McIntyre (01:56) There should be able to have multiple people to have that access. I know I have the viewer access, so I wasn’t sure if that’s because I’m the contracting person rather than the credentialing person.
Rasencio (02:08) Correct. Yeah. For the contracting team, we just have the viewer role since you guys won’t need to go in and do any requests. You’ll just be viewing the information that’s in there.
Connor Morley (02:19) Okay. My next question is for the contracting team, would they need to see only specific provider teams or would they need to be able to view all of?
Brittany McIntyre (02:29) We have to view all.
Niccole Russell (02:30) Yeah. Okay. So.
Connor Morley (02:31) In that case, that would actually be the auditor role.
Rasencio (02:34) So,
Connor Morley (02:36) that you can view all providers in the system. So I’m just going to change those really quickly. I just wanted to confirm that, but it does look like everyone else has admin access.
Rasencio (02:45) Amy will need admin access, Amy lemonian, she’s a credentialing specialist. Yeah.
Connor Morley (02:51) Okay.
Brittany McIntyre (02:52) Yeah. So it’s going to be me, Alex, stankiewicz, Gretchen. Yeah, Gretchen, Keith, she’ll, need auditor. Okay?
Niccole Russell (03:05) And Liz, too, yeah.
Brittany McIntyre (03:07) And… Liz, who?
Rasencio (03:14) She’s in there? She’s listed in there. She’s back there. She,
Connor Morley (03:18) is admin access? Do you want auditor or admin access?
Connor Morley (03:25) Probably.
Niccole Russell (03:26) Wouldn’t hurt for her to have admin?
Rasencio (03:28) Access. That’s what I’m thinking we can leave her yeah.
Niccole Russell (03:30) I would definitely.
Connor Morley (03:33) Okay. No problem. All right. So, I’m going to start with a kind of a brief overview of medallion in general, and then I’ll kind of go and dive more into the credentialing workflow.
Niccole Russell (03:47) Connor, can I ask a question about the payer scoping real quick? It won’t take that a second.
Connor Morley (03:53) Okay. Yeah. Okay.
Niccole Russell (03:55) I’m going to share my screen?
Niccole Russell (04:03) Renee it is populating for you here. You have, these are specific to your company. So, all of these payer plans are specific to your, to you as a group, not like a standard process across the board. Is that correct? Because all of these say, yes.
Rasencio (04:25) Yeah. In all honesty, I’m not 100 percent sure some of them could be standard to just our company. Some of them could be, you know, this is how they have all of their providers set up to enroll. I’m not 100 percent certain. These are just the ways that we’ve reached out to our contacts at those payers and confirmed that our groups are required to submit enrollment.
Niccole Russell (04:46) Okay. Because I was working on a payer directory. And as I started looking, I mean, I’m you know, there are several 100, you know, several 100 that say yes, and I’m like, are they all really specific to your group? Because, yeah, if we follow our payer directory, then it’s not really a, yes. It’s just a standard across the board.
Rasencio (05:07) Yeah. If it’s if it’s a link to something on their site, obviously, that is just across the board that’s not.
Niccole Russell (05:12) Yeah.
Rasencio (05:14) I imagine there’s going to be quite a few words. Humana, just has their roster that we submit. I imagine that’s kind of across the board as well. So.
Niccole Russell (05:25) Could I ask you to update this? If it’s not specific to your state then, or to your group, then put no.
Rasencio (05:38) Yeah, absolutely. Okay. For the ones that I’m certain of, I will. Okay. Yeah, that’s fine. Do I have access to this in Google docs? I’m sorry, I can’t remember… or is there a way you can send me a copy?
Rasencio (05:51) That way I can make updates to it… because we do have a couple new payers that we need to add in?
Niccole Russell (06:00) Okay. Yeah. Connor, we can share this, right? Is this the one you shared?
Connor Morley (06:05) Yep. You can share it. Okay? I’ll.
Niccole Russell (06:08) stop sharing and I will let Connor take back over and I’ll share it with you Renee. Thank you.
Rasencio (06:12) Awesome. Thank you, Nicole.
Connor Morley (06:14) Okay. All right. I’m going to dive in really quickly again just because I want to go through kind of the brief overview of medallion. And then we’ll dive into credentialing specifically.
