Transcript
Vanessa Persha (00:00) hi, Deanna. Good afternoon. How are you?
Deanna Purchiaroni (00:04) Hi, good. How are you?
Vanessa Persha (00:07) Good.
Vanessa Persha (00:11) Give me one second. I’m just rolling out of another meeting. So I’m going to make sure I have the tracker pulled up here.
Vanessa Persha (00:22) Did you end up getting an email from our support?
Deanna Purchiaroni (00:27) No, oh.
Vanessa Persha (00:29) He sent it yesterday. Let me go. Give me one second. Let me flag him.
Vanessa Persha (00:41) Did you already have your weekend with your brother?
Deanna Purchiaroni (00:45) Yes, I did. And now I’m in California.
Vanessa Persha (00:49) Oh, nice. Yeah. How was that? Good?
Deanna Purchiaroni (00:54) I came out for my friend’s bachelorette party, and then my mom retired yesterday, and then Easter. So, lots of exciting things very.
Vanessa Persha (01:03) Good. That’s awesome. Yeah. Okay. I just need to find my support ticket in here so I can follow up with.
Deanna Purchiaroni (01:14) him. Was the email going to be sent to my email or the credentialing at cortica?
Vanessa Persha (01:21) Two, that’s a good question.
Deanna Purchiaroni (01:24) I mean, I own both mailboxes and I haven’t seen it, but just so I can keep a closer eye out.
Vanessa Persha (01:32) Okay. Let me tag him and I’ll ask him which email he sent it to.
Vanessa Persha (02:04) What is it credentialing at cortica? Com?
Deanna Purchiaroni (02:08) Corticacare. Com? Care?
Vanessa Persha (02:13) Okay. All right.
Vanessa Persha (02:21) I just responded to him there. Yeah, he was saying, you know, he’s like this is so bizarre. Like I’m not seeing anything that would be jumping out to say why these emails are not coming through.
Vanessa Persha (02:35) Yeah. And I shared him all the snippets of everything that you gave me from your it team. So he’s going to keep looking into it. I know that Sarah had raised that in her escalation email yesterday, just the volume of tickets that you guys have sent that have not been resolved. So I definitely want to find a path forward for you there. I’m assuming a majority of those are payer approvals.
Deanna Purchiaroni (03:03) Yeah, payer approvals, and there are a few like application is on pause because they needed something additional.
Vanessa Persha (03:12) Okay. Rather than piecemealing all of those emails together. Is there any way you could send me one email with all of those sent ones in an attachment, and then I can just forward the entire email over to our support team and just have them work one email at a time out of the attached emails?
Deanna Purchiaroni (03:37) Possibly that might be a little tricky because some of them aren’t just attachments. It’s like an email explaining what is needed, okay?
Vanessa Persha (03:46) Oh yeah, no, no, I’m sorry, not like just the attachments but like put the email itself as an attachment in one. Oh.
Deanna Purchiaroni (03:54) Okay.
Vanessa Persha (03:55) Yeah. So if you guys use outlook, you should be able to like select all of your sent ones, right? Click and then forward. And I think it should put them all in one one email with them all attached or like attach as email. And then it’ll allow you to send them all in one email. It may end up, it may be too big depending on how many you have. So you might have to break it up into like two or three emails, but at least if we have that, then I can forward those over to support in chunks rather than one by one.
Deanna Purchiaroni (04:36) Okay.
Vanessa Persha (04:39) All right. So, let’s go ahead and jump into our tracker. Is there anything urgent in here? You want to address first? Because I do have a hard stop today at our normal time.
Deanna Purchiaroni (04:56) Yeah, I can kind of go through and see the ones, Marley… chang is quickly…
Deanna Purchiaroni (05:11) Did you have an update for line 81? Brenda rodriguez? That was where her health net app showed that maybe like she, I think the specialty was listed as like autism something instead of bcba.
Vanessa Persha (05:30) Let me go check my incidence tracker here.
