Transcript
Amy Barfield (00:00) morning, everyone. Good morning.
Amy Barfield (00:09) So,
Amy Barfield (00:17) happy. Good Fridays. Everybody have plans this weekend for Easter?
Brittany Dees (00:22) Yes, yeah.
Amy Barfield (00:26) Just go ahead. Yeah… I almost forgot it was Easter.
Brittany Dees (00:33) Right. Well.
Svetlana Vinokur (00:34) When you?
Brittany Dees (00:35) Have, because your daughter’s my daughter’s age too, right? 13. Yeah, they get, well, all she wants is those neetos, you know, I cannot find these neetos, anywhere like they’re just or if you find them there’s, someone else selling them for like triple.
Amy Barfield (00:55) The price, crazy money. Yes, neetos, and.
Svetlana Vinokur (00:59) lip? Gloss.
Amy Barfield (01:00) Oh, my gosh. Summer Fridays and blush. Yes, yep.
Brittany Dees (01:06) Summer Fridays, they’re like 20 dollars a thing. I,
Amy Barfield (01:09) know.
Svetlana Vinokur (01:09) It’s like a really good conversation here.
Amy Barfield (01:12) Yeah, we’re talking about the things that are pre teen daughters want in life.
Svetlana Vinokur (01:20) Oh, I don’t need to deal with that with two.
Amy Barfield (01:22) Boys, I know you have boys, right? You have all boys. Yeah.
Svetlana Vinokur (01:27) Yeah, I have two boys, so I don’t need to deal with that.
Amy Barfield (01:30) Yeah. It’s a blessing and a curse. You’re like, it’s fun. And then you’re like, it’s so expensive. So, yeah.
Svetlana Vinokur (01:37) I would have been the worst mother of a teenage girl, like the worst. Oh,
Amy Barfield (01:43) I don’t know about that. You would adapt. I think most boy moms say that… the girl’s.
Brittany Dees (01:51) soft in you?
Amy Barfield (01:53) Yes, yes.
Svetlana Vinokur (01:56) Or?
Brittany Dees (01:56) You might even have this part in her?
Amy Barfield (01:58) You’re like, was I this way at the same time? Stay back? Yeah.
Svetlana Vinokur (02:07) Okay. Well, happy Friday and we’re celebrating Easter… so, good Friday as well. So, yes… Amy, maybe let’s payers.
Amy Barfield (02:21) Are closed today by the way.
Svetlana Vinokur (02:23) Yeah. The market is closed as well. So, yeah, but the banks are open so.
Amy Barfield (02:28) Yeah, right.
Brittany Dees (02:30) Got our money.
Svetlana Vinokur (02:32) Yeah. So, Amy, I wanted to connect with medicaid Georgia. Okay? For Theoria, because sounds like we’re having a lot of issues right now asking for retros. And I really don’t understand kind of like what happened, right? Because the providers were already enrolled and why retros were not asked and medallion was waiting for the group enrollment. I don’t know. But now medallion is saying we cannot ask for retros because it’s only two months and I have probably 100,000 dollars right now sitting on medicaid Georgia. So we need to like someone. And I think you said that the main Guy is going to the main person is going to look into it, but they’re tasking us basically saying like we can’t ask for retros and I have a lot.
Brittany Dees (03:32) Okay. And,
Svetlana Vinokur (03:34) you know, this is very time sensitive, and I know kind of like, you know, we have 10 days whatever, but they, like we ask you for retros and then like nothing happens, right? And then it takes 20 days for them to even then task. And then we go back and forth. And so, it takes like 30 days until something even happens. I mean, medicaid of Georgia. We, we think I literally have 100,000 dollars right now plus on the retros. Okay?
Amy Barfield (04:02) I’ll do a deeper dive into that with our medicaid specialist. And, yeah… he’s aware. And I’m wondering if some of the retros are location based, like if it’s just not retroing based on like a location ad or if it’s just no.
Svetlana Vinokur (04:21) It’s it’s really the retro, it’s really because it took so long to get, so to get, the actual that we need, to actual kind of retros. And like this masadiyat, right? That was the one that we need one location, right? Like the arrowhead and it’s like 30 grand plus just on that one location for that one provider.
Amy Barfield (04:50) And the ssau, yeah.
Svetlana Vinokur (04:53) So, yeah. So I’ll show you all the kind of medicaid… it just clear.
Svetlana Vinokur (05:07) And is juby on… juby’s not on. Yeah, hold on, I’ll share with you, Amy, hold on link to our latest credhole report.
Amy Barfield (05:22) What is his name? What’s his last name? Masad? Let?
Svetlana Vinokur (05:27) Me just, I will, Ellis, is it Ellis masad, Ellis? Yeah, thank you.
Amy Barfield (05:32) ELLI.
Svetlana Vinokur (05:33) S, yeah, I’m starting to memorize these providers. They come up so often. Well, yeah.
Brittany Dees (05:37) I’m.
Svetlana Vinokur (05:38) spelling.
Amy Barfield (05:39) it wrong. Yeah, I just want to make sure I get… so I can look into it. Yeah.
Svetlana Vinokur (05:49) So, there are a bunch of them. So I was just looking today. So here… so we have like split it between credfold and pride to cred. So, so dr adams, my favorite dr adams finally got approved, right? But we need like retro almost a year back and they haven’t even submitted it yet. This nalima, daturi, we had outstanding enrollments since may that hasn’t been completed.
Svetlana Vinokur (06:26) This Anaya, the retro hasn’t been submitted. We need the retro and it has not been submitted yet. And then if I go to the ones that are already credfold?
Svetlana Vinokur (06:47) Yeah, no, no, oh, that’s probably post submission. Sorry, this is post submission right here. See 30 grand on Alice 25 grand on Martha. And now a medallion came back and said we cannot ask because, it’s not within two months, two months since the agreement show you, Martha.
Svetlana Vinokur (07:22) Okay. So look at this Martha thing. So she got approved on a 912, effective seven one on.
