Transcript
Max McGlothin (00:00) hey, Dreama.
Dreama Hembree (00:01) How are you? Good? How are you? Good, good. How’s your week going?
Max McGlothin (00:08) So far? So good. Yeah, not too bad. How are y’all doing out there?
Dreama Hembree (00:14) Not too bad. It’s busy, but that’s a good problem to have, right?
Max McGlothin (00:19) Right. Exactly.
Jack Schell (00:21) Is anybody?
Dreama Hembree (00:23) Else joining today?
Max McGlothin (00:24) I don’t believe so. I think it’s.
Dreama Hembree (00:26) just gonna be me. Okay? I don’t have a ton to go over. I have a couple things… I did outreach to ultimate to Rachel the office manager about the medicare surrogacy, and then she had asked to put that medicaid line on hold. I sent her a bunch of instructions on how to link the group, ao all of that. She just basically wrote back and said, could we please keep the medicare and medicaid lines on hold? But proceed with the rest of the enrollments… and I want to make sure that she understands that the managed plans are dependent on those enrollments, right? So we can’t move forward with any of those managed plans. I don’t know if she’s going to do the medicare and medicaid on her own. I don’t know what her plan is. I didn’t ask her, but I’m happy to go back and explain that. I don’t know that she does know that or doesn’t know that, but I just wanted to bring it to your attention that she seemed okay with that plan, but I want to make sure she understands that if she is processing those on her own, that, you know, there’s a spot in the platform to load those enrollments that are already approved or completed. So we know that we can move forward with the managed plans. Okay? Hey, I see. Jack joined. Bye, Jack.
Dreama Hembree (02:07) No, you’re not muted. It doesn’t show you’re muted. Can you hear us? I?
Jack Schell (02:13) Can hear you now. For some reason, it was connecting to my airpods which were in their case. So I don’t know. Sorry to be a surprise guest today. Oh.
Dreama Hembree (02:25) No, no worries.
Jack Schell (02:28) I actually, I just wanted to pop in. Do you mind if I just take a second?
Dreama Hembree (02:31) No, no. Go ahead. Yeah.
Jack Schell (02:32) Yeah, max, I just wanted to pop in real quick. I know that was it last week or two weeks ago. I provided Dreama with some consumption reporting detail that I know she shared with you. I hope that was helpful. I have some additional internal support and updates with regard to reporting for structures like veridigm which I’m excited about but I did just want to get face to face with you because I did just send out an invite to both you and matt or sorry you and Ian for quarterly business reviews. I reached out to him because typically I meet with executives and our client organizations on a monthly basis. So I was working to set that up with him. We’re going to move forward with quarterly. And he did say, of course, we want to include you as well. So I just wanted to acknowledge that because I literally just sent out an invite and saw that this meeting was happening and didn’t want there to be any confusion and wanted to make sure everything was all right.
Max McGlothin (03:27) Yeah, yeah. No. I saw those anticipated them. I think that’ll be a good insight.
Jack Schell (03:35) Great. Awesome. While I’m here before I hop anything that you’d like to bring to my attention or that I can work on for you in the background as I prepare for that meeting in two weeks.
Max McGlothin (03:49) You can also.
Jack Schell (03:49) Feel free to get back to me because I know it’s just got organized.
Max McGlothin (03:53) Yeah, yeah. I’ll get back with you on anything specific. I think just getting some of those updates on reporting structures would be beneficial for sure. And then I had noticed, I didn’t know if this was going to be for you or Dreama, but I know the support email is changing, yes, but, you know, we have a lot of automation with that. So I’m hoping that I can get ahead of that piece before the changeover happens. But Dreama, I also knew we had, we have an individual support email as well that’s dedicated to veridigm. So I didn’t know if that was going to be updated or not too, or if that one was still going to work. I.
Dreama Hembree (04:43) Don’t think that one’s changing, but I will definitely verify with the team on that one. Yeah, I think it’s just the general support one, but, let me take that as a takeaway. Okay?
Jack Schell (04:55) Yeah, I doubt that. I doubt that your dedicated inbox would be impacted by this change. This is just, a general support channel change. Also just to reiterate, you do have two weeks, so till April the fifteenth to kind of make the changes necessary. So if you want to mark that deadline in terms of when our email, when we will be sunsetting the other email, please feel free. But you can start using the help, the new email as of today?
Max McGlothin (05:27) Okay. Sounds good.
Jack Schell (05:30) Yeah. So for your purposes and automations internally again, April is the drop dead date to remove the old email. And then, yeah, Dreama, as Dreama said, like we can just doubly confirm that your dedicated email won’t be impacted by this.
Dreama Hembree (05:47) Okay, good. Thank you. Yeah.
