Transcript
Kyle Rice (00:00) good morning. Hey, Shane. Good morning. How are you today? It’s great to meet you. Good. Nice to meet you as well. Are you based out of North Carolina as well?
Janet Harris (00:08) Yes, I am.
Kyle Rice (00:09) Oh, well, it’s great. I’m glad to have you on the team and it’s great to meet you. And hopefully I can, if you guys need anything from me, I’ll share my email after the call so I can help support you guys in any way. And then I think Janet’s popping on here too.
Janet Harris (00:22) Yep. I think she’s on here. Yep. I see Janet. Good morning, Janet. You got it. Good morning.
Kyle Rice (00:29) Good morning, Janet. Good morning. Happy Thursday. How are you doing this week water?
Janet Harris (00:33) Well, I’m doing well. I’m glad to hear that. So you met Cheyenne already? Just?
Kyle Rice (00:39) Met Cheyenne? Yes, understand. She’s based in North Carolina and helps supporting you guys, Cheyenne, just for my clarification, what is your role within the Cheyenne medical partners team?
Kyle Rice (00:48) I am a, credentialing specialist. Awesome. Well, it’s great to meet you and glad to have you. Nice to meet you as well. Great. Janet, I had a couple of updates for you. I updated the license renewal workflow document to add the frequency. The Dea workflow should have the frequency for notifications as well. And then I have a revalidation and re credentialing request process that I wanted to review for you guys today. Okay. Quick question, sure.
Janet Harris (01:20) On the Dea renewal process, what triggers that for the reminders?
Kyle Rice (01:27) 90 days out, as soon as the license expiration hits 90 days out from expiration, that should trigger the reminder.
Janet Harris (01:37) So, well, with the medical licenses, we have to put the auto renew on. We.
Kyle Rice (01:43) Don’t have to, we can opt in or opt out on that based on individual licenses. Like I know from like our previous conversations, I know North Carolina should probably be opted in. But if providers have any licenses outside of those like North Carolina, South Carolina that we’re not renewing, we can opt into them on a case by case basis for each license or we can choose to enable auto renewal for all provider licenses, which should pick up their license renewals within as soon as the board portal opens up the renewal window there.
Janet Harris (02:16) Okay. So that’s what triggers medallion to send out renewals for the medical license, correct? Right? Correct? Yes. So, what is the trigger to send out reminders for the Dea?
Kyle Rice (02:32) Within 90 days of expiration, the platform will start sending out expiration notices.
Janet Harris (02:38) So there’s no trigger for it.
Kyle Rice (02:40) There’s no trigger for it because we don’t support the Dea renewals due to the multi factor authentication? Okay?
Janet Harris (02:46) So, what if we decide since it’s really, we’re only sending renewals if we decided we were going to keep that in house, how would that work?
Kyle Rice (02:54) Just let me know your preference for the state licenses and we can opt in the auto renewal on a case by case basis or we can do it kind of across the board. It’s kind of up to you guys.
Janet Harris (03:05) Not the state license, the Dea. We.
Kyle Rice (03:08) Don’t yeah, we don’t renew the Dea licenses. Okay?
Janet Harris (03:12) Let me wait. Give me one second. Let me give you the whole question. Sure. Original question. Dea, what triggers the renewal notices? What, how does medallion know to send out Dea reminder notices? Is it only the expiration date or?
Kyle Rice (03:34) So, it’s the expiration date at 90 days out that’s what triggers the expiration? Notice? Okay. My apologies. I did not understand it completely.
Janet Harris (03:43) That’s okay. So we can shut that off if we needed to.
Kyle Rice (03:48) For the deas, I can check on that, but I do not believe so. But the proprietors, once they log in, they can opt out to these renewal notifications as well.
Janet Harris (04:00) Okay. So they can opt out. The providers aren’t going to do that. Remember, we’re the concierge service. So we would have to do it. So we would have to go to each one and opt out of Dea renewals. Is that what? Yeah.
Kyle Rice (04:17) So it’s essentially all. Yeah. So it’s either all renewal notifications or no renewal notifications. I don’t believe there’s a way to single handedly trigger those by either state license or Dea.
Janet Harris (04:31) Okay. Thank you. Yeah, no problem.
Kyle Rice (04:38) And then, I know I’m tracking the email address update for the provider experience video for the slide at the end to add my email, your email and Cheyenne’s email. I just wanted to check in to see if there’s any additional feedback or any additional edits that we are needing for that from either Mary or for yourself?