Svetlana Vinokur (07:36) 912 on 912 on 913 on nine six. We ask for retro. We ask for retros… medallion, completed the task, added the facilities but did not add down the retro. Okay. We then juvie put again retro request and then medallion coming back and says you can’t do that because you are sending it, submitting it too late. No, we submitted it right in time. Medallion just didn’t ask for the retro. Okay. So, and that’s kind of going on and see this one. Yeah, they test it out to us, right? So, and it’s instead of like doing they’re going back and forth right on what is it? 310 25.
Svetlana Vinokur (08:40) Demographic update was completed in two five attractive. The thing has been completed.
Svetlana Vinokur (08:52) So like hold on, see this is what’s completed. They’re saying it was completed, effective 310 25.
Svetlana Vinokur (09:02) 310 25 will work for us. But, but then they’re saying ask about retro effective date, but they cannot be completed if it is allowed time frame. So then what are you saying that it was completed here? Yeah.
Amy Barfield (09:21) So any of the retros that are denied, I’ve asked them to change the status to request… denied rather than stopping or completing the line so that you can see what was denied. And.
Svetlana Vinokur (09:35) Yeah, just your application submitted for director and application has been completed.
Svetlana Vinokur (09:49) And then when was this? Two five? And then on 320.
Svetlana Vinokur (09:58) They called asked about retro effective enrollment status, but the right request cannot be completed if it’s allowed time frame must be submitted within two months.
Svetlana Vinokur (10:27) And they test it out to us right now. So that’s why Martha, then I have the same with Jennifer and Alexander, right? The same story.
Amy Barfield (10:41) So, the demographic update, hold on but I’m seeing where it states that it was requested December thirtieth… you said there’s one from September six… and it says this was completed one.
Amy Barfield (11:07) Please link provider to Georgia locations, follow your location to acquire retro back pay of 310?
Svetlana Vinokur (11:14) Yes, I see they completed the completed effective nine one. Do you see that? Yeah.
Amy Barfield (11:20) I’m just looking to see what they requested on the application because if we requested on the application, I feel like they should push back and say, well, that’s the, okay?
Svetlana Vinokur (11:29) Yeah, but we were very clear that we needed to see, the notes were very clear, right? 310 for.
Amy Barfield (11:35) Sure. Yeah.
Amy Barfield (11:42) Yeah. I’ll look through this and see if we can push back to the payer from the original request, not seeing where there’s effective date requested though.
Svetlana Vinokur (12:02) So, Amy, I shared with you the link to the latest cred hold report and there are two kind of if you look at the cred hold and the prior to cred hold medicaid. This is like all the, so, so 100 grand on prior to cred. So we are looking for, and then this is also hold… on how much is here. So I have 130 grand sitting on medicaid. Okay?
Amy Barfield (12:40) Okay. Yeah.
Svetlana Vinokur (12:45) So, and then any update on blue cross blue shield of Michigan, because the numbers are growing. I just look at that like look at this. I have medicaid 518, 100 and Michigan 31. So 650 grand.
Amy Barfield (13:02) Let me get you some number or get you something here.
Amy Barfield (13:13) Where is it? Where is it?
Svetlana Vinokur (13:37) Why isn’t it showing me?
Amy Barfield (13:55) It’s not showing me data. Hold on. I don’t know why I show a lot of completed, but my question is for Michigan Theoria, there are some thoughts.
Svetlana Vinokur (14:10) Well, if you look at kind of, you know, you can see the providers, right? So, like look at this providers, Patricia 134 grams. So let’s look at her, right?
Svetlana Vinokur (14:26) Oh, it’s slow again.
Amy Barfield (14:29) I know that’s what I’m having the same issues, sorry.
Svetlana Vinokur (14:34) Okay. So, yeah. Okay. So look at this. It’s still pending since August. Check your validity showing nothing. Okay. This is how they follow up check your validity shows nothing, unable to connect with the rep. I mean, this is the effective follow ups. So they basically haven’t talked to anyone for the last two months… unable to connect. So like, I mean, it’s just, I don’t know how to get to kind of Nicole that, this is like.
Amy Barfield (15:11) Yeah, I talked to the manager this morning about it specifically around complex care, but I think blue cross blue shield of Michigan as a whole. I made this priority back in October when I first started with you guys and I’m not sure where the gap happened because I’m pretty frustrated myself over it. And so I talked to her this morning. I think she’s going to talk to Nicole today about seeing if we can get a specific person who’s very knowledgeable in this payer to just work this payer for you so that we can get these pushed through. So hopefully I’ll know more by the end of the day. But yeah, to your point, I recognize it. So… I haven’t had much time to push this morning. I’ve been on a couple of calls, but also, I did push with the manager. So it just,
Svetlana Vinokur (16:12) it just feels like I’m it’s either, I’m crazy that I’m like, you know, like repeating myself and hoping for a different, I don’t know, I don’t know if, you know, right?
Svetlana Vinokur (16:20) It’s just the children in Michigan is our, the biggest payer right outside of medicare and medicaid. Like this report is shared with everyone and everything, right? And I’m kind of like back to square one. Like it’s all of them, all of the, all of the providers on this list, they are all because of la crosse, blue shield of Michigan, right? Yeah. Okay. Yep. So what are we doing?
Amy Barfield (16:50) Okay.
Svetlana Vinokur (16:51) So, I don’t know, I have a call with them on Monday kind of, right? I sent that email to Amy yesterday as well, on the complex care. Like I don’t know what else to do. Yeah.
Amy Barfield (17:01) I think Derek’s waiting for a response from me on your email. And so I’m going to go back to him, you know, just letting him know like, yeah, there were some things that should have happened that didn’t happen and that I’m meeting with that. I met with the manager. We’re trying to get a game plan for blue cross for shield of Michigan.