Connor Morley (06:27) So for medallion, here is where you can see just your provider directory. So the full list of the providers all down here. And then you’ll be able to see other providers as well. If we go all the way to the bottom. And then this is just kind of like a table overview. If you want to look at a specific provider and their profile and all the information that we have on them, we can click into that provider’s name from the provider directory, or we can search their name, and you can see all of the information that we have here. In general when submitting a request either for payers, tjc credentialing or licensing. We’re going to need that their provider profile be at 100 percent complete and their agreements also signed. So as credentialing folks, you do have the ability to go in as admins and enter in information for them. When we invite the providers into the platform. We do ask that they fill out as much as they can. We do ask that they link their caqh profile, so we can get about 60 to 70 percent of their profile completed. But you can also see within medallion, this is where you could look up this information. We do have the ability to go and run reports on provider information, credentialing requests, in progress, payer enrollment requests in progress or completed. And we also have just some generic kind of analytics for all of those things as well. One thing that’ll be important if you’re looking for kind of a complete either payers list, you can look individually on a provider profile to see the payers that they’re associated with. We haven’t loaded in all of the provider or group enrollments just yet. But once we do, you will be able to see all, the billing status for all of, the payers associated with an individual provider… or you’d be able to, if you go to this payers tab over here on the left, you would be able to see all of the group and provider enrollments for your entire organization. Right… here. And all of this information. If you see any of these tables, you are able to export this as an excel file. You would just need to go all the way to this kind of right hand tab over here, this little download button. And then it would ask you or it would download this information and this file would be sent directly to your email associated with your medallion. Account? Okay. One thing that’s going to be important to note when you’re going through and you’re doing these, when you’re doing payer enrollment or you’re doing tjc credentialing is that you can submit requests for providers, you can submit requests for group payer enrollments. And if at any point we need more information than what’s on the provider’s profile, let’s say, for example, a provider is 100 percent complete, but a particular payer requires information that’s not on our standard profile. We as medallion will assign tasks either to the provider or the admin. The standard is that we first assign the task to the provider, we reach out and remind them about that three times. And then we create another task that says we can’t get in touch with this provider about this task, and we assign that to the organization admin. So as team managers, you will see tasks for the providers that are assigned to your team as admin. You would see overall tasks and where you could view that is, you’ll be able to go into this overview tab right here. You’ll be able to look at provider tasks, admin tasks and expirables as well.
Connor Morley (10:27) So this could be board certs. This could be licenses. It could be a lot of things that are expired or if you do want to filter to things that are expiring within 90 days, you can do that as well. We can look at some certifications right here as well that are coming up in 90 days. So I’m going to pause right there and see if there are any questions the.
Rasencio (10:54) Expiration date for these expirables, is this pulled from caqh directly?
Connor Morley (11:01) So for these, it is, but if a provider were to input a new board cert into their profile in the provider profile, we do have a lot of expirable dates that they would enter for some of their information that we would pull that from as well.
Rasencio (11:22) Okay. So there’s a way to manually overwrite that yep.
Connor Morley (11:25) Yep. So if you were to go in, this is not a provider as a board cert. But if they did, it would be listed here and you would be able to go in and update that information. And.
Rasencio (11:36) If that needed to then be updated to caqh, I know that our contract has medallion doing the caqh management. What would that process look like? If we notice something’s in there, we manually update the expiration date in here. What… is the next step to making sure that gets updated in caqh?
Connor Morley (11:57) You wouldn’t have to do anything. We would automatically update caqh because we have caqh management. Okay? And.
Rasencio (12:08) when those expirables are coming due, do you automatically run those verifications like on their license, their board cert, Dea, stuff like that? Or do we have to submit a request for that?
Connor Morley (12:19) Nope. We automatically run those verifications typically for board certs licenses, things like that just to see if there’s a, if they have re upped their board certs. We run that about two weeks, one week and the day of the expiration.
Rasencio (12:39) Okay. When would we receive notification? Because we’ve worked with our providers before we typically give them about 60 days, 60 to 90 days notice that their board cert is expiring. That way, it gives them time to kind of get their stuff together if they need to submit additional ceus, stuff like that in order to renew. And then we let them know, you know, obviously specifically when it comes to their license, not so much when it comes to the board cert, if we’re not able to verify the renewal by the day of, in the case of the licensure, they’re not able to see patients. So at what point are we notified that a new, a renewed date has not been able to be verified? Because we’d like to give them notice ahead of time like, you know, a week out? Hey, we’re still not able to verify this renewed date, heads up for the date that expiration date hits.
Connor Morley (13:31) So you would get that verification. So we send out a weekly admin email every Monday. You would get that verification if in that weekly admin email. So if you’re looking at a provider and they’re two weeks out from the let’s say… they’re two weeks out from their license expiration. We haven’t verified it. That would be in the weekly admin email summary. And it would call out specifically that we could not verify that.
Rasencio (14:02) Okay, perfect. And.
Niccole Russell (14:05) Renee, during our syncs, after you finish with implementation, I do add expired documents within 30 days to my update to you as well. So, I will bring it to your attention just so you’re aware?