Janet Harris (04:55) I did remind Mary yesterday, she’s going to get that to you.
Kyle Rice (05:01) I think.
Janet Harris (05:02) She expected yesterday, but it’s been busy. It’s been very busy listen Kyle, when and life happens. I know things happen if we are rescheduling our meeting especially at the last minute, just in respect for everybody’s time. If you can’t do the time that I’m giving you. If we cannot just send out a notification with a time and then say, hey, can we do it if we need to wait to the next week? But if we’re waiting for things and I understand that you’re waiting for somebody else to give you something, if we can know about that a little bit ahead of time or just make the meeting for the next week, if you can’t accommodate.
Janet Harris (05:49) I mean, I understand you have other meetings, but if you’re canceling, if you would adjust your schedule to meet our needs, because now there’s two of us trying to adjust our schedule, so that would be… helpful sure.
Kyle Rice (06:05) Yeah, absolutely. We can do that moving forward. So. Okay.
Janet Harris (06:10) All right. I’m sorry to keep interrupting you, no.
Kyle Rice (06:13) It’s all good. I just clearly understand where you’re coming from here. So totally get it. And then I had the revalidation and credentialing request process that I wanted to review with you guys as well. I know we were, I know you asked for like kind of the workflow for that. So I just wanted to share that and I’ll send this over after the call as well, but just wanted to quickly review this with you guys. So this is the revalidation and let me know if you can see my screen. Okay? If it’s too big or too small. Nope. I can see it. Okay. So this is the revalidation and recredentialing request process. So you can request revalidation or recredentialing enrollments for both your groups and providers to continue network participation within different insurance plans. Just the revalidation request process. All payer lines will go through the intake process. Once complete, the file status will be updated to intake complete, indicating the file is ready to be worked by our payer enrollment team. After it moves to intake, completed, the file will be signed to a specialist within 24 hours of changing the status, and the status will be changed to assigned. And within the platform, during this process, the specialist will review the revalidation and recredentialing notice provided by the client. In the edit request dialog. There’s three vertical dots on the right of enrollment line in which we will change the due date, including the direct contact indicated at the next steps. If all steps are present on the notice, we’ll proceed to the next step within the process. If we did not get a notification from you guys, we will verify that the recredentialing and revalidation is due by contacting the payer via phone and verify the date of recredentialing. If the recredentialing is not due, they will verify the document and correct date if given on the existing enrollment. And then they will change the request to stopped. If it’s not current. We’ll verify all locations in medallion. If the payer revalidates credentials based on location. If there are missing locations, we’ll ask the payer if the location was associated with the tax id, if so, was it termed or deactivated? And we’ll give some additional information and the status on that. After that, we’ll access the provider group portal if applicable and verify that the recredentialing is due. They will verify the request notes and edit the dialogue. And then we’ll contact the payer via email if no method exists for recredentialing. And revalidation if it’s due, and then the team will move the status to sent requested within the platform. The team member doing the discovery will follow up five business days for a response. And then if it is not due, they will change it to the request stopped. Or if the revalidation date cannot be verified, we will document that the revalidation date should due date could not be verified, and we’ll proceed with submitting the revalidation with the credentialing within the payer. The third, excuse me, go ahead quick.
Janet Harris (09:26) Question there. If we can’t verify… the revalidation date… do we get notified? Just try and get notified of that?
Kyle Rice (09:39) Yes, they will yeah via the notes section. You guys will get notified via that. Okay. So within our payer directory, we’ll fill out the appropriate request type, application type, and service type. We will review the application method, application instructions and required documents within the additional notes. If caqh is required, we’ll review the provider caqh profile using the login and external accounts. We’ll update or correct any missing information per our caqh management. If caqh is the only requirement, we will gather all documents and credentials. We’ll populate, complete, and enter the appropriate application once the application is populated and all required documents have been gathered.
Janet Harris (10:25) Can I interject right here? Kyle, oftentimes, we will get letters medcas in particular for letting us know that the revalidation period has started. How do we communicate that with you to medallion on the platform?
Kyle Rice (10:43) So you can add that into the revalidation request. There should be a dropdown and a PDF section for notes. If you guys happen to receive any notices from the payer, Janet, if you happen to have any problem with that, you can also send that to me and I can attach that to the line for the team as well.
Janet Harris (11:01) Okay. Where would that be? I’m sorry.