Jack Schell (05:50) All right. I’m gonna hop and let you guys get back to it. Thanks for letting me steal a couple minutes. I just wanted to touch base and hopefully everything’s going smoothly if anything comes up for me. Max certainly feel free to let me know. Okay. Sounds good. All right. Have a great end of your week, max. Have a great weekend. Talk to you in a bit. Dreama. Bye. Okay.
Dreama Hembree (06:11) Bye. Okay. So ultimate, so do you want me to just outreach Nick on that stuff? Or I know he’s more, you know, client forward facing than you are with like meeting with them and stuff. So I just wanted to, yeah.
Max McGlothin (06:30) Yeah. Any specific updates on that can go? You can just respond back to. I want to say, was it Nick that sent the original or was it me? Oh, there’s a, there was.
Dreama Hembree (06:45) Several, there was several back and forth. I think one of them came from mentu. One came from Nick. Yeah. So there was.
Max McGlothin (06:51) Several. Yeah. And I would just, yeah, I would just send an email to Nick and mentu as well, just outlining that indication because both of them are meeting with the client as well. Okay?
Dreama Hembree (07:05) And then I’ll include this next bullet point also to them separately neighborhood instance, she seems to be struggling a lot. There are a ton of tasks in there. She’s not adding provider lines. When she’s requesting like a group enrollment. She’s just doing the group. She’s not attaching provider. So then that’s causing delays. Obviously, she entered in the wrong tin in the beginning. So the medicare surrogacy went to someone else. So, I think she’s just confused altogether on like how to proceed. I know that there was a billing related question from mentu earlier in the week regarding her. So again, I just kind of wanted to bring it up and make it known that I will relay all this back to Nick. Okay? And I’ll try to outreach her to like help as much as I can. But she does seem very confused overall. And then obviously, that’s holding up her enrollment. So, yeah, other than, that is all I had on my agenda to talk about. Do you have anything specific for me?
Max McGlothin (08:16) Yeah. Let me see if wait just got back to you real quick.
Max McGlothin (08:27) So, we did have… was it clearfield? I think re, escalated again, it clearfield professional just said something recently to us regarding provider attestation and authorization agreements. Yes. I don’t know if you’ve had another opportunity to meet with them. I know there was, again, they complained about doing it in the platform. We told them like, hey, you have to do it in the platform. There is no other option to do it. You have to be the one to do it or the providers have to be the one to do it. So I didn’t know if you had any additional insights into that, but I just wanted to bring that one up again in case you guys do get some notice. And then we had, oh, one of the questions that did pop up this week, is there still a backlog of instance build out? I?
Dreama Hembree (09:34) Believe that. I have a handful of them still to recreate, and I have that on my list to finish out today and tomorrow. So I can send you that list. They come, you know, via those tickets. So they go into a different platform. So I’ll pull that and let you know where I’m at on that. I think I was up to date on the deactivations outside of, I can’t remember the name of the one it’s like pain and spine or something like that. That was a four one deactivation. And I have that to do today. So… okay. And then I’m pulling just reconfirming that I’m revoking the API keys on those. Yep. Okay. Got it. Yep. Yeah.
Max McGlothin (10:19) After deactivation.
Dreama Hembree (10:20) After deactivation. Yeah, not before.
Max McGlothin (10:22) Yeah, because we’re not, yeah, because we’re not going to be following up with those, with that same process we have not been leveraging. Actually, there was a question for the API keys. We were receiving them. I think it was… oh, I want to say it was on a weekly basis. And then all of a sudden, we had a delay and then it over like a month and a half period and then got them back on March first. I want to make sure that we’re receiving those apis. The request was at least once a week, if possible. Okay.
Dreama Hembree (11:08) And just so I know because I came in kind of, you know, midstream on this, I’m creating those API keys, I put them on a spreadsheet. I put, I think it’s James, is his name, James on there as the contact for that. So, let me check with our technical team and find out, how are you receiving? Are those coming over via email? Is that how you’re getting them? Max? Or how you’re getting them?
Max McGlothin (11:35) I don’t man, I don’t remember now, either, I think we’re getting them through an sftp.
Dreama Hembree (11:40) Okay. Let me check with Jim. He’s our technical solution Guy, and I work with him on the background and all of that stuff. So, let me find out how those are being sent to you, let him know that, you know, there was a disruption, and kind of find out why, and that you want those weekly. So I’ll get with him on that and take that as a takeaway. Okay.