Vanessa Persha (05:44) My biggest complaint about our new escalation tracking thing we do is like, it doesn’t make it easy to find it when it’s about specific providers. Like I have to read through the details to find out who it was for. Just go see… Brenda radry?
Vanessa Persha (06:17) Let me… let me highlight this one. I will follow up with PE ops as soon as we get out or as soon as I get out of my next call, okay? For an update on that one?
Deanna Purchiaroni (06:32) Okay. I’d also say like the highest priority out of all of these is the medicaid, North Carolina. Yeah, I did go in and update that tab, the medicaid North Carolina tab. It looks like there was only one provider, Lauren, Geary, whatever the third.
Vanessa Persha (06:53) Line? Oh, yes. Yeah, she.
Deanna Purchiaroni (06:56) It looks like she was the only one that received like a correct medallion task with the link actually to the training. And I guess they also need to be provided a username and password. And of course, I kept it on here just so you guys could like refer to her task. But of course, she’s now termed. So the one that was correct is termed and it doesn’t even matter. Okay? So I didn’t want to fully delete this line just so we can use her as reference. But all of the providers in red, either don’t have a training link like, sorry, they don’t have a task at all or the training link brought them to that website that like doesn’t direct them to the training. I did start emailing a few providers, but then they started emailing back saying like, I don’t have a task. I don’t see it. Well, boss, I was like, I’m just going to stop emailing them because I know I’m going to get this response from everyone. Yeah. So if those could be updated.
Vanessa Persha (07:53) Yeah, absolutely. So I am, I’ve escalated this again. I know we went through this a couple of weeks ago, but I did like I’m pulling in everybody and anybody who will listen to me. I’m like look like I have asked multiple times for all of these tasks to be reviewed to ensure that the proper link for the training is there. And I’m being told that it’s done because, and then the customer comes back and says it’s not. And then I check and they’re right? It’s not like I need something. So I am having the ops team do an exercise right now where they’re like doing a full breakdown of all the providers. I want them to indicate when the training was, the training email was received by North Carolina medicaid, when was the correct task attached to the provider’s request with the correct links? And then when was the training due? And has the training been completed as far as they can tell so that I can identify all the lines that are medallion error versus a provider who did receive a task but just didn’t complete it on time. That way you guys have visibility to that as well. And then I’m working with Molly to figure out like, you know, because obviously all these providers that have to be resubmitted are going to require an additional 100 dollar application fee. So, I’m working with the accounts account management team to understand like the impact there. Like, you know, it’s obviously not right for us to pass through fees to you for something that you couldn’t complete in the first place. So, those are all part of bigger conversations that I’m having with cross functional teams and all the leaders. And, you know, like I said last week, like I am definitely like your advocate here. I’m your partner here. Like I want to see these get pushed through for you. And I just like I’m struggling like I am trying to wrap my head around like why does this continue to be a problem? So yeah, we’re definitely digging into it though.
Deanna Purchiaroni (10:03) Okay. Thank you. There also are a few, the ones in yellow. I don’t know if they’re necessarily like… I know that you had notes that say that they are par and need cortica’s approval. I’m thinking that they don’t need training because they’re already par’d and you’ve already completed that training. Okay? So I do think that those ones can be completed. I don’t know if you needed like our confirmation, but those ones can be.
Vanessa Persha (10:34) Yes, Sarah confirmed last week that we can mark them complete. She was going to check with somebody just to make sure. Okay, she did share last week, we can mark them complete. So I’ve asked the ops team to go through and mark anyone that they’ve confirmed as par complete. I was going to go through it and do it, but then I started like seeing notes and things and I was like, unless they heard from the payer and have documentation, like I don’t want to touch these lines, I am letting them mark them complete. But yeah, it should be a decent handful. Like any of the ones where I put par, needs cortica’s approval. Those ones should all be flipped to complete here pretty soon if they haven’t been already.