Amy Barfield (17:24) But yeah, he’s he, I don’t think he’s responded to you yet because he’s waiting on a response from me. Oh,
Svetlana Vinokur (17:29) I, yeah, I understand how it works, right? But it’s just, you know, but it’s like, I don’t know.
Amy Barfield (17:38) No, I.
Svetlana Vinokur (17:39) Get it. Yeah. Okay. Okay. Carrie, on the blue cross blue shield of North Carolina. Schmoke is our biggest one. So, you just emailed something or you said something right on, yeah.
Carrie Reding (17:57) They were waiting on a peer reference form. So I pulled his peer references that he had in caqh, and put them on a form and I just closed the desk out.
Svetlana Vinokur (18:06) So, okay. Yeah, I had.
Carrie Reding (18:09) Started it but I was having some weird formatting issues but it’s so.
Amy Barfield (18:15) So, you sent it to us or you sent it to the peer? It was a task? Yeah.
Carrie Reding (18:18) It’s a task.
Amy Barfield (18:19) Okay. I just want to make sure.
Svetlana Vinokur (18:21) Okay. So, okay. So then we are okay. So then, that one is okay. And, and I, again look at blue cross blue shield of Wisconsin, Amy, and again, follow ups are unable to call, send an email that is not helpful. Like it’s like nothing.
Amy Barfield (18:43) It’s not creating movement, no.
Svetlana Vinokur (18:45) No, no, yeah, I know before.
Amy Barfield (18:48) Kelsey left, she was trying to nail down some sort of like efficient follow up contact. So and Brittany’s out today, but I can ask our PE manager if she can look into that. Oh, I forgot. Linh, I just saw you here… apologies, Linh, had, yeah, Linh, had something she wanted to share with you today from a product. Okay. Am I doing that real quick? Sure. Sorry, sure.
Svetlana Vinokur (19:21) Sorry to interrupt if you want to. No, you’re good. I didn’t see you there. No worries.
Linh Nguyen (19:27) Hello, everyone. I’m Lynn, I’m on the product design team on PE. I’ve met Svetlana before, but hello to everyone else. We also have Annette on the call today who’s also a product designer on the PE team. We’ve been working on representing inactive closed practice locations in medallion. We’ve been like designing for it, kind of planning out for it, but we would love to collect feedback from this group as we know it’s a very big pain point for your organization of like tracking closed locations today in medallion. So main purpose is to kind of share what we’re thinking, get feedback before we start building this. Any questions?
Annette Hong (20:11) Okay, great. All.
Linh Nguyen (20:12) Right. So we, yeah, are working on active inactive and archived practice locations. A little bit of the context here. Go to the next slide is today in medallion as you all are probably familiar with. There’s no way to like formally close a practice location. So it kind of stays active. And then we’ve noticed that a lot of customers kind of add like termed with the date or closed with the date before the practice location. So they’ll like change the practice location name so that it’s like clear when you read the location that it’s no longer open. But we know that it like continues to appear on requests and you kind of have to like remember to like not click it. So we hear you, we see this as a big pain point. The way that we’re thinking about approaching this is kind of capture three statuses for practice locations. So we would have active, which is kind of what, you know, practice locations as today in medallion, we would add a status for inactive. So you would be able to mark a location in medallion as inactive. And then the third status would be archived, which is today, there’s like an option to delete a practice location. This would essentially replace it while kind of preserving some of the data because today, if you delete it like you can’t revisit the, yeah, we ran.
Svetlana Vinokur (21:29) Into this issue right now, right? We went through this project and now, like it’s all zeros, right? So, yeah, right.
Linh Nguyen (21:36) Yeah. So, yeah, we’d love to kind of show you what we’re thinking to see if this like addresses what you’ve experienced. All right. I’ll hand it to Annette to walk through the designs all.
Annette Hong (21:48) Right. Cool. Hello, everyone. I’m Annette, sorry for having my camera off. It’s a little early on the west coast but lovely to meet you all. Svetlana I think I’m getting on a call with you later today as well. So, you’ll be, you’ll get plenty of me today. So let me walk you guys through three flows. So the first one will be marking a practice as inactive in which the close date had already passed. So this means that the practice is closed past tense. The second one I’ll walk you through is how to mark a practice as closing. So if you set, if you know that a place is going to a practice location is going to close in the future, how to set that, and then finally going through what it means to archive a practice location. So first off how to mark a practice as closed in the past tense. So you would be able to mark a practice location as inactive. If you were to go to any of either the practice location page profile or just opening up the practice locations, tables, you see in the groups, open up the kibah menu. On the side. You’ll see that you’ll have your options to edit mark inactive or archive. In this situation, you’re going to be marking inactive… upon hitting that button. We’ll push a modal just to let you know, hey like once inactive, this practice location will just be, will no longer be available to add to any new service requests or new enrollments. But any in progress service requests, will that include this location will be unaffected and will continue to continue through to completion. And if you want to find what those service requests specifically are hitting the view request button over here will just open up a new tab with the filter down list of the related service requests. And down here, we’re going to ask you to enter a close date. So let’s say this is in the past, it closed in earlier this year in February. If you mark inactive, then we will append a tag to the practice location… just wherever you see the practice location. It’ll have the inactive tab. Like for example, if you go over to existing enrollments, that inactive tab tag would also exist here within the profile page. We’re also going to append the tag here. Include the close date, all the different modals and whatnot that tag will propagate through. So wherever you are on the platform, we will recognize this as an inactive practice location. Therefore it may exist around the platform. However no new, no net, new enrollment. No net new service requests are allowed. Let’s see. And then in the next scenario, what that would look like if you are marking a practice as inactive, it’s closing. So set to close in the future, you would do the same thing. It’s just that the close date is now set to the future. So let’s say it’s closing later this year. We’ll push we’ll show some helper texts to be like, hey, this location is automatically going to become inactive on this date. But until then it’s active. You can remove, you can clear it. You can edit it. It’ll be you’re all good here. And that scenario instead of showing the inactive tag that you saw previously, we’ll just be showing a closing tag. So it’s going to be taking up the same. It’ll have the same exact behavior. It’s just a slight nuance difference of this is closing. And also like yellow treatment as sort of like a warning. And again, this is going to propagate throughout medallion. So it’s going to have the same behavior. So wherever you see this practice location, you will see that this is closing. And then finally what it means to archive a practice. So same way you would navigate to the practice location that you want to archive. And the requirements for archiving are going to be a little different. The requirements is going to be that in order to archive a practice location, basically, it needs to have like no associations, no in progress service requests, just like a full check that this practice location is fully dormant and there are it’s like fully stale. No, no active pipelines involve this. We’re good to, we’re good to go to archive. But in the case that we recognize that there are still in progress service requests. We will not allow you to archive. We’re going to ask you like go figure that out either like wait till these are done or go manually, stop them or do what you need to do in order to archive this. And if we recognize, hey, yeah, you’re all good over here. No active service requests, no active pipelines running involving this practice location. You’re good to go. If you hit archive. In that case, we’re just going to fully hide it from medallion. So there’s no way for you to encounter it, run into it. And by the off chance that you run into like an old URL that takes you directly to that practice location profile page, then we’ll just surface like a read only view. We’ll tell you like, hey, this place was archived on this date. Archive’s going to be read only. So like the information is still there. If you need to reference. It, but you can’t really do anything with it. So those are the three flows that we are thinking of. So I will pause here. I know I just walked through quite a bit. Any questions quick?