Max McGlothin (12:03) Additionally, with those apis, we are in the process now of mapping. This has been a very long process, but we are now trying to map the medallion payers with our clearinghouse payers. That is a, so that we can start track. Like what basically, the goal here is once a credentialing application is approved, it gets built into our internal tracking system for our enrollments, our Edi enrollments team to begin… doing Edi enroll, you know, our Edi and era enrollments for those payers. What I’m running into is, you know, potentially identifying what payers some of these… medallion payers are actually linked to as.
Dreama Hembree (12:59) Far as they like in terms of the names and like mapping them back to.
Max McGlothin (13:03) Yeah. So I don’t know if there’s like what, we pulled it from the API. I don’t know if you have additional, you know… triggers… or… like data points that are tied to these payers. I know you have your, we have the payer name and the medallion payer id, which is like a guid number. I don’t know if there’s anything else like if you guys have address or something else that we can tie this to. That might help because I do have a lot of gaps. Like I don’t know what your guid number is, but one of them is like, ma, blue cross blue shield, and then we have, a medallion payer id number, but I don’t know, what that links to. There’s no other identifying information. And then at the same time, we have like one that’s listed as like ma, medicare part B, but there’s like seven of them. And so I don’t know it’s hard for me to determine which payers you guys are actually talking about with those. And so I just any other type of, like data point that I can utilize identifying?
Dreama Hembree (14:20) Information, yeah.
Max McGlothin (14:21) Other than just the name or your specific payer id that?
Dreama Hembree (14:25) So, that’s why we moved to those standardized naming for the payers because before it was kind of for lack of a better term, a free for all where, you know, the client would put in a payer name and then we would try to map it to what was in our database or we were getting, you know, non standard payer names in there. So we went through and standardized the list to where it’s not like a free form where you can just type in, you know, like it, you have to match it in the platform to what we have. So I think probably some of those instances were created prior to that occurring. So there’s some fuzzy matches there. But let me see what I can figure out with the technical team in terms of helping you identify, you know, what’s in our system versus what you have, you know. So there’s a direct correlation.
Max McGlothin (15:16) Okay. Yeah, sounds good. And I mean, at the same time, I can always send over… a list of our payers. But again, I mean kind of from our end, we use tisbid numbers. So tspid, numbers… from payrpath. So I don’t know if you guys align or have ever aligned with payrpath payers, but that’s what I’m essentially trying to align to.
Dreama Hembree (15:44) Okay. Let me ask Jim because he’s my technical Guy in the background on this. So I’ll start with him and then I’ll kind of go from there to see what I can help track down for you.
Max McGlothin (15:54) Okay. Sounds good. All.
Dreama Hembree (15:56) Right. Anything else?
Max McGlothin (15:59) I don’t have anything… specific. One of the areas that I am looking at though is our… active, our turnaround times.
Max McGlothin (16:16) I am noticing an increase in days right now. Our average open turnaround times are sitting at 89 days. That has been driven up recently. Just trying to make sure that medallion is because right now, what I am showing is we have 902 active open enrollments whether that be at the… client side or the medallion side, there are 260 pending client or this was, as of Monday, there are 260 pending client tasks, but we have a significant number of active open enrollments that are just creeping up and creeping up and creeping up. My question is when I pulled the enrollments report, there were a, I don’t want to say a significant number, but there was a high number of enrollments that are even over 120 days. There was 57 of them. Some of these being as far back as 260 days. Some of the stuff is sitting in follow up progress. You know, a couple of them are pending customer responses. I understand those. But some of these like they’ll say pending customers. Oh, here, let me just share my screen. So you can see what I’m seeing… just so you have a… pick the right screen, share. All right. So, like for example, this is just the enrollment request report. The American house call is, you know, one of the more, I guess bigger clients but you’ll see what I’m showing? I see like pending customer response. But the last note date is since January… fifth and it says as per the client, they have not signed the contract yet. So, I’ve replied to the task and should listen to complete the task once the contract is signed. But that was again almost three months ago. I don’t know where we necessarily stand. And then these here where it says the panel remains closed. Yeah, these just show on hold. Like I’m getting a little bit lost on the there’s so many statuses now, wouldn’t this one on hold? Shouldn’t this be panel closed? I guess I’m because what I do is I filter out any of the active, any of the enrollment, denied enrollment, stopped and panel closed ones. And then pending dependencies. I pull all those out and then just filter those. Right now. I’m showing with client profile completions of 100 percent. I’m showing 633 open. But again, these are all, it’s all mixed up like I can’t I just, I can’t figure out where like some of them. I can obviously like follow up in progress. I’m seeing a lot of these but it shows like follow ups in progress. But these are 239, 237 days old. I understand without going like back and reviewing each individual line and seeing if they were reprocessed or anything like that. But this number right here is, it’s a bit troubling when this is all I have to go off of, right? I see these. So what my question, is number one, we have a lot of open active open enrollments, is medallion staffing based on our scale and our scaling up. And at this point in time, do we have dedicated individual dedicated enrollment individuals just working veridigm, or are we more of a shared platform at this point? No?