Rasencio (14:18) Great. Thank you. You’re welcome.
Connor Morley (14:28) Sorry, I just had a little momentary brain blank but so from here, this is the provider profile. If you need to make requests, you can pick a certain provider and create a request for new… payer enrollment or credentialing, right from the provider profile, or we can go into the individual tabs to start to make those requests as well. One thing that I did want to kind of talk about a little bit is we’ve loaded a lot of these providers that are existing in the platform. Once we get to the point where we are officially live and we’ve loaded all the details and you’re making requests. When you have a new provider that has started with vivo. Typically the workflow is that you would click on this button right here, this invite provider button, and… you would put in their email, first name, last name, start date. And are they an MD, do, apn, etc, their profession? And then we can send them that invitation email. Once that’s been sent out. If you collect their social security and their caqh id beforehand, you can go back into that provider’s… basic shell while they’re about, you know, while they’ve got the invitation sent out to them and they’re waiting to log in and you can run a caqh integration to pull in all their information from their caqh profile. So if I were to go into an example provider profile, let’s just imagine that I just created this provider, their information is very blank right now. But I’ve sent out the invitation email by inviting them into the platform. And I have their caqh id and their social security number. And I want to link their caqh profile. You can scroll all the way down to this data imports tab right here. And then what you would do, this would actually say link your caqh profile right here. And we would put in their caqh id, social security number. Their last name will pull in automatically based on what you entered. And then you would hit verify. Now, it usually takes a couple of hours for that integration to finish. Once it does, we will ask you what data do you want to add from caqh to the profile? And it’ll show review and add data right here. So you would click on this. And then you can decide what information from caqh you want to pull into this provider’s profile. So you can have the option of selecting all or just selecting some. So we can select some of the documents, education, hospital, affiliations, licenses, additional payers, malpractice, insurance. It’s up to you what you’d like to pull in from caqh. Okay?
Rasencio (17:34) Hey, Connor. I have a quick question. Yeah. So it doesn’t happen frequently but every now and again, we’ll have a provider that starts and they’re already employed with the company as an RN. We actually have a provider in Pennsylvania who’s getting ready to go through this exact situation. She starts may tenth. She is an RN. She’s recently received her NP license and they would now like to get her set up credentialed enrolled all that. And so typically, when this happens, obviously, they have no caqh set up. A lot of the times we have to walk them through that process. Typically, what that looks like for me is, you know, I let them know. Hey, you have to do the preliminary information, set up, your caqh, enter as much information as you possibly can, and then send us the login information. That way we can enter our group information as far as employment locations, Coi, stuff like that. What would that process look like working with medallion now?
Connor Morley (18:37) Gotcha. So this is a little, this is actually an interesting workflow. Couple things that we would need to do. One is we would need to change their profession… right off the bat. This is if they are an RN, that’s in the system, we would need to change their profession from RN to NP two would be, they would still need to create the caqh profile in general. But they, if they’re already in the system and medallion is the source of truth and has all their information, they don’t need to fill out anything in caqh. They would just need to add the caqh username and password to this external accounts. And then our team would go and update their caqh profile for them. The other step that I’m actually missing… here is that you’d also need to check off this button that says caqh management so that we know that we are managing them. Okay?
Rasencio (19:43) So, they wouldn’t be in the medallion system already because we don’t credential our RNS. So they would have to be invited to medallion, which we would do that way they could go in. But as far as again setting up that caqh, obviously, they enter as much information as they can, but they can’t attest anything because there would still be a lot of missing information that we would have to provide. Caqh would not allow them to go through with entering. I think without certain information. So then would we still have to go into… caqh? To probably not, I would imagine we can just get them to fill out whatever information they need. If we manually enter that missing information into their profile on here and check off caqh management. You guys would then take that information and upload it to caqh.
Connor Morley (20:39) Yes. And there’s an attestation in the agreement as well that they would have to, in order, they would just also have to make sure that they give us permission to update their caqh.
Rasencio (20:53) Yeah, absolutely. Okay. So then, yeah, there would be no need for us to go into caqh. We would make all updates in medallion and then submit the request to you guys to begin that process yep.
Connor Morley (21:05) The only key there would be like our caqh management team does not create caqh profiles. They would just need to create that and then add in the username and password on their medallion profile. Okay. All right. I did want to discuss a little bit the tjc credentialing workflow.
Connor Morley (21:32) One thing that I want to call out here is that for tjc credentialing within medallion, there are two credentialing tabs. One is called credentialing, and the other one is called privileging, credentialing actually relates to ncqa credentialing. So, for tjc credentialing, you’re going to need to click on privileging and request the privileges or the tjc credentialing through the privileging tab right here. Okay? And then in addition to that, what you can do is you can select a provider and we can select the different entities that you would be choosing as well as some of the privileges. And I want to show you a completed or a kind of a more full workflow. So I’m actually going to jump into a demo environment real quick to walk you through the committee, the closed status, ready documents and how to move completed credentialing packets to the different committees. So give me one second while I jump into that while?