Deanna Purchiaroni (11:17) Okay. Yeah.
Vanessa Persha (11:20) But I will provide you with a full breakdown of all the trainings that were needed. Okay? When we, you know, when we received the email, if they completed the training, and if they even received the correct task for training. So you’ll have that.
Vanessa Persha (11:38) Go back to like a.
Deanna Purchiaroni (11:42) different setup. So my laptop fully blocks my mind.
Deanna Purchiaroni (11:53) For line 73, Mariah Baldwin, I know we had talked about you or you had mentioned for me to submit like a ticket to have that uhc line opened again because she was originally submitted using her temp license and not the permanent license, but we felt like that maybe didn’t seem correct. I have tried messaging. I think I’ve submitted two tickets, possibly three and everyone has said like that, they’re not going to reopen it. So I don’t know if that’s something that you’re just able to do with reopening it because I still don’t really feel confident that she doesn’t need to be submitted with or like at least have uhc be notified. They just keep saying that since her permanent license is on caqh, then they’ll automatically check that and update their system.
Vanessa Persha (12:44) Let me go. Let me move our, oh, gosh. Our call over here because, I asked our operations team to confirm like call the payer, confirm what’s on file. And if it was still her temp license to reopen the line, let me go check. I’m going to search our chat here and just see what they, Mariah… Baldwin?
Vanessa Persha (13:24) No response yet.
Vanessa Persha (13:30) Give me just one second. Sorry?
Vanessa Persha (13:47) Sorry about that. My kids are home from school today. So I’m like, hey, I’m like on the call?
Deanna Purchiaroni (13:52) Over here?
Vanessa Persha (13:54) No worries.
Vanessa Persha (14:04) All right. I just flagged her again. Let me make a note in here. So I don’t forget what I did. Oh, shoot, I just realized my laptop is not plugged in and it’s going to die. Give me one second. There we go. My dog ran through here the other day and like wrapped himself up in all of my cords and took off running and like ripped my laptop down, all of my stuff. I was like.
Deanna Purchiaroni (14:30) Okay.
Vanessa Persha (14:34) Jeez… okay.
Vanessa Persha (14:42) I know that I would expect that we’re going to start getting some answers pretty quickly here from the ops team on all of your open items because I did bring attention to a much larger group like, you know, I am doing the best that I can to flag these issues and to raise awareness of what’s happening. But like my hands are tied if I can’t get a response and I need to bring something back to the customer on this. So I know we have much higher level leadership looking at your escalations. And so I have a feeling that this is going to result in much faster responses from our ops team.
Deanna Purchiaroni (15:25) Yeah, yeah. I hope so. And I feel like it is frustrating because it’s like I’ll try reaching out to support. I don’t get responses really in the chat in the system, I’m not able to email. And then I know when we escalate things to you, it’s like you are the middleman. So it’s not you that’s causing the issues, but just like the frustration of like I.
Vanessa Persha (15:44) know you are.
Deanna Purchiaroni (15:45) The one that we talk to, and then I know you kind of have frustrations because you’re not getting responses either, that’s like, it feels like there’s no, nothing that’s being resolved because even like you, our main contact isn’t getting responses like what are the next steps? Yeah. And I do feel like for a while, we’ve just been having like so many outstanding items that feel like high priority and it’s like there’s I think I also just have so much going on with page leaving and things that I’m like there’s so many things stocking up that it’s overwhelming but I appreciate you escalating it and hopefully we can get answers soon, yes.
Vanessa Persha (16:21) Absolutely. I plan sometime early next week. I’ll schedule time with you and Sarah, we’ll go through all those issues, but I have already created like for the independence blue cross issues. Like I looked into that. And I was like, what the heck like a month? Are you kidding me? What happened here? You know? So all of those things have already been escalated in addition to the North Carolina medicaid doing a full like root cause analysis, long term planning, like how do we stop this from happening moving forward? So hopefully early next week, I’ll be able to summarize everything and share that with you guys.