Carrie Reding (27:52) Question if we’ve archived something and recognize that it needs to be used again, what is the workflow? Can we unarchive it or do you have to add?
Annette Hong (28:05) Because I can see that happening.
Linh Nguyen (28:10) Yeah. The way we were thinking about it is archive would not, you would not be able to unarchive something. I guess maybe we’re a little bit curious to hear more about like use cases where you would mark a location as inactive versus archive just given the way that we walk through it… do you have like different?
Svetlana Vinokur (28:30) Scenarios, well, you’re saying inactive, that means that it’s termed, but we still have open enrollments, right? Archive. You’re saying that when all the enrollments are done and everything. And I guess what Carrie is saying, what might happen is two things one is we thought we had done and then we get some claim for that location, right? Carrie or so… if that location, you know, was termed, but then let’s say six months later, they decided to hire us again and… we want to activate that again. So do we need to put it back in as a new location versus unarchived it?
Linh Nguyen (29:19) Yeah. So I’ll just maybe voice over the difference that we’re thinking of inactive and archive. And perhaps this is not the right model but it’s just like, you know, our initial thinking was inactive would basically be the practice location would still be visible in medallion. So we now have this similar to the way that you all are like putting termed or closed before the name, it would still be visible. You can see that it’s associated to these requests. You just can’t request new enrollments with that location for archive. The main difference is that it will no longer be visible in medallion. So it’s essentially to replace that delete button that exists today and to basically say like this should no longer appear anywhere.
Svetlana Vinokur (30:03) So maybe for the time being, we’re just not going to use archive button.
Carrie Reding (30:10) We could for duplicates because there was an instance where duplicates were getting added and we don’t need them in there. It’s the same tax id. We’ve checked it. That would be the only instance that I can think of where or?
Amy Barfield (30:26) We.
Carrie Reding (30:26) had a facility that we were supposed to go live and then something happened and then they’re not going to move forward. Those would be the two instances where I would archive something, but knowing that we may or may not have just depending on the time frames have requested enrollments with a pending date.
Carrie Reding (30:45) But technically, we’re not ever going to go live. Those would be the two archive instances that I can think of off the top of my head or.
Svetlana Vinokur (30:53) Carrie, you know, like a year from now when we know we’re done with Virginia, let’s say we’re done right? Then we can, yeah, yeah.
Amy Barfield (31:04) So, Lynn, are you seeing them? Are you saying that if it’s inactive, you can reactivate it, but once, it’s archived or once it switches, yeah.
Carrie Reding (31:16) I.
Linh Nguyen (31:16) was gonna, yeah, I punted that response because I wanted to talk about that next. So we want to better understand, yeah, use cases for reopening or reactivating a location. We don’t quite know enough. So we’d love to hear from y’all, like how often that happens where you like close a location. And then maybe down the line, you’re like it’s gonna reopen again.
Amy Barfield (31:37) So, I’m gonna add just to say, so you understand their business model, Linh, is they work in skilled nursing facilities. So they’re contracted with skilled nursing facilities to come in and give services to their residents if they have a contract with the company or a facility, and then the contract terms, but say a year from now they decide to renew their contract, they would need to reactivate those locations. Okay?
Linh Nguyen (32:08) Got it. Yeah. So in that case or the way that we were thinking about it is at least for the first version of this because we wanted to better understand the reactivation flow. We would just allow one direction. So from active to inactive or active to archived or active to inactive to archive, but we wouldn’t allow reopening.
Linh Nguyen (32:30) So no unarchiving, no like reactivating, so in the like kind of way that we’re thinking about it for right now, you would have to, yeah, open a new practice location, like create a new practice location, so.
Svetlana Vinokur (32:42) Linh, but that would create duplicates. My.
Carrie Reding (32:46) Thought process would be, I can see not allowing a reopen of an archive, but I feel like you should have the ability to go from inactive to active, if that’s possible. Because that would make more sense from.
Amy Barfield (32:58) A business standpoint, yeah, I think the only thing you’ll run into with that is say you reactivate a location and all its enrollments and everything that was tied to it prior. If we show that active and a year went by and say revalidations happened or terminations happened or it’s not accurate data. When you reactivate it, you know, further on down the line even though, yes, you had a relationship prior, there would still need to be some type of work to find out what your current status is with that location.
Carrie Reding (33:31) Let me ask this then. So if you have an inactive location and it’s inactivated for 126, can you bill anything prior to that was covered during the activation period, maybe that’s the question we’re not asking.