Rasencio (22:52) You’re doing that? Can I ask a quick question? Connor, is there a way to remove credentialing from our platform?
Connor Morley (23:00) There? And,
Rasencio (23:03) if not, is there like what if someone accidentally forgets and does it through credentialing rather than privileging. Is there a way to remove it? Swap it? Do what we need to do. I just, I know in the beginning, there may be… some moments of gosh. I don’t remember, or I just, it’s a habit you see credentialing and you’re like, yep, that’s what I want. Yeah.
Connor Morley (23:29) So, this is something that I’ve been working on with our engineering team to do initially, it’s not possible… but we just trialed it and it does look like it is now. So I think in two weeks, we can remove it. Okay?
Rasencio (23:52) That would be great just to remove any confusion because again, on our end, you know, it’s always just been referred to as credentialing and old habits die hard. No.
Connor Morley (24:03) I agree. And honestly that was feedback I gave engineering that it is kind of a little ridiculous that it’s on there still and we can’t remove it. But anyways… so I want to pull up essentially what the credentialing workflow will look like. So if you go into the, and keep in mind, this is going to say privileging, not credentialing.
Connor Morley (24:32) But essentially you’ll make your request for… an initial or a re credential, that request will go into the spreadsheet. You’ll be able to look at and see all the requests that are in process and from the states, the type, all the information and as well the entity. And while we’re in process. And while medallion is putting together the packet, your team will need to make sure that the provider has their profile at 100 percent that they’ve signed the agreements and that. And then once we’ve run all the primary source verifications, we put together a credentialing file and you’ll be able to look at and to see what primary source verifications are still in progress versus what are not. If there are any that have kind of shown as a, needs attention, it will be yellow. But if there are any serious adverse issues with the primary source verification report, that would be a flagged… admin task sent to you to let us know what do you want us to do with it? Like this is a, and this is a serious… issue that we’ve found and we want to know, do you still want us to move forward with this application or do you want us to essentially end it or archive it? We don’t typically move those serious adverse reports all the way through to committee, but we can, if, sorry… I shouldn’t say we don’t we want feedback from you all on what the next steps for some of those serious adverse issues could be on that PSV report. So if you do want to move it to committee and then take it from there, we can do that. If you want us to remove that application or that credential altogether, we can archive it and remove it that way. Does that make sense? Yes. Okay. Now, next up, once the credentialing packet has been completed, once the primary source verifications are done, then the packets move into this ready state. So you’ll be able to see if we didn’t find any issues with any of the psvs, the PSV report will show this green shield. If there’s anything that needs attention, it will be a yellow yield sign and you’ll be able to click in and look closer on what the issue was right here. You can also view the credentialing file and you can download it at any point in the process. So you’ll be able to see this is the summary page right here where we have all of the elements, how we verified it from the data source, when it was verified, what the status was, and who verified it as well. If you keep going further into some, like if we go to the ofac or the mpi, you’ll also have information here and evidence as well. And if you need, I can supply a redacted credentialing packet that kind of goes over a sample of what that would look like.
Rasencio (28:07) Okay. I think we still have the one that you’d sent over previously to Kenzie and myself. So I’m happy to forward that to the team as well.
Connor Morley (28:15) Okay, perfect. Now, once it’s in a ready state, then you would be able to send it to a committee for review. And for that committee, we can do a couple of different things. I think… we can either send it to Renee and Kenzie or if there is something more serious where it is like yellow, you can have that be sent to the medexec board. But Renee, I think we had talked about sending it to you and Kenzie for the committees right now.
Rasencio (28:48) That’s correct. Yeah, yep.
Connor Morley (28:50) So you would just pick what committee to send it to. And then once it goes into committee, we would see here… Kenzie and Renee, you would be able to look at the entirety of the credentialing packet and you’d be able to approve or reject it. We also have a feature update where there will be a third option that says defer and a reason why that should be coming within about another month. But just to give you a heads up, so there will be three options. Anyone with credentialing admin does have the ability to move packets from ready to committee. Only committee members can vote on the committee in medallion. So it’s just Renee and Kenzie right now.
Connor Morley (29:46) Okay. In addition to that, you also will have your directory… of all of the credentialing requests that have either been archived rejected or approved and you’ll be able to view the credentialing packets. You will also upload your reappointments… or recredentialing. And here… you’ll be able to see what is coming up.