Deanna Purchiaroni (17:03) Next, I haven’t I’m on line 62 Laura burex, her California and Texas enrollments. I have not gone through and like updated the tab for her. So I can do that today and see if there’s been any update.
Vanessa Persha (17:20) I actually have some for you because I went line by line on her yesterday with our ops team. So let me share with you what we pulled out of this. So, for Texas, Scott and white health plan is in process. Yep, we had that blue cross blue shield of Texas. Yes, optum, yes… pediatric subspecialty, network. We have that one on here. Yes. Okay. So that one?
Deanna Purchiaroni (17:52) Sorry, I think they’re the same update. Okay?
Vanessa Persha (17:54) So, we found out that caqh would, will not let us update her specialty because bcba is not a subspecialty of SLP, but what the rep said was to submit the application as a bcba, and they will go ahead and process it that way. So, for PSN at the very least, they are going to submit her as a bcba even though caqh doesn’t match payr’s, fine with it.
Deanna Purchiaroni (18:21) Okay. I also did… Whitney at PSN emailed me about all of this and she, it wasn’t that I just needed to submit her as a bcba, but for them to pull like since they can’t pull from caqh medallion has to fill out that caqh state form.
Vanessa Persha (18:44) Oh, that was not related to me. Let me add that to my notes here.
Deanna Purchiaroni (18:55) Yeah. So I… the cortica at medallionteam. Com email was included in that?
Vanessa Persha (19:06) And she,
Deanna Purchiaroni (19:13) so it’s.
Vanessa Persha (19:15) the state specific caqh application that has to be used for her submission? Is that what you said?
Deanna Purchiaroni (19:23) I believe? So, let me look for the email.
Deanna Purchiaroni (19:36) Here’s. My crazy.
Deanna Purchiaroni (19:54) Yeah, I’ve gotten like three emails from different payers about the caqh issue.
Deanna Purchiaroni (20:07) Okay. I’ll have to find the email should I forward it again to the cortica at medallion team?
Vanessa Persha (20:13) Send it to me, so I make sure that they get it and understand what they need to do?
Deanna Purchiaroni (20:19) Okay. We also got the same thing from healthnet for Laura burek. I responded to healthnet explaining the whole thing where we couldn’t add bcba as a specialty in caqh and they responded back the forms that need to be filled out. And I think it’s the same. I actually haven’t clicked on them… but I think it is the same like caqh application or maybe it’s just like a paper application. So filling that out instead of them checking caqh. So I will forward you this one so you can see it.
Vanessa Persha (20:58) Give me one second. I’m so glad that you and I talked through this because that is very different information then was shared with me from ops. They told me that the payer confirmed that they were processing the enrollment as a bcba. Okay?
Vanessa Persha (21:38) I mean, unless they’ve already submitted that form.
Deanna Purchiaroni (21:43) I don’t think so because she just sent this on three 31. Okay? And the cortica at medallion team email was included and she said that they would have to fill out this. It’s the Texas standardized credentialing, it’s like the full caqh form. And then I responded with medallion cc’d saying that I have informed medallion. I believe I submitted a ticket or it was a separate email I’ll have to check, but I did like also separately tell medallion that they needed to do it. So they should have been like notified twice through this email from PSN and me directly. Okay? I just forwarded it to you. And then I’ll also forward you the one from healthnet.
Vanessa Persha (22:28) Perfect. Thank you pending dependencies for Aetna Texas delayed due to npi registry. So that one interesting. I just realized that we had a note on here from 325 that they resubmitted it already. But then Aetna is a two step process, right? We submit it and then we have to add them to the roster later. I think that’s what it is. So she said the roster is supposed to go out the end of next week. They just received their report from the rep and then they do the, you know, they find all the providers that need to be added to the roster. So they confirmed that Laura will be added on the roster that goes out by end of next week.
