Transcript
Sandhya Kapila (00:00) hello?
Sarah Melby (00:04) Hello?
Sandhya Kapila (00:15) Hello. How are you?
Sarah Melby (00:17) Good. How are you? I’m.
Sandhya Kapila (00:18) good. Thank you. How’s your week?
Sarah Melby (00:23) You know, just starting it’s going?
Sandhya Kapila (00:26) Okay, good. How was your week? Were you off last week?
Sarah Melby (00:29) I just had a couple days off.
Sandhya Kapila (00:31) Okay. Nice. Good. Well, I hope you had a good few days off.
Sarah Melby (00:38) Yep. I think Justin has to miss. He has a sick little one. So, I don’t think.
Sandhya Kapila (00:43) He.
Sarah Melby (00:44) is coming and I’m not actually sure if hilka is or not. Okay. That’s all good. That’s fine because she did have last week off. So, yeah.
Sandhya Kapila (00:54) She’s probably catching up.
Sarah Melby (00:56) Yes, I’m sure.
Sandhya Kapila (00:58) All right. Cool. Okay. So, I was actually just going to go through the platform training a little bit if that works. Yep. Okay. Perfect. Okay. Hold on one second. And I think, hilka,
Sarah Melby (01:15) just hello?
Sandhya Kapila (01:16) Hi. How are you?
Hilke Riechardt-Martinez (01:18) Good. How about you?
Sandhya Kapila (01:20) Good. Thank you. I hope you had a good week off.
Hilke Riechardt-Martinez (01:23) Yeah, it was very nice and the teams, they were busy bees, just walking away… which is great.
Sandhya Kapila (01:34) That’s nice. Good. Well, welcome back. All right. I’m going to go ahead and share my screen. Give me a second.
Sandhya Kapila (01:52) Sure.
Sandhya Kapila (01:58) One, here we go. Can you all see my screen?
Sarah Melby (02:05) I can. Okay.
Sandhya Kapila (02:07) Great. Okay. Sounds good. Okay. So I think what we’ll start with is, and I know Sarah, you’ve been in the platform a little bit, so you’ve seen a little bit about it, but we’ll just go through a few of these tabs on the left hand side.
Sandhya Kapila (02:29) Yeah, we’ll just walk through all of these sections here. So we’re going to go ahead and get started. I’m sure you’ve already seen on the top, right? This is where you have your profile info. You can go into your profile. This may look funny because when I went in before, yeah, you can edit your name here. I’m in the medallion staff account. So you can edit your name here if you want to. If there’s an email address that you need to change here, you can do that from here as well. But the, one of the core pieces here is email preferences. This is where you can toggle on and off the emails that you want to receive or whoever the user is here wants to receive. You can easily toggle those on and off. Yeah. And then just, I don’t even think you need to say that. Yeah, the ones that you see on my screen are general. So you don’t have part analysis. You wouldn’t get, you wouldn’t see that, ongoing monitoring. You wouldn’t see that either. So you’d only see the ones that are relevant to you. Okay. So the next thing that we want to go into is members. So members is probably more important for you right now is as you add new folks to canvas to the platform, this is where you can invite them to the platform. You’ll see here that we added quite a few providers and we did not invite them yet because we’re not ready to do that yet. But once we do on our end, what we’ll do, we can run a bulk invite. And so it will go out to them in bulk. We’re not going to have to go in and invite them one by one. So, but when you do have new members that you want to invite, you just click into the invite members button here and input their email address, first name, last name, their estimated start date and their profession. And so you can just choose that from a drop down here.
Sarah Melby (04:24) If you’re.
Sandhya Kapila (04:25) ready to invite them right away, you can send them the invitation email and it’ll go out to them. You want to make sure that it hasn’t gone to spam because that happens sometimes and they can check there too if they say that they haven’t received the invite. If you would like to do work in their account prior to inviting them, then just deselect the send invitation email and then add member. Okay. At that point, when we were looking at those, the three dots on the side where it said invite member, when you’re ready to do that, then you can go ahead and invite them.