Kyle Rice (11:03) So, that would be, hang on. Let me just stop sharing for one second. So I can pull a platform and show you.
Kyle Rice (11:29) So if you’re within the payer section of platform when you go to request, and if you do request revalidation, it’ll say who’s working on the request medallion is request validation type, either if it’s for a provider or for a group, just select either the applicable provider or group impacted as well as the enrollment. We’ll just use unitedhealthcare. If you received a notice about your revalidation, just click yes, and then it’ll populate a section to upload the attachment there. And then if you need to add any applicable notes to that as well, that will get attached to the team as well just for their awareness and tracking.
Janet Harris (12:11) Okay, perfect. Thank you.
Kyle Rice (12:14) Yeah, no problem. Okay. So once the application is populated and all the requirements have been gathered, the specialist will remove the enrollment request to application. QC required. A copy of the screenshots and application and documents will be uploaded to the medallion task that has generated, moving the application forward. So you’ll have visibility into this as well. Once QC is approved, we’ll submit to the appropriate payer and move the enrollment request to application submitted. If the application is submitted via portal, the team will upload screenshots or a copy of the application and all documentation and a copy of the confirmation to the enrollment notes. If any documents are expired or will be expired prior to the reval recred due date, the team will assist with making any caqh updates. This one’s not applicable here since we’re not since you guys are enabled with caqh management. And then the enrollment request will be assigned to the designated coordinator for follow up with the appropriate cadence. If the application is submitted via email, fax, or email, the team will do will emulate the same steps where they’ll upload a copy of the application and all documentation and confirmation of email into the enrollment notes. The follow up date will be set one week out from the date of submission to follow up with the payer, to confirm receipt of the application for providers for commercial medicare advantage, or managed medicaid and exchange marketplace. If the recredentialing requirement is up to date, caqh, we will submit the applicable caqh updates or any corrections needed to their profile, depending on the payer, follow ups will be conducted every 10 to 20 business days via phone portal, or email. Follow up agents will use our payer guide or your project plan to determine the follow up method, the data points to follow up. They’ll check if the revalidation is complete, what the next revalidation due date? If they provide it, if the result recovers additional information requests from the payer, our agents will respond to the payer with the requested information, or they will refer to the pser back to the submitted application specials for more complex and additional requirements from the payer.
Janet Harris (14:39) The revalidations… or re credentialing that medallion initiates. They’ll put notes in that same place that you showed me for us, those their notes will be there, progress, that kind of thing. Okay? Is.
Kyle Rice (14:57) it possible progress? Go ahead. Sorry. Okay. No. I’m sorry. Is it?
Janet Harris (15:04) Possible to run a report when we have several people out or something that we can trigger. I mean, obviously, you don’t want to send a report that says nothing for three or for nine months and then the three months. So, is there a way for us to, and is that appropriate for the apk key that you were talking about or that’s strictly for something else? So.
Kyle Rice (15:31) That, that the API key is a little bit separate. We are able to run a report for all revalidation requests and process. So, yeah, what that will do is that’ll pull the provider, name the specific payer, all the applicable dates and then it will pull in the last note from our team on there. So whether they’re following up on the submitted application, whether it is an intake, you know, basically give you a status within the current notes section, and we are able to pull additional reporting on that for you. So.
Janet Harris (16:00) What would you recommend the frequency of that report? Because I know that they open up like three months before. So it may not be an empty report. What do your other clients do as far as frequency… let.
Kyle Rice (16:13) Me check in with Leigh on that just to see what she has been doing in terms of reporting. I would maybe recommend it to run every two weeks or so just in terms. So the team has sufficient enough time to follow up because they will be usually following up. I believe it’s at a five business day cadence. So it should indicate some additional movement there, kind of give you a good status. So I would definitely recommend two weeks, but I’m happy to confirm that with Leigh as well.
Janet Harris (16:37) Okay.
Kyle Rice (16:39) All right. Perfect. So the team will repeat their follow ups until we receive receipt of approval from the payer, the follow up agent, or our team will receive the information, will close the line. They will complete the line modal and approve that. And then you’ll receive notification and platform. So that’s kind of our workflow here in totality for the revalidations and I’ll send this for you guys to review as well. Okay? And.
Janet Harris (17:08) In the case, and I know that’s a general form or workflow if you need something for the provider, I know that you guys aren’t quite used to our concierge approach. If we can just note somewhere as far as our workflow that would come to Cheyenne or I versus the provider?
Kyle Rice (17:30) That’s not in the task exactly. Yeah.