Connor Morley (30:26) All right. Any questions so far? None from me?
Connor Morley (31:00) All right, team. Is there anything else that you would like me to cover right now?
Rasencio (31:11) I think everyone’s absorbing.
Rasencio (31:17) I did direct everybody to kind of hop into medallion, see what we’ve got. You know, my direction to them is essentially right now the providers have received the outreaches for them to go in and complete things and to obviously sign off and attest everything that’s required before we go in and make sure that those profiles are complete at 100 percent. I think that’ll give an opportunity for them to really dig in and explore the program and… see where they’re going to have additional questions or maybe want a little additional training.
Alexandra Stankowitz (31:53) Do you, Renee or Connor, do we have a go live date for this yet? And by the way, I’m very impressed you had me at expirables… and how you guys can handle that, which I thought was amazing. So.
Connor Morley (32:10) We do have a go live date. Sorry, I’m just pulling it up right now. And right now, it looks like the go live date is may… fourteenth.
Alexandra Stankowitz (32:29) So next month?
Connor Morley (32:30) Wow. Yeah… I.
Alexandra Stankowitz (32:33) Think that’ll take a huge burden off the credentialing ladies.
Connor Morley (32:37) That’s what I’m tracking right now for the go live date. Oh.
Rasencio (32:40) Yeah, may fourteenth.
Connor Morley (32:43) May fourteenth.
Rasencio (32:44) Okay. I’m just going to communicate that to Greg because I think he was waiting for a go live date because we have our single sign on. They want to create and it manages that Greg wants to create a ticket system in our it ticketing platform so that if we need to give new access, they’re able to manage that. And he wanted to make sure he knew what that date was. So they could have it set up in their system by then.
Fatima Faraz (33:11) I have a question and Renee, I discussed that with you yesterday as well. That will we receive notification or you or Kenzie receive notifications? Like when are the providers going in and actually doing some work before we can go in and do our work.
Rasencio (33:29) Ah, yes. I remember Connor. So when a provider goes in and say they’ve done their work, they’ve signed off, they’ve given permission. They’ve attested to everything. Do we get notification of that? What does that look like? That way? We know to go in and just double check their work and what they’ve done. So.
Connor Morley (33:51) You don’t get notification on like individual providers, but within medallion… you do have the ability to look at the… percentage of complete providers. So if I go to the provider directory and hang on while I pull up my screen again.
Connor Morley (34:17) So within medallion, you do have the ability to kind of filter this pie chart right here will show you the provider’s profile completion percentage. So you can filter to see who’s at 100 percent complete. Right now. No one is, but you… would be able to filter here as well. Admins will get weekly updates on the number of providers who have not completed their profiles. It’s in a it’s in essentially a weekly admin summary report that gets emailed to you on every Monday. Okay?
Rasencio (34:54) So then everyone should be able to, since all the credentialing specialists are admins, they should all be included on that report weekly. Yes, great. And that report comes to our email?
Connor Morley (35:07) Yeah, it would go to your email, okay?
Alexandra Stankowitz (35:10) Does it also include the providers who are not complete, so that they know they need to go out and do some additional work in there?
Connor Morley (35:18) So the providers who are not complete, they do get a profile completion reminder. In general. I don’t turn that on immediately just because it reminds them every day and can be a little overwhelming at the beginning. I.
Alexandra Stankowitz (35:35) Would agree with that.
Connor Morley (35:38) But usually, after about like a week to two weeks, we turn that on just so you know… all 100 of your providers are not getting notification fatigue or email blasts from medallion, right? As we begin.
Rasencio (36:02) I have a question in regards to enrollments. So obviously, we have a lot of enrollments that are currently in process and those are still those are going to stay managed by us. It’s too difficult to switch over the contact. So we’ll stay on top of those. Obviously any new that come in closer to obviously, our go live date will be managed by medallion. But for those that we are currently managing, how do we update once we get the effective date? Or if we get any updates, say, you know, and this has happened more times than I’d like to even admit is where we submit the enrollment, but they’ve lost the enrollment application or it’s not showing in their system and they need us to submit a new one. It’s aggravating when it happens, how do we need to go in and document that in medallion? That way, at least we have a running track in the system of what we are currently managing.
Connor Morley (37:01) So we can add those in Renee. But the way that we do that is through the data import template and it’s within the provider enrollment requests tab. We would just mark those as transfer requests that denotes that those applications have been submitted. And then if your team is working on the follow up with the payers, we would just also mark that medallion is not owning those transfers. We can also switch it over to medallion, can own those transfers and we can follow up with the payer. The only thing would be that we would like to see… like tracking numbers and maybe a date of submission with that. Yeah.