Amy Barfield (33:48) If there’s I think what Linh, is saying is that as long as it’s in an inactive status, you can still process active requests. You just can’t make new requests to that inactive location.
Carrie Reding (34:01) Exactly. That’s where the issue is going to come in.
Amy Barfield (34:05) Yeah. So if you have new, if you find out six months down the line that my gosh, we forgot to make requests for this provider. I mean, in reality, it would be difficult to get an enrollment for somebody who’s that far down the line anyways. If they’re if the location is termed or you’re not seeing, you know, because it takes, you know… so I don’t know, Linh, maybe there can be like a window to where you could reactivate, like maybe a three month window or something. And then once it’s past that or not even be able to make requests. Yeah.
Carrie Reding (34:44) You can’t make requests after the inactive date, but you should be able to make a request within that time period. So anything after four one, we should not be requesting anything but anything prior when, from the active date of that location through the inactive date, we should be able to make requests that’s the way that should work.
Linh Nguyen (35:03) And that’s what we were thinking. Yeah, exactly. Okay.
Svetlana Vinokur (35:06) So, Linh… if I have an inactive location, but I learned that I need to ask for retro for that location. What happens? Yeah?
Linh Nguyen (35:17) I guess is that, would you submit a demographic update today? Yes. Yeah. So what retro? I guess what would you do? Just a other option?
Amy Barfield (35:28) You would, so you do a retro or you do a demographic update. And you note that this is a retro request in the demo, but I know you guys just did kind of an overhaul of like requesting effective dates for a provider. Remember, I know Svetlana wasn’t.
Linh Nguyen (35:45) keen on that.
Amy Barfield (35:47) Yeah, for new enrollments, but I’m wondering if you can also do that for retros or demographic updates to have that effective date. And that way that’s where it would be effective for Svetlana and her team is that if we do this inactive and you’re requesting an effective date prior to the term date, then it’ll allow the request. But if it’s an effective date after the term date, it would deny the request. It won’t allow you to. Got.
Linh Nguyen (36:14) It. And then Annette, could you go back and that?
Svetlana Vinokur (36:16) Actually will solve another issue because it will make it easier for medallion. Because right now, like we rely on medallion to read the notes, what’s really need to get done on a demo, right? And so, so, because, when you ask for the demo, it asks, if you want to add the location or something, but it doesn’t ask if you want a retro, right? If you would have another kind of like saying I want a retro, and this is my, I asked a retro day. I think that will make it much easier for medallion people to know what they need to be doing. And.
Linh Nguyen (36:49) that’s definitely on our list. In order to like cap, I guess the way that we’ve been calling it is like the proper request type for retro for demographic updates. Could you go back, Annette to the Du screen?
Linh Nguyen (37:06) Yeah. So the way that we were thinking about it at least for this, the way that we have it like scoped in this slide deck is for demographic updates, we would not let you select the termed location in this, like which practice location do you want to add option, but you can select it in the, which practice location. Do you want to remove option? So even inactive locations would be able to select, you would be able to select it here. And then for your retro case, you could select other. And then, yeah, unfortunately type it in notes, but you wouldn’t be blocked from making that request. Yeah.
Svetlana Vinokur (37:47) And that’s where you guys need to say retro request, right? You have what needs to be updated, but majority of a request are actually on the retros, right? Yeah. Can I?
Amy Barfield (37:59) Make an outside suggestion. I mean, it has to do with this request. But when we make a note or say someone makes a request and they say we want this retro date, whatever is in the notes that they put, our team has to scroll up to the top of the notes to find out what is supposed to be happening with this request. And it should be a stagnant note with like where the locations are and where the, where we’re requesting provider locations. On the left hand side, there should be that note that they put in rather than having to look all the way to the top to see what was being requested on the line from the client because then they see it every time for all requests. Okay?
Linh Nguyen (38:44) Yeah, I can log that. That might be something I can just work off on the side. Okay?
Carrie Reding (38:52) No, I think this is a good place. I like it. So, I think if we can just fix, that… date range to be able to do retros, I think that’d be great. So.
Amy Barfield (39:03) Yeah.
Linh Nguyen (39:04) The demographic update support… enhancement definitely noted on that. I think we wanted to also just validate like the terminology we’re using. So as you can see here, we’re using the word inactive. Does that like does that resonate with the group? Is there a better term like we see termed as sometimes we see closed sometimes like what would be the best representation of word to represent like this?
Svetlana Vinokur (39:32) I think inactive is fine. And I don’t think either of them right will work. I don’t know.
Amy Barfield (39:40) Yeah, I mean, inactive just is fine. But if it’s like archive, then I think that would be communicated to our PE team that this is just, but would that just disappear from the system completely if it’s archived?
Carrie Reding (39:54) The archived ones? Yeah.
Linh Nguyen (39:55) Yeah, exactly.
Annette Hong (39:57) Okay. Even.
Amy Barfield (39:58) If it’s in an active request?
Carrie Reding (40:00) Oh, well, you can archive.
Amy Barfield (40:02) Yeah.
Linh Nguyen (40:03) You wouldn’t be able to archive if there’s active requests for it. Okay, they would all need to be closed or addressed somehow first.
Carrie Reding (40:11) I do have a question just for visibility. Is there a way when we archive? Is there a way to search for archived or does it just literally go away?
Svetlana Vinokur (40:21) Yeah.
Linh Nguyen (40:22) Maybe I’ll bounce that question back to you. Like what would you expect it?
Carrie Reding (40:27) Would be nice to know if we ever needed it for whatever reason? So I don’t know how you guys feel about it, but I mean, it’s.
Svetlana Vinokur (40:36) the same for the providers right now for us to be able to go and see deactivated providers is actually helpful because sometimes we do need to go back and look at that.
Carrie Reding (40:49) I don’t need to see them on the whole. But is there a way to say I want to look at archived somewhere? So we know what was archived? Just?
Linh Nguyen (40:59) For reference?