Sandhya Kapila (04:55) Okay? So there’s three there’s you know, three core rules. So the provider role for our providers, the admin role, which I’ve set you and Justin up with. And so that’s pretty straightforward email, first name, last name, these admins have access to everything, making updates to providers… sending out enrollment requests. And then the third one here is the auditor role. This is just view only so they can’t make any updates, any requests. They can’t do any of that. But they can take a look at into, you know, the platform and see what’s going on.
Sarah Melby (05:32) Okay. One question about that, yep, like when a provider logs in, they can only see themselves correct? Unless they are provider and admin.
Sandhya Kapila (05:41) Correct. Exactly. Okay.
Sarah Melby (05:43) So, like some of the supervisors may not want to see all the providers, how would we make that happen?
Sandhya Kapila (05:50) Yeah. So we could actually set them up as team managers. Okay? And so we can, we’ll be able to create a new team? Okay? And then you can let me know… who reports to which team manager, and we can set it up that way. And then what I can do is I can do that once or I could do it, you know, if you already have a list, we can do that on our end. But what I can alternatively do is set it up once and like show you how to do it and then you’ll have clarity into how to do it yourself as well.
Sarah Melby (06:24) Okay. Cool. That sounds good. And then like for our intake team to know who’s credentialed with who, what would we set them up as, just like an auditor, so they can see the list of everyone. We just don’t want them seeing personal data or do we, is… there reports that we can send weekly with? Who’s credentialed with? Who?
Sandhya Kapila (06:49) Yeah, you could send, we can set it up to send weekly reports to specific people. I think, I’ll double check into that and how we can do that. Yeah, I can double check and see how we can do that. And so, can you talk to me a little bit more about those folks?
Sarah Melby (07:05) Yeah. So we just have a centralized intake and they take care of all of our providers in the agency, and they set them up with the clients based on which insurance they’re currently credentialed with typically. So they just like to see kind of a general overview roster, okay? Of all providers. Okay.
Sandhya Kapila (07:27) Great. And they don’t you don’t want them to see specific information about the providers?
Sarah Melby (07:33) Right. Like their dates of birth, their home addresses, all of that. They obviously do not need to see any of that. It’s really just the provider and who they’re credentialed with. Okay. Who they’re active with currently for payers?
Sandhya Kapila (07:46) Perfect. Okay. I can follow up. There is a report builder as well. Okay? So we can… I can take a look and we can figure out how to create a report specifically for them.
Sarah Melby (07:57) Okay. Thank you. Cool.
Sandhya Kapila (07:59) Of course. Okay. I’m just going to go quickly back to the members tab just to show that if for some reason a member needs to be deactivated if they’re no longer with canvas, you can do that here. But before you deactivate the, before you deactivate the member, you’ll want to go into their profile… are you seeing the screen as well? I am okay. You went to Anne’s profile. Okay? So then you’ll want to go to, I think it’s professional info. Yeah, termination date. You’ll want to edit, add their termination date first and then go back to the member tab and deactivate them. And so when we deactivate them, it’s not deleting them from the system. It’s essentially just deactivating them. So if they come back, their information will still be, we’ll be able to reactivate them. And then their information will still be available. Okay? And then any requests that we have pending with them, you know, when they’re deactivated, all that stops. And then when we reactivate them, it’ll start up again. Okay. Perfect. Cool. Yes. All right. So we’ll go into the overview step right now. Your tab is empty here. But once we have requests coming in, there’s a few buckets here. There’s the all tasks bucket which is provider tasks and admin tasks. You as an admin will have access to see all of the tasks. Provider tasks are just the tasks filtered out by provider. And then the admin tasks are tasks specifically for admins. As you have tasks in here, they’ll be in a few different buckets. They’ll be either ready. So tasks that the medallion team has worked on, but they need work, they need some follow up from you. And so they’ll be placed in the ready. Tasks. You can go through those tasks, complete them and then mark them as complete. Then they’ll go back. They’ll go into the in review bucket which then goes to the medallion team to review to ensure that anything that they need outstanding has actually been completed and is ready for them to process. Once they’ve completed it. It’ll go into the completed bucket. Okay? And once we have data in there, we can go through it. And so you can see for your workflow what that’s going to look like. And then this expirables tab gives you a list of anything that’s expired right now or coming up.