Rasencio (37:53) Absolutely. So if it’s something that we manage on the data import template, there was, I believe somewhere close to a 1,000 line items of current enrollments that our team is following and managing when those get entered into the system. How do we then update? Once we get that approval? How do we update in that system? Hey, we’ve gotten the approval. This is the effective date. If we have an approval letter or email, which we typically always save that way in case our fabulous RCM team has to fight it in some way shape or form. We have a document that we can give to them that shows that proof of enrollment. Yeah.
Connor Morley (38:35) So within the payers tab, you can go to this add enrollment button, and then we can enter in that information and you can download the payor document, the effective revalidation date and all of the information by payor. Great.
Connor Morley (38:58) Yep. So you can essentially create a new payor enrollment right? From medallion. If needed. I will say as well. One thing I want to call out for payor enrollment and revalidations. Medallion does not automatically do revalidations because typically, we found that the commercial payors just pull whatever is on their caqh, and we don’t need to do make these requests and we don’t want to overcharge you for those requests. So if you do get a letter from a payer saying we could not complete this revalidation. You do also have the ability to do and request a revalidation on the payers module. Okay? Great.
Connor Morley (40:01) All right. If at any point while you’re in the system, you run into an issue. I do just want to call out. We have a support center right here and you do have the ability to kind of go to messages and submit new tickets, and then your tickets will be viewable… here within medallion. So we’ll keep track of your tickets right here and you can see updates for these tickets. Okay?
Connor Morley (40:42) Lastly, for some of the contracting team on the phone, you do also have access to the report builder. So if you want to run reports on providers or payer enrollment requests that are in progress or credentialing service requests, you can do that and pull in any of the information that is on those directory tables. If you’re looking for some like additional information either on credentialing or ongoing monitoring, payer enrollment. We also have a general analytics dashboard that will show you as well some additional information. So there’s a lot of things that you could look at here. We do have provider onboarding to look at how the providers are getting into the system. And if they’re logging in and filling out their forms that are needed, we have provider summaries as well to look at your provider information as a whole. All of this is able, you can kind of sort this. You can also export all this information into an excel if you’d like.
Rasencio (41:50) Hey, Connor, would you mind also showing our contracting ladies, the groups, how the groups are set up? I know that when it comes to contracting, you can see I’m making a little bit of headway completing these group profiles, but I know there’s a place in here where we can store documents. And I wanted to give the contracting ladies an option. I know they have their filing system on our M drive, but there is a place where we’re able to update group information, keep documents required for those groups. I know I’ve been putting in articles of organization and incorporation W9 cois for all the groups. Can you just do a rundown for the contracting ladies? But everybody on the call?
Alexandra Stankowitz (42:36) Yeah. Like if we have a contract, can we save the actual contract? Like the base agreement, amendments, updates?
Connor Morley (42:48) From.
Alexandra Stankowitz (42:49) providers, if they’re automatically terminating a network or automatically adding a network?
Connor Morley (42:58) You can definitely store group documents here on the group profile. For the out of network in network piece. I might need to ask where the best place to store that is. You can store documents here in the group profile. You can also store documents in the provider profile. But if you wanted to store documents in the group profile, we would go to groups. You would select the group that you’re interested in. And then there are documents that you can add here, and you can upload your documents by clicking on this button.
Alexandra Stankowitz (43:32) Oh, I love this. Yeah. So we can actually house our contracts in there along with the Coi that goes with it. The W9 medical… director information, tjcs in the case of Pennsylvania.
Rasencio (43:49) Our certificate… of occupancy, the clia, if you guys want to get in there for the groups, yeah.
Alexandra Stankowitz (43:57) I think, this is wow. This is going to, thanks for getting this for your team, Renee, but I think it’s going to work for us too. This way, it’ll be a nice clean place to have all of this like in one one stop shop to get everything that we need… instead of using. Obviously, we’ll still have to save things on the M drive however, but this is like a lot, it looks so much neater.
Connor Morley (44:28) Yeah. So, yeah, and you can store a lot of this information on the group profiles right here just in the documents section and it’s whatever.
Alexandra Stankowitz (44:41) You have saved, just click the upload document and name it whatever you want to name it and load it. Yep. Essentially, yeah, nice. No, this is great. Yeah, this is what I was wondering about Renee. So I’m glad I got this, to attend and see this… and.
Connor Morley (45:00) In addition to that, you would be able to look at your group enrollments as well by group here. It won’t be on the profile, but it’ll be in the payers information. You’ll be also able to see all the providers associated with that group and all the practices associated with that group.
Alexandra Stankowitz (45:15) That’s actually handy now for the payers… would locate, we could add like every payer that’s attacked that we’re contracted with for that specific entity, add all those documents and keep it in here. Wow, this is nice. Well.