Amy Barfield (41:01) Like a history, I mean, would being able to pull that in report builder be enough… that would be fine? Or can we?
Carrie Reding (41:13) Or can we do a section underneath? So you already have like your groups and your group profiles and practice locations? Can you create a column for archive locations? You know, where it says groups group profiles?
Svetlana Vinokur (41:27) What they’re saying kind of they will allow you to build the report, right? That’s fine. So because you don’t go there very frequently, but if you really need it, you can build the report and pull it.
Carrie Reding (41:40) Yeah, that’s I mean, that’s fine. I’m I was going for shortcuts but, yeah, yeah.
Amy Barfield (41:46) That’s good. I don’t know.
Linh Nguyen (41:47) Yeah. Okay. I just wanted to confirm I guess how you all were expecting the requests. So for new enrollment requests, anything that was processing before you are sorry before you marked the location as inactive, would continue to process any new requests, enrollment requests you make like from the future date after the inactive date, you would not be able to select that location for demographic updates. We wouldn’t allow you to add the inactive locations to it. We would allow you to remove it. And then for the retro case that you all often encounter, you would continue to like select other here. And then like type that in and then for revalidations, curious, how you all would expect the inactive location to?
Annette Hong (42:39) Either.
Linh Nguyen (42:41) Appear or not appear on those requests because I understand you can’t revalidate and like you wouldn’t revalidate it with the inactive location. So would you expect it to not show up on the revalidation request? How would you expect that to work?
Amy Barfield (42:56) Revalidations work more on the payer level, not location level, most of the time. Yeah. So I don’t think we’ll run into that with this scenario? Okay?
Linh Nguyen (43:06) Because like today, we show all the locations that are on the enrollment when you like request revalidation. So, I was just curious, like would you expect to see the inactive ones or should we not show it? I?
La Toya Pough (43:18) Don’t think we should show it if we’re not going to revalidate it?
Svetlana Vinokur (43:22) Yeah.
Carrie Reding (43:22) Exactly.
Amy Barfield (43:23) I would.
Svetlana Vinokur (43:23) Expect it to not show up.
Linh Nguyen (43:26) Okay. Amazing. I think that covers, and then I wanted to, I guess, yeah, validate one more thing with you all is around the association. So for inactive locations, would you still expect like, you know, how in the provider’s profile, you can like see the locations that the provider is like, you know, part of? Would you still expect to see those inactive locations there? Would you expect it to be hidden? Like how would you expect we?
Carrie Reding (43:57) Would want them to still show? Yeah, yeah.
Svetlana Vinokur (44:00) And they would show inactive right next to it, right? So, yeah, we want them to show.
Linh Nguyen (44:06) Okay. Are there any other like reports or like things that you all use frequently where locations show that would be important for us to keep in mind?
Svetlana Vinokur (44:20) On the enrollments, right? Like, so even if the enrollment complete, they will show that inactive was added, right? Yeah.
Linh Nguyen (44:32) Okay. Annette, do you have anything else?
Annette Hong (44:37) On your side, could I ask? So going back to the reopening scenario, I’m wondering if maybe a like reopen as new type of scenario would make a little bit more sense? Like in that scenario where like a location was closed for a year and we want to reactivate it, it’s like a lot of the information can be outdated. So, well, how would you guys feel about having an option to reopen as new? And that would just purely be… repopulating a bunch of the fields in the add new practice location modal. So it’s not necessarily like reopening the same object you are opening a new practice location, but it’s like it’s an easy way to sort of port over a lot of the information. So you don’t have to enter everything again from scratch?
Amy Barfield (45:46) So, would we just reopen group information and maybe attach providers but not their existing enrollments, prior requests, things like that.
Linh Nguyen (45:58) I think so.
Svetlana Vinokur (46:02) I.
Linh Nguyen (46:02) mean, I’m curious, right? Like do all the associations stay exactly the same or would you want to just like copy the main like facility information and then do the associations again, we’re not super sure on our end? Well?
Carrie Reding (46:15) If you’re doing a retro most of the time or a retro request, a lot of times it’s because a location didn’t get linked or something like that. So I would think that you would just want to add that one or two, whatever it is that might be missing. I mean, that shouldn’t be a huge issue going forward with some of our stuff, but we’re adding and removing locations pretty frequently. So I don’t.
Svetlana Vinokur (46:39) know, no, Kerri, that’s not the question. The question is basically the location closed and a year from now, we are opening it again, right? Oh, a year from now. And so it really depends right on the payer and where you are in the revalidation process with that payer, right? Because if you haven’t been in the revalidation process during this time, then all those locations are probably still active and you are good to go, right? And if you had revalidation, right? And those were inactive and we are not revalidating them, then it might be an issue and that’s when we might run into… a problem. So, I, you know what? I think that it doesn’t happen very frequently. So I wouldn’t be solving for like maybe one offs and I would just say probably for now, if we are reopening, we’ll just add it as a new location, kind of, right? And then we probably just need to archive the old one. Yeah, I think that.
Amy Barfield (47:48) Would be good too, that way if you needed to do more of a comparison of what you had and what you’re moving forward with there’s a clear line of difference, right?
Svetlana Vinokur (47:59) But I do want, you know, like if we have an active location, we add a new for the system to flag. Hey, you have the same location that is inactive. Do you want to archive it before you add the new one, right? Kind of, so.
Amy Barfield (48:14) Can I do that as well? Linh, like if someone, because there were a lot of duplicate locations added, if it sees like some similarities in an address that’s being added, is there some way to flag? Like you already have a location similar to this. Is this the same? Are you creating a duplicate? You know, that kind of thing? Yeah.
Linh Nguyen (48:35) That is a really good feedback for us. I know that was super painful for y’all, I’ll log it for us to address separately from this project. Okay?
Svetlana Vinokur (48:45) Cool. And, you know, it would be really good also to know some sort of record like who is adding the locations because we do have a record like who is making requests, right? But we don’t have a record ability to see like, okay, who added that location, right?