Deanna Purchiaroni (23:22) Okay. And,
Vanessa Persha (23:24) then for her, California.
Vanessa Persha (23:31) Her Aetna application was resubmitted on 324. And then again same thing roster will go out… client task, completed anthem blue cross. So this for her anthem blue cross, the team is running into the issue and availability where the application doesn’t allow them to select the bcba specialty because of caqh. So I asked them to submit it, submit additional documents in their request like submitted as is, but put an Loi that states we need her enrolled as a bcba. We can’t do it in caqh, you know, just go through the whole gamut of explaining and then to call the payer to confirm that they received the attached documents. So they’re going to try to do that.
Deanna Purchiaroni (24:29) Okay. And if that does not work, I’m assuming that all payers have some sort of like workaround for providers who don’t have caqhs of how to submit applications. Yeah, we.
Vanessa Persha (24:43) can check with them. I know like typically when you go through anthem’s website or any of the blue cross blue shields, like when you click the option that says I don’t have a caqh, it redirects you to say here’s, how you create one.
Deanna Purchiaroni (24:58) Oh, okay.
Vanessa Persha (24:59) So they may not like, I think for a while they were allowing workarounds but they may not anymore. So I’ll let you know what the outcome is of that Loi, I mean, it’ll all come down to like a business decision for you guys. Like if they absolutely will not enroll her as a bcba, like, you know, we can mark the line stopped or inactive so that you guys know for scheduling and billing purposes. But I’ll keep you posted and let you know what comes of that.
Deanna Purchiaroni (25:28) Okay. I do think it would be good to kind of document like what each of these payers are saying and like if there’s a workaround if there’s not yada, because unfortunately, this is going to be coming up a lot because this provider is currently in process to get licensed as an SLP and a bcba in every single state that we’re in which… is not fun.
Vanessa Persha (25:52) Okay. That’s a good call out though because what I can do is I can flag that for our payer research team and have them kind of starting to get the jump, like they can pull all of your payers, And find out like what those nuances are and push for that. So that’s a, let me make a note of that. Where do I want to? I’m going to put that on our agenda?
Deanna Purchiaroni (26:16) Okay.
Vanessa Persha (26:19) Yeah.
Deanna Purchiaroni (26:19) When she requested that, I was like, gosh, we’re already having so many issues with her one bcba. Now, we have so many more coming up.
Vanessa Persha (26:27) So, it’s not technically, is it a dual enrollment then, or would it be… because you would be picking her as an SLP for one group but a bcba as another? So it’s not technically a dual enrollment.
Deanna Purchiaroni (26:46) Yeah. No. So it’d be like separate groups separate. Okay?
Vanessa Persha (26:51) Enrollment by specialty group.
Deanna Purchiaroni (27:16) Okay. And then just the last thing I have, I know you have two more minutes, Laura bierk, again kind of like going off of that. She does have a lot of requests right now for new licenses and it looks like a lot of them are on. I think it’s like needs client attention status. Okay.
Vanessa Persha (27:40) Let me go look because I know I flagged a class at least last week that she had a blue cross or an anthem line sitting and requested and I didn’t understand why it was just sitting. So I need to go back to the thread to understand like what’s blocking her. But let me, Laura bierk, let me go see what I see in the platform. Okay?
Deanna Purchiaroni (28:20) Oh, I guess it is, needs client attention intake. So, is that?
Vanessa Persha (28:24) Yeah. There’s something missing with her profile.
Deanna Purchiaroni (28:30) What I’m seeing is that it’s like for Texas bcba, a professional diploma. So I don’t know why that would be holding up all of the other licenses.
Vanessa Persha (28:43) Let me go, look… missing education, history institution for a professional degree. Let’s see, are we missing her bcba education?
Deanna Purchiaroni (29:00) Yeah. Okay. Is there a way for like us to see those notes?
Vanessa Persha (29:08) So, in the overview tab of her profile, it will tell you exactly what’s missing. So, if you see professional history is at 94 percent, am I sharing my screen?