Connor Morley (45:32) You don’t have to add any of the payers because we’re currently uploading all your existing, what we.
Niccole Russell (45:37) Gave you.
Connor Morley (45:37) And group enrollments, but if there are any additional documents for those payers, you can certainly add it to the group enrollment now.
Alexandra Stankowitz (45:45) I have a silly question. I don’t know if this, we do a lot of initiating… payer contracts where we’re not fully contracted yet, but we do keep like smart sheets and so forth to identify what we’re working on, where we’re at with progress and so forth. Do you guys have a place to have like pending a new contract or anything like that. I’m just asking. I don’t think you do, but just in case in.
Connor Morley (46:20) No, we don’t really, do. We don’t really do that? We don’t really get involved in contracting workflow?
Alexandra Stankowitz (46:29) Okay. So you just? Okay. So that’s fine. I was just kind of looking for a glimpse of hope. I didn’t think you did, but I thought I would ask, I,
Rasencio (46:38) will ask.
Alexandra Stankowitz (46:38) So, this is established though contracts that we’re gonna put here. I,
Rasencio (46:43) want to ask a follow up though. When we do get a new contract, how do we go ahead and notify medallion of that new payer contract? You?
Connor Morley (46:51) Would reach out to Nicole, your em, and she’ll meet with you once every two weeks, sometimes more, sometimes less, and then you would just kind of go ahead Nicole.
Niccole Russell (47:05) Yeah, I was just gonna.
Rasencio (47:06) Say, yeah.
Niccole Russell (47:07) Our things will be weekly for the first month, and then if you feel comfortable, we can move it to bi weekly, but anytime you have any updates, you would just email me or if we need a quick call or anything, if you need to explain anything to me, then, I can set up a quick call as well, but, I would give the information and take care of it on my side. Okay?
Alexandra Stankowitz (47:28) This is really good. Wow. I’m all happy now, it doesn’t take much.
Connor Morley (47:39) Okay. Is there… anything else you’d like me to show you on the group profile?
Rasencio (47:50) Not that I can think of no, okay.
Connor Morley (47:53) Yep. There is a section for group officials, external accounts… linking the practice locations. Oh.
Alexandra Stankowitz (48:04) I like this.
Connor Morley (48:05) Operational info. And then similarly, you will also have practice location information… where you can load business license or state registration, and then operational info, information as well. Can you?
Alexandra Stankowitz (48:23) Go back to that one screen where you had like the fictitious, I think it was. I think it was like fictitious name filing because I know we have a lot of that.
Rasencio (48:31) Oh, I think it was under the basic info.
Alexandra Stankowitz (48:33) Okay. I just want, was it in there?
Connor Morley (48:39) Sorry, what were you?
Rasencio (48:41) That dba name, are you looking?
Alexandra Stankowitz (48:43) At it? No, it was different. It’s the fictitious name filing… okay?
Alexandra Stankowitz (48:54) I don’t know, click on groups. Maybe it was groups… I don’t know.
Connor Morley (49:03) But yeah, we also have accreditation documents. Oh,
Alexandra Stankowitz (49:06) I love it P.
Connor Morley (49:07) Notices of approval, things like that, but I’ll go back to groups really quickly.
Alexandra Stankowitz (49:16) Fictitious, there we go. So that, okay? Or the dba is perfect. Yeah, yes, you were right. It was dba. I only caught half of that when I was reading it, but, okay. And then an internal group id is going to be whatever the payer signs us for a group id? Okay?
Rasencio (49:34) Beautiful. I think that internal group id, Alex is more like if we assign an internal group id.
Alexandra Stankowitz (49:40) Oh, okay. Yeah. I didn’t know if it was like what the payer assigned, you know, how we have like unitedhealthcare says you’ll use this group id when you’re searching or whatever that I don’t know, but, okay.
Rasencio (49:53) Yeah, I’m not sure. Connor and Nicole, that would be a great question for you guys if we have, I mean, obviously, our groups have ptans and medicaid ids but if we have specific like blue cross blue shield ids or the ids for those specific contracts, is there somewhere that’s housed?
Alexandra Stankowitz (50:13) Is that what that feels intended for? I?
Connor Morley (50:17) Have to double check if that’s what this is used for, but I mean, it is optional. I don’t think.
Rasencio (50:24) It is for that one just because it’s not linked to any specific payer. This is just showing generalized group information. This would go specific to each individual payer, if we were to have it.
Alexandra Stankowitz (50:35) So, are you?
Niccole Russell (50:35) Talking about just an individual pan for the enrollment? Yeah.
Rasencio (50:40) There we go. Provider id?