Amy Barfield (49:06) Yeah. I usually have to get tech support involved on that and.
Svetlana Vinokur (49:10) That would be very helpful because when all this happened, we had no idea where even to go kind of who was the source of all this and if we would have had that, it would make it easy because right now, like if I see some requests that like doesn’t make sense, I see exactly who requested. So I can go back to that person and ask them why they requested. But in this case, we couldn’t even ask or go back and like what happened?
Carrie Reding (49:37) Yeah, we need some history.
Linh Nguyen (49:41) Yeah, that is a, I know… it’s kind of like basic stuff we’re.
Svetlana Vinokur (49:48) giving.
Amy Barfield (49:48) you all kinds of stuff today.
Svetlana Vinokur (49:49) No, I,
Linh Nguyen (49:50) know, I mean, it’s all very fair and valid be.
Svetlana Vinokur (49:53) Afraid what you’re asking for, right? Your ideas, it’s.
Linh Nguyen (49:58) literally like bare minimum, so I understand. But we could run a like pull a report probably for you of like the location and who created it. I know it’s not in platform, but if you need like that information quicker, that would be a way we could get that to you. It’s.
Svetlana Vinokur (50:14) only in the cases where kind of stuff like that happens, right? And typically, dom’s is the only one right now who is editing it. And so, of course, all went to him. And he was like, I don’t know, I didn’t do that. So, yeah. And then we were like, okay, who did that? And then we were like at loss, right? Yeah. Okay.
Linh Nguyen (50:35) Well, that’s everything from us. Thank you so much for the feedback. Really appreciate it. Yeah, this came. I think like directly from feedback that y’all gave to us. I know this has been painful. So, glad that we’re gonna work on it this quarter and before we drop or Annette and I drop just quick plug that I think last week or maybe a week before we released rearrangeable columns on PE. I don’t know Svetlana, if you saw that.
Svetlana Vinokur (51:01) Well, you sent me the YouTube video. I didn’t get to it yet. Yeah.
Amy Barfield (51:05) Yeah.
Svetlana Vinokur (51:08) It’s really nice to be able to move your.
La Toya Pough (51:09) Columns around so you can actually arrange them the way you want.
Svetlana Vinokur (51:12) I like that. Yes. Yeah, I know that was my pinpoint because I wanted to see it on the screen exactly what I wanted to see. So, thank you. Totally.
Linh Nguyen (51:21) Yeah, yeah, please keep sending feedback our way. We really appreciate it and thank you for all the feedback today. I think we’re gonna drop so you all can wrap up your call. Thank.
Amy Barfield (51:29) You, thank you so much for letting me crash. Yes, thank you. Go get your coffee. All right… Amy?
Svetlana Vinokur (51:41) Just reminding you that I won that label for my favorite person in Louisiana, you?
Amy Barfield (51:48) Won your, what label?
Svetlana Vinokur (51:51) The mail, yeah.
Amy Barfield (51:54) For Cynthia and, you know what? The?
Svetlana Vinokur (51:56) Kind of, I know that it’s like different people are doing things, but they submitted for her the link to the Theoria that for us to sign. But it’s useless because the provider is not even enrolled. So that link document will not work until the provider is enrolled. And we’re trying to enroll her with complex care, right? And they, it was denied. And so, it’s just like, you know… like people, they’re not connecting the dots, you know? Yeah.
Linh Nguyen (52:30) Not.
Amy Barfield (52:33) really sure how to comment on that. Yeah.
Svetlana Vinokur (52:35) You know? So just, you know, okay… yeah, I can get the label so I can get it out because I’ll be not at home for the next week. If I don’t do it today, it’s good. Yeah. And then I sent you an email yesterday with what Latoya was sent. It was saying that like, medicare, midwest, Indiana is kind of open, can iterate and so they need to get it done. So then, yeah, it’s processing if.
Amy Barfield (53:11) it’s open. We can add whatever you’re trying to do to that application. If there’s a request in medallion, what is there? I don’t.
Svetlana Vinokur (53:20) think there’s a request. I think we’re trying to add a provider. It’s.
La Toya Pough (53:25) I’m just trying to add a provider to a couple of the ones that the group are pending at this time. I did send you an email yesterday evening before I left about it. Okay?
Amy Barfield (53:40) If there’s certain providers you’re trying to add, and you put a request in the dining, we can have them add it to that when they resubmit this one because it’s okay. The.
Svetlana Vinokur (53:48) Challenge is like if I will put the request right right now, it’s going to tend to take 10 days, for medallion to pick it up, right? And that’s kind of like, so that’s why? Like for us, it’s some of those things are easier. We just do it ourselves, right? Nowadays.
La Toya Pough (54:04) Okay. But I’m just since I am in CMS a lot and he goes, I’m just gonna watch and see when the group will be approved. And then I can do the request myself because it’s well, let me,
Amy Barfield (54:17) ask you this, Latoya, are these providers, are, do they already have active eight five five eyes in the system? Yes?
Svetlana Vinokur (54:23) They do. Yeah, yeah.
Amy Barfield (54:25) You can go in their I application and submit them individually there too. So even if the group is tied up, you can go in their individual application and then submit for reassignment. So you submit for reassignment under a group on that first page where it’s like what are you trying to do to this? I, and it’s add to group. And then you can go right in it’ll. Give you two options. The contact and the reassignment just do the reassignment and submit it. It’ll all fall under the I application and.
La Toya Pough (54:56) So, I don’t know how much, I do know the steps that you’re stating, but I don’t know how medallion did it because they’re not showing up under my list when I go and view the provider. So I do see them. If I’ve decided to add them to another group, I will see them come up, but it won’t pull up their 855. I do know that they do have an active one because I did call CMS to verify.
Amy Barfield (55:25) Okay. If I know the provider’s names, I can look.
Svetlana Vinokur (55:33) So, who is the provider? She said?