Deanna Purchiaroni (29:23) Oh, I’m not even looking at her screen. No, you’re not.
Vanessa Persha (29:26) Okay. Give me one second. Let me share it here… because.
Deanna Purchiaroni (29:33) I know that you can look at it under the overview, but I feel like it’s not always clear of like what is needed? Like how did you know that was tied to meeting her bcba?
Vanessa Persha (29:42) Yeah. So, and it was saying here, it’s missing an institution for professional degree. So to me, that’s either going to be her SLP or her bcba? So when I go in here and I look at her education, I see her SLP, I see some other things here, but I don’t see like training or education specifically tied to her bcba.
Deanna Purchiaroni (30:05) Got it. Okay. Yeah.
Vanessa Persha (30:08) And then let’s see what else? And so,
Deanna Purchiaroni (30:11) that’s what’s holding up those licenses is because those, yeah. Okay.
Vanessa Persha (30:15) Yeah, it looks like your professional diploma or transcript, graduate certificate in behavior analysis. Yeah. So it looks like they were able to pull from somewhere that it’s related to a university of north Texas institution, but we just don’t have it on file.
Deanna Purchiaroni (30:34) And.
Vanessa Persha (30:34) then, licenses.
Deanna Purchiaroni (30:35) Under the request, like when it shows that it’s on hold, do you see under notes that there’s like a description or reason for why it’s on hold or you just are assuming that it’s because this, her profile is missing things?
Vanessa Persha (30:52) Yeah. So if it actually like when it says needs client attention intake, there should be a task associated with it. If it’s just sitting in requested, then it’s not there’s not a particular task for it, but God, did I lose you?
Deanna Purchiaroni (31:15) No, I can still see you.
Vanessa Persha (31:16) Okay. Sorry, everything on my screen just froze if it’s just in requested, then to me, that means that something in the profile is missing that’s part of like the standard required information and they don’t task for that. Let’s see this one is in, I don’t see a task here for this, yeah.
Deanna Purchiaroni (31:38) And that’s what has kind of just been confusing me is I feel like I see this a lot, but there’s never a task. So, I’m like how do we know what is exactly needed to continue with this? Yeah.
Vanessa Persha (31:48) Yeah, nope, that’s a great call out. They have this here.
Vanessa Persha (32:00) I’m almost willing to bet that it’s this task here even.
Deanna Purchiaroni (32:04) Though that’s only for Texas.
Vanessa Persha (32:08) What is the she’s.
Deanna Purchiaroni (32:12) getting licensed in like every state, yeah, every state corticus.
Vanessa Persha (32:18) State licensure board, Washington. So it looks like for, do you guys have a request for Washington? No… for an account for her in Washington then I think.
Deanna Purchiaroni (32:33) She has a license there, but we aren’t we don’t have a clinic there. So we aren’t she’s.
Vanessa Persha (32:37) just like housing missing required license, state, California, that’s… interesting. I’m curious if.
Vanessa Persha (32:53) So, yes, her missing Texas diploma would impact the licenses you’re requesting in other states because it’s Texas… is just so happens where she completed her education, but that still needs to be provided on other applications out of state too. Yeah. Okay.
Deanna Purchiaroni (33:14) Okay. And I see that she’d love to note that she already requested them. So if we’ll get that soon, okay. Yeah, I’m sorry, I know we’re over time but that was all that I had. Okay. Awesome.
Vanessa Persha (33:28) I am spending the rest of my afternoon after this next call like digging through all of my outstanding emails and everything like that. So, if you have anything that’s overdue for me, expect a response here between today and Monday. All right. Awesome. Well, thank you, Tana. I hope you guys have a nice Easter and enjoy time with your family, thank.
Deanna Purchiaroni (33:52) You, you too. Have a good weekend, you?
Vanessa Persha (33:54) Too. Bye.