Janet Harris (17:32) Would it be helpful for, in their contact information to put our actually, no, I’m not volunteering that nevermind. Excuse me. Okay?
Kyle Rice (17:45) No problem. But.
Janet Harris (17:47) If there’s a way that makes it easier because I know that it’s out of the norm, let us know so that we can make sure that we do that. I’ll say that.
Kyle Rice (17:56) Okay, perfect. Yeah, we can do that. So, I know we talked revalidation, we talked Dea. I edited the state license renewal workflows as well. So this gives you, I know you’re asking for the notifications. So I outlined that here in section one. So you guys will receive these notifications up to 90 days prior to license expiration reminder notifications are sent every five business days until the license is renewed. And then you can also opt out via email platform and email preferences, and I’ll send this to you guys as well. And then I believe the Dea workflow does have the notifications and tracking in here as well. So you guys should receive them 90 days in advance weekly reminders on Monday. And then again, we can opt out of those just depending on preferences moving forward. Okay. Janet, what other items do you have for me this morning?
Janet Harris (18:53) One of the things we were going through on the platform and adding payr ids to each of the providers clinicians, I got to stop saying providers because I’m making that bad habit. I.
Kyle Rice (19:06) Do the same thing. So I get you.
Janet Harris (19:09) I’m sure you have clients that want the reverse. So it’s probably much harder for you. Can you pull up Mary doerr? Yes.
Janet Harris (19:30) And if you wouldn’t mind, can you go into her existing payr’s.
Janet Harris (19:41) and met cost… if you can go into, yeah, for medcost… actually right into as if you’re going to add an id number for her. And so I went to add her id number and it’s C as in cat three five zero seven. And it would not allow me to add it. Let me.
Kyle Rice (20:11) see if I can add it from my end. So just we’ll just confirm C as in cat three five zero seven, correct?
Kyle Rice (20:21) Looks like we need a document to upload. We don’t have something like that, let.
Janet Harris (20:26) me.
Kyle Rice (20:27) see.
Janet Harris (20:30) looks like that. It did not allow me. It told me that it was an invalid number hold down one second and it was weird because I have other doctors but they were loaded during the implementation. I didn’t load them personally, but it would not allow me to add her number. And maybe I did something wrong. I mean that’s never… there’s. Always an option I should say. So I’m going to just delete it. And, okay, I was.
Kyle Rice (21:07) going to say if you happen to have a screenshot of that or if that runs out again, Janet, let me know and I can have our tech support team take a look at that.
Janet Harris (21:15) Okay. Give me one second. I’m trying to create that and I thought it was the C that was doing it.
Janet Harris (21:35) No. Now it’s let me do it. That about drove me. Okay? So we can mark that off. Erica, Peter, fai, is there a way if you can see if someone’s working on something for her? And while we’re looking and I can wait if you want me to… Erica is an acp that actually bills under the physician. She does not bill anything of her own under herself. We do keep all her license and ids updated. Obviously because she still needs to be… active and keep things up to date to, yeah, I don’t have that in order for, you know, her to be in good standing. So in my record, she’s up to date. I have not apparently updated her in medallion, but my question is I got a random request from unitedhealthcare trying to enroll her. And so I saw that you guys don’t have anything. So that means you didn’t initiate that. Okay?
Kyle Rice (22:50) No, I’m just checking right now just to double confirm. It does not look like we have any enrollment requests for her or active requests for her at the moment. So I wonder if she maybe is completing that outside of tmp. Interesting. Yeah. But we’re not submitting anything for her at this time for any payor requests.
Janet Harris (23:12) Okay. Then I’ll update her profile.
Janet Harris (23:19) Let’s see if we can add to our standard agenda… just to review any platform updates. Excuse me, platform updates and anything that’s coming up just so that we keep a good handle on changes that may happen. I, when I logged on this morning, I see that the email address for medallion support is changing, yes?
Kyle Rice (23:53) I was going to cover that with you as well. Just one change there. It was updated from support at medallion co, to help at medallionco. And I believe that is going live as of April fifteenth. So if you need any additional like support help or anything like that, just feel free to utilize that address. And then as always, you can loop me into any issues or concerns or any process updates as well. And.
Janet Harris (24:20) when you say support, are you talking issues that were at like the thing with I was having with Mary doerr’s account, something like that? Yes. Okay. Yeah. So more issues, working issues. Yeah?