Amy Barfield (55:36) There’s no request for them. So I don’t know why medallion would do anything if there was no request. So, can.
La Toya Pough (55:41) I request my profile. I cannot see them. They’re 855. I do know that they did request it because I see the request in medallion. They submitted a copy of the provider and.
Amy Barfield (55:56) Pete goes and look at it.
La Toya Pough (55:57) It’s dr, T, yes.
Svetlana Vinokur (55:59) It’s my favorite doctor tell like a tour. Yes, he’s moving because he’s Amy going to Indiana like next week and I need to add Indiana to his kind of so that’s why?
Amy Barfield (56:12) Well, that’s if we have requests and they’re already in there, then I’ll just tell him he needs to put that on there. Can you, did you send me an email of those names? And I can look at it. I.
La Toya Pough (56:22) Can follow up with you with the names. I just sent you the groups yesterday, the ones that were pending, the three groups that were pending in CMS. Okay?
Amy Barfield (56:35) I’ll look at those this morning and then… you’re going to send me those names. I’ll look what we have in medallion versus what we have in medicare. And then I’ll let you know how we can move forward.
Svetlana Vinokur (56:47) Sounds good. Okay.
Amy Barfield (56:51) Was it only two providers?
La Toya Pough (56:53) For now? Yes. Okay. And I think the other person was second.
La Toya Pough (57:06) I think her last name was fox if I’m not mistaken.
Amy Barfield (57:10) Okay. You can just send me an email. Yeah, yeah.
Svetlana Vinokur (57:14) Okay, perfect. And.
Amy Barfield (57:16) I just requested shipping labels. So as soon as I get that, I’ll email it, I’m trying to get it this morning, so you at least have time to email, so, Amy.
Svetlana Vinokur (57:25) But we are trying to like medicare right now. A lot of medicare, we’re going to do ourselves because it’s much faster for us to do it in pcos because it takes medallions so long, and then just like this one that happened yesterday, right? They, when something comes up, we don’t even know, their issues, right? That can be done and resolved. So, so, it’s really concerns me. Like, I don’t know if Nicole still haven’t gone back to me, like what happened that the 30 days, right? That email wasn’t addressed?
Amy Barfield (58:04) It was, yeah, I’m looking at it now that it.
Svetlana Vinokur (58:06) Was resolved, right?
Amy Barfield (58:08) I looked at it this morning and I looked under her eye.
Amy Barfield (58:11) It looks like one is processing, but one was rejected. So, I asked our team to call and find out why it was rejected to me. It looks like a duplicate, but without calling, I don’t know for sure but we did, but there is one processing under complex care, the same complex care. When I looked at her eight five five eye… and she is linked to Theoria. But I know we need to get her on complex care age?
Svetlana Vinokur (58:40) So there.
Amy Barfield (58:43) Is one processing, I’m just trying to get confirmation on whether it was rejected due to duplicate or something else.
Svetlana Vinokur (58:51) And Amy, so that priority list that I sent you yesterday, will someone work on it to kind of update all of that in medallion?
Amy Barfield (59:04) Yeah, I’ll get that to the team and see when they can get that out, okay?
Svetlana Vinokur (59:08) Because that would be very important because we need to figure out like who was missed right in those rosters that we can then addressed as soon as possible. I may.
Amy Barfield (59:22) Have already given it to him yesterday, but I’ll verify when they’re going to get that approved or worked. So. Okay.
Svetlana Vinokur (59:34) Sounds good. So, again kind of if I look at, my top list, right? Oh, maybe one more, same question since we, we’re out of time, but ucare, Minnesota, can you look at? I don’t understand what’s happening with that? Like like I really have like really one big provider, not Theoria, not complexcare, no, nothing is enrolled, right? So.
Amy Barfield (60:02) They will not honor a contract for last year because of closed networks. I had them, but would,
Svetlana Vinokur (60:11) they do the one going forward for complexcare or like what do we like? We need to kind of like figure out?
Amy Barfield (60:18) I thought ucare was the one that they’re that they are not in Minnesota anymore. It’s it’s like a different payer now that took over for one one.
Svetlana Vinokur (60:33) Okay. Because I have.
Amy Barfield (60:36) I.
Svetlana Vinokur (60:37) guess the latest one I have is December of 25 because they have like 30 grand… and one is like the one is the big one like, so, and it’s all element. Unfortunately. So… so who is that? Like, what do we then do going forward to ucare?
Amy Barfield (60:58) We would enroll with that new payer? We had discussed it a couple weeks ago. I can’t remember who the new one is. Medica. Let me check. Does that sound right? Yes. Yeah, I think so.
Svetlana Vinokur (61:12) Who is this Mary?
Amy Barfield (61:14) Hold.
Svetlana Vinokur (61:15) on that’s what Laurie keeps saying kind of.
Svetlana Vinokur (61:26) Laurie keeps saying we are not in Minnesota with medicare, but it’s ucare, that they sent an email. They sent me an email asking for information. I think you, Carrie, you copied as well or medica here, medica is souton, right?
Amy Barfield (61:47) I think they need a roster or something. Wouldn’t it. Okay?
Svetlana Vinokur (61:51) So, we’ll talk about it when we talk, but they said they asked basically for the information. But no, that’s Missouri.
Amy Barfield (62:02) Yeah. There’s a, that’s.
Svetlana Vinokur (62:05) Missouri that they’re going to need to look at that. Okay? We need to look at the, you care for who that is.
Amy Barfield (62:21) Yeah. And we have a request for medi co, right? Yeah.
Svetlana Vinokur (62:25) And anything from humana, healthy horizon. I haven’t.
Amy Barfield (62:35) got anything back from them yet, but I can add that to my list for Brittany to check on Monday. Yeah.
Svetlana Vinokur (62:41) Okay.
Svetlana Vinokur (62:47) Okay. Sounds good. Well, have a great weekend, everyone you.
Amy Barfield (62:53) too happy Easter. Okay. Thank you.