Alexandra Stankowitz (50:41) There we go. Provider id. Okay. Got it. Okay. So it’s just in a different place.
Niccole Russell (50:45) Okay. Yeah, it’s under the payer tab.
Alexandra Stankowitz (50:49) Okay. Yeah. Okay. This is great.
Rasencio (50:55) Alex is going to have fun digging around in this guys.
Alexandra Stankowitz (50:58) Yeah, I will.
Connor Morley (51:00) I do just want to call out. Auditors. Do not have the ability to change or update any information in medallion.
Alexandra Stankowitz (51:11) Can we upload documents?
Connor Morley (51:14) No. So then.
Rasencio (51:15) Maybe we change you guys to admins?
Alexandra Stankowitz (51:17) Okay. And then we take an oath and swear on the Bible that we don’t update provider information, which I wouldn’t plan on doing anyway.
Rasencio (51:28) That way you can get in and make updates because you guys manage a lot of that group information. And so if there’s changes to group information, licensing, stuff like that, they’re going to be the ones who manage that.
Alexandra Stankowitz (51:38) Yeah. And I don’t think Liz would like all the emails saying, hey, can you add this out there? Do that out there? I?
Connor Morley (51:45) Will say we do have audit logs. So, if… someone does update something, we would be able to tell.
Alexandra Stankowitz (51:55) You who, when and where?
Connor Morley (51:56) Yeah, nice somewhere?
Alexandra Stankowitz (51:59) In here, or do we have to ask you specifically to send it?
Connor Morley (52:04) The audit log, no, you can view the audit log for everyone who’s admin or auditors can view the audit log. It would just be looking at essentially actually… for the group profile, you might have to check in with us on that. But for the provider’s information, if you go to the provider profile and you click on the updated on button, you can see who updated, what when?
Alexandra Stankowitz (52:32) Oh, nice. That’s handy. Now, would we send, if we have a brand new contract we send you? We could just go out here and add it or we send it to you to add we.
Rasencio (52:47) Send that to Nicole, correct?
Alexandra Stankowitz (52:48) Okay. That’s right? Okay. Good, good. I’m swirling with information right now, would?
Connor Morley (52:56) You like me to change these user?
Alexandra Stankowitz (53:01) Roles, yes, please.
Connor Morley (53:03) Thanks, Renee. Okay. Yeah, that’s all set. Thanks.
Rasencio (53:10) Connor, yep, to.
Alexandra Stankowitz (53:12) Any one of my contracting people, if you go out there and update on providers, they can pull a report.
Rasencio (53:18) I’ll find you.
Alexandra Stankowitz (53:20) Yep. I was going to say, I’m going to come fight you. No, I’m not fighting with my senior. All right?
Connor Morley (53:33) Are there any other questions around medallion right now? Is there anything that I haven’t shown that you’d like to see? I don’t have?
Rasencio (53:45) Any, I don’t know if anybody else does. I have a feeling there will be a lot more once we get into the program and start working around in it.
Alexandra Stankowitz (53:56) Agreed. I don’t have anything either at the moment, but I am pleased to see what I’ve seen.
Connor Morley (54:04) All right. That’s pretty good feedback. Okay? We’re just about at time right now. We are recording this call… Renee. Do you mind if I just share the recording with you and then you can distribute it to the team.
Rasencio (54:22) Yeah, absolutely.
Connor Morley (54:24) Okay. All right. Well, if there are any other questions, just let me know Renee, we’ll well, we still have our weekly calls and I think we’re all set for today.
Rasencio (54:41) Yeah, sounds good. I will certainly forward along any questions that come through in the meantime. That way, when we have our calls, we’ve got our list, we can run through, okay?
Connor Morley (54:51) Sounds good awesome.
Rasencio (54:53) Thank you guys. So much. I appreciate it. You’re welcome. Thanks, everybody. And Nicole, I’ll go through this document that you sent me and I’ll make those updates and I’ll get it back to you as soon as possible. Wonderful.
Niccole Russell (55:06) Thank you. I don’t know if I sent my email, I had drafted one. I also sent one about the… availity access. So the team isn’t seeing that. I don’t know if you added an M to dot.
Rasencio (55:19) Com. I did see that come through. I didn’t add the M. I’ll go ahead and take a screenshot. I’ll log into availity. I’ll take a screenshot because I should be able to see the invite that I sent out and I’ll send it over to you that way. If we have two sets of eyes on it, maybe we can figure out what happened. Yeah, that’d.
Niccole Russell (55:35) be perfect. Thank you.
Rasencio (55:36) Yeah, absolutely all.
Niccole Russell (55:38) Right. Have a good day. Bye.
Alexandra Stankowitz (55:40) Everyone. Thank you so much. Bye, everyone. Bye.