Sandhya Kapila (10:32) So 30 60 90 days, you can filter it and see anything that’s coming up to be expired within the next 30. Days… 60 90. I did see a few that were already I.
Sarah Melby (10:45) Did too. Yeah. So.
Sandhya Kapila (10:46) There’s four here that are already expired. So these are going to need some updates from those specific providers.
Sarah Melby (10:53) Okay. And do we, so if we update it in here, will that update caqh automatically or do we update it in caqh to come into here?
Sandhya Kapila (11:02) Not yet. So we do have, you do have the caqh management with us, so I need to turn that on. So when I turn that on, then if you update it here, then it will update there as well. Okay?
Sarah Melby (11:14) For these expired ones currently, are you, should I do it in medallion then? So when it is turned on or do you want me still to do it in both?
Sandhya Kapila (11:26) I mean,
Sarah Melby (11:28) I just don’t know what way it feeds like if you go out all the time or they come in like.
Sandhya Kapila (11:33) Nico, do you have an answer to that? Do you know for caqh management? Because they canvas has cqh management and I haven’t enabled it yet.
Niko Byron (11:46) Sorry, can you repeat the question? I was, I missed the first part of it. I’m.
Sarah Melby (11:50) just wondering like, do you want me updating this in medallion only? Or should I be doing it in both until we are live in caqh and medallion?
Niko Byron (12:00) Well, once it’s caqh maybe makes the most sense because like it’ll import from there once it’s enabled, no matter what, but I think either or would work but, you know, it’ll be the least moving pieces that way.
Sarah Melby (12:14) Okay. That sounds good. Thank you. Okay.
Sandhya Kapila (12:22) All right. So then excuse me, we can go through the provider directory. So once you click on, have you taken a look at this one already? Yeah, I.
Sarah Melby (12:30) have I’ve been poking around so?
Sandhya Kapila (12:33) Perfect. Yeah. And so you’ll notice Anne, we don’t ever see a QH number yet. So hers is 38 percent or 23 percent complete. There’s still some info missing. But for these other folks that… where we were able to pull in their data, you can take a look into this little circle here and it’ll tell you exactly, you know, percentage oops, percentage complete for their profile, what’s missing?
Sandhya Kapila (12:59) And you can click in there… and it’ll give you kind of exactly what you need to update. Okay. Yeah. Anything with the green checkboxes means that that’s, good to go anything missing in the checkboxes. Those are the specific areas where we need updates. And the nice thing about this is it will give you a little indicator as to what is missing. Okay. Yeah… from the provider’s profile, yeah, you can take a look and go through each of these different subtabs and make those updates. You’ll be able to see any existing licenses that we have for them, the practices that they’re associated with. Once we have the payers in there, it’ll have the payer list, enrollment requests, and then any current enrollments. This note section, this is something that you can either use to add notes for a provider. Either you can do it. And then our team will also use this section to add notes, any notes that they want to send out to providers. Okay? And so the email preferences, similar to what we looked at earlier, this is specific to the provider. So they can go in here and edit their email preferences, or they may reach out to you and ask you to update their preferences, but this is where you can go and do that. Okay? Would there be any reason where you would not want them to receive any email notifications?
Sarah Melby (14:43) No, not. As of now. Okay. We would like them to see as much as there will be. Once we get going like that when she’s not, she’s only like 78 percent done. I won’t want her getting notification that her profile is incomplete if it was something we missed on our end. Sure. Okay. Sounds good.