Dreama Hembree (20:26) We have a dedicated, I have a dedicated team lead and a specialist just for veridigm, that I outreach on all things. Veridigm. So we do have a dedicated team for that. What I will do is pull these over one, especially the over one, 20 days and send them to that team and let them know that we need to look at these and really dig in on them. The one thing that I don’t know is the outstanding tasks, what the cadence is in terms of, you know, continuing to outreach the client on those because they obviously do put things on hold pending, you know, additional information. So let me see if I can target those as well, those older tasks. So maybe we can identify those and, you know, get those over to Nick and say, look here’s, the ones that are really holding up, you know, progress. Maybe the client doesn’t know. And then one of the things that’s super important when he is communicating to the client about tasks is they have to close that task out once they’ve updated it. Otherwise, we won’t know it’ll just set out there. Like if they just go in and put a note and they don’t close it, we won’t get that notification until somebody goes back in there to look at it, you know? So. Yeah.
Max McGlothin (21:54) Even if.
Dreama Hembree (21:56) they close it out and the specialist needs to reopen it. They will, so don’t hesitate to close it if you’re responding back because if they need to reopen it, they will. Okay. Other than that, like, yeah, I would definitely get this to the team and let them know, you know, these really need to be focused on, we need to target these and I’ll push them on that. So, and then I’ll get in there and see if I can poke around and especially on the American house call the one, you know, some of those larger instances and see if I can help facilitate some of that. Okay?
Max McGlothin (22:36) Yeah. And like I said, these are just some of the we’re all still within what I would consider our slas, yeah, you know, our… what I’m tracking right now is, you know, kind of as much as I can from a aggregated standpoint. But again, like I’m the way I’m filtering a lot of this stuff, I show 902 active open enrollments. Average turnaround time, of those active enrollments right now, is sitting at 89 days. So we’re kind of right at that 90 day mark, but we have anything open over 90 days, is 17 percent. I’m trying to keep that number under 20 percent. So basically anything over 90 between that 90 and 120 days is kind of when things, are supposed to be approved. But like I’m tracking this weekly on our weekly completions, our completions over 90. That was at 14 percent. But these weekly completions also include what I would believe are ones that are being added in that are already active credentialing enrollments from, you know, maybe not medallion… because, those are populating on, these reports as well. The payers that, you know, the providers are already credentialed with that they’re inputting. And so, like right? Like last week, our average turnaround time was 67 days. This is, this is just continuously driving up. So like the week before it was 60 days, it’s continuously driving up by about four. This one was seven days, but by about four days per week. Over the course of the last eight weeks, it’s driven up about four days per week, which tells me that we’re not completing enrollments and that’s what’s driving this turnaround time up?
Dreama Hembree (24:28) Yeah, they’re aging out to different buckets. Yeah.
Max McGlothin (24:31) Yeah. So I just want to make sure that that’s a call out like, hey, that we, I am seeing this starting to rise. It’s starting to get to a point where… I don’t necessarily know if we’re maintaining volume or if we’re staffing correctly at this point, for the volume that’s coming in. Again, the goal is, you know, to continuously scale and build. I think we’re adding, you know, for every, you know, client that we terminate at this point, I think we’re adding like four. So it’s just going to continuously scale up and build. So.
Dreama Hembree (25:06) Yeah, I did convey that to Jack just to let him know that, you know, you would indicated that, you know, the plan is to keep growing and adding additional instances.
Dreama Hembree (25:15) And from, a staffing standpoint, you know, with the PE team, that is not a concern. We have a very large PE team and we’re constantly adding to it. So as well as, you know, layering in more rigorous and pre app, post app quality reviews daily, you know, reports for operations leaders are being reviewed. So, a lot of that stuff being layered in terms of support and QC and QA, so, but I will definitely get those. I will pull those numbers especially the over the 120 and above to have the team look at those. I’ll see about if we can pull a task related report just, you know, per org to kind of identify the ones that are super old. We need to get in there and look at them and make sure that those clients are aware of them and are addressing those. So let me take that as a takeaway back to the team. Okay. All right. What else do you have for me?
Max McGlothin (26:21) I think that’s it from this week. Okay? All right.
Dreama Hembree (26:25) And then Jack has on the books to meet with you at an executive level. So let us know if there’s anything else.
Max McGlothin (26:32) Okay. Sounds good. I appreciate it. Dreama. Thank you very much. All right?
Dreama Hembree (26:35) Enjoy the rest of your week you as well. Okay? Bye.