Kyle Rice (24:36) Yeah. So if you use the, and the, I believe it’s the support center here. This has the live chat. This is the fastest way to get in touch. So if you click ask a question here, it’s just gonna, it’s gonna do a quick AI triage just to make sure it gets you to the correct person within our support team. If you click or type talk to human… about like let’s do Mary doerr add payer id, it’s gonna spit out some information from our AI agent, but it will put you in touch with one of our support team as well. Okay. So just in case I’m out of office or if you need like any additional support, I believe they are working, I believe eight to four PST. So I believe they’re operating until seven Eastern Standard Time.
Janet Harris (25:30) Okay. That could prove valuable when we do get the demo out and the providers, if they run into issues… we’ll be able to disseminate those pretty quickly. Myla Chung is… intake or enrollment working on her second location.
Kyle Rice (25:51) We are working on her.
Kyle Rice (26:00) For medicaid? No Tryon?
Janet Harris (26:05) Has medicaid and medicare. It’s the payers that you guys enrolled her for… second location was added a week after the request, the enrollment request was sent, but she was approved but only for one location. So let me.
Kyle Rice (26:33) Follow up with the payer specialist on that. I know they were working on closing out her line and then I can check in with, the second location as well to get you.
Janet Harris (26:41) Some information there’s money attached to that. Kyle. So if those locations aren’t added, we can’t get paid for that. So we’re seeing patients kind of for free. So if they can do that sooner than later, that would be very helpful because that there’s money tied to that.
Kyle Rice (27:01) Absolutely. The reimbursements and pending claims and whatnot. So, yeah, I will ask our team as soon as we hop off here and then I can provide an update as soon as we get some feedback on that.
Janet Harris (27:11) We would like it back to her original approval date, which is 12 eight.
Kyle Rice (27:19) Back date to 12 eight, correct?
Kyle Rice (27:26) Let’s see 12 eight, 20 25. That seems like it was years ago, ah, just without how the, how 20 26 has been going?
Janet Harris (27:37) You’re not kidding on that one. Alright?
Kyle Rice (27:40) I will pause on that. And then, I know we’re just about at time. Anything else top of mind in terms of the opentracker or anything else I can help assist with for today?
Janet Harris (27:51) Nothing that needs to be done. I can table this for next week, Cheyenne. Do you have any comments or concerns or any questions with the platform?
Cheyanne Soltau (27:59) No, not as of yet. I know once I get a deep dive into it, I may have some, but not at this moment. Thank you. Yeah.
Kyle Rice (28:07) Cheyenne, I was going to mention as well since you are relatively new. I don’t know if you have any previous experience with the medallion platform, if it’s helpful. I’m happy to set up some additional time to kind of run you through a quick training session on kind of what each section of the platform entails. We can do a quick one on one if you want to. And then I can kind of show you the functionality, how to search through and just give you some additional insight into how our system works.
Cheyanne Soltau (28:33) Okay. Absolutely. That works perfect.
Kyle Rice (28:35) Do you have a time? Maybe maybe Monday or Tuesday next week? What works best for you?
Cheyanne Soltau (28:43) Yeah, Tuesday should be fine. I’m just seeing, I know we have the Tuesday meeting on for 11. Yeah. Maybe like I guess before that or after that would work, would.
Kyle Rice (29:00) You be able to do, I can do directly after I can just extend our call a little bit or if you want to do after 12, I have pretty wide open availability that day. So whatever works best for you. I’m happy to schedule there.
Cheyanne Soltau (29:13) Okay. Would you like to do 12 30 to one?
Kyle Rice (29:17) Sure. Yeah, that works. Okay. Sure. I will send out an invite for you after we hop off for today’s, call.
Cheyanne Soltau (29:24) Sounds good. Thank you so much.
Kyle Rice (29:25) Yeah, no problem. Perfect. Well, thanks so much for your time today, Janet and, Cheyenne, it was great to meet you. I’ll get you scheduled for some additional like walkthrough for next week and then I will get you guys confirmation on Myla Chong’s second location here. And if there’s anything else in the meantime, just let me know.
Cheyanne Soltau (29:44) Perfect. Thank you. If you just.
Janet Harris (29:45) Check the task list. I know that we have a few things out from there, so you can check that and just give an update next meeting for sure. Absolutely. Sounds good. Thank you, Kyle. Thanks.
Kyle Rice (29:58) Guys. Have a happy Thursday. Take care. All.
Cheyanne Soltau (30:00) Right, you as well. Bye.