Sandhya Kapila (15:08) And so they’ll also have access. When they log in, they’ll have access to their overview tab. So they’ll be able to see exactly what needs to be done. Okay, great. Okay. So this groups profile is similar to the provider, but specifically for the group, you’ve seen this one already because you’ve completed it 100 percent. So this is where you’d be able to make updates to the profile. Yeah, I got an error here. Not sure what that is. I have to look into that. Okay… providers, your list of providers practices… from this practices tab as well. For those that are not complete, you’ll be able to see here which ones are not complete, what info is missing and then what needs to be added yep.
Sarah Melby (15:58) And I am working on those. We just need to combine a few more license PDFS… for you since we have multiple license at locations, perfect.
Sandhya Kapila (16:07) Okay. Sounds good. And then similar to the payers that we talked about before, and this is where I was talking about the caqh management. Once we have the caqh management piece turned on, you’ll see information in here too. Okay? Yep… licenses. Just another way of seeing this. Any new license requests that you put in will be shown here. Our existing licenses are here… pay enrollment. We’ll have a separate session specifically on pay enrollments. We talked about this already, but just to give you just to give you an insight… into this tab, the analytics tab. All right. So on the analytics tab, you’re going to have a number of different analytics reports that you’re going to be able to see here. So you’ll be able to see any in progress requests that are coming in, just details about those. Any requests that have already been completed, you can filter that out by month… turnaround times, how long it’s actually taken for our enrollments to be completed? Again? Average. And then by month… payr, you’ll be able to see it by payr, state. So these widgets will be filled out. But just to show you what you’ll have access to. Okay, thank you. And then report builder, you can, you know, if you have deactivated providers, for example, you can create a report and,
Dreama Hembree (17:45) see just.
Sandhya Kapila (17:47) Get information on when they were created and, you know, just any, pretty much anything we’ll create a report, we’ll build it. This has nothing in it right now because we don’t have any deactivated users, but you’ll be able to export that report or save it. And so you can just kind of go into saved reports instead of recreating the report over and over again and you’ll have that information here. Okay? Let me just make sure.
Sandhya Kapila (18:19) Any questions?
Sarah Melby (18:21) No, not really. I mean, I’m sure there will be some, once everything’s up and rolling, but it’s pretty self explanatory, honestly, it’s pretty easy to navigate through as far as an admin so far.
Sandhya Kapila (18:33) Perfect. Yep. Okay. Wonderful. Cool. Yeah, if there are any questions. And as we get more data in here, we’ll be able to go through it in more detail and show you exactly specific, especially like with the reports and the request piece, the payer side and the request side of things, I think it’ll help a lot more when you see your data in there.
Sarah Melby (18:54) Right. Yeah, great. Cool. Okay. What else are you waiting for me on the practice? The provider enrollments are pretty much up to date. Okay? So those can be completed. I did do the group enrollment tab. I’m not sure if I did it correctly. I know we talked about last week that.
Sarah Melby (19:21) I didn’t necessarily. I still did one for each site. So it’s like blue cross. I have listed nine or 10 times because of our, that’s how many locations we are, but basically every location we work with per payer. So I just duplicated all that information. So I put nine or 10 blue crosses, nine or 10 health partners. Okay?
Sandhya Kapila (19:48) I’m just looking at it right now. Sorry, let me get it. Oh, okay.
Sandhya Kapila (20:12) Is this the one?
Sarah Melby (20:14) Yes. So the billing address is all the same, but then the practice address is what’s different on each one?
Sandhya Kapila (20:20) Perfect. Yeah, I think this will be good. I’ll take a, I’ll take a look at it today. Yeah, reach out with any questions. Okay. Yeah. And then, and the provider enrollments you said are in a good spot too, and this just carries down, right?
Sarah Melby (20:36) It does. Yeah, perfect. Great.
Sandhya Kapila (20:41) And then any that are missing, should we just mark them as na?
Sarah Melby (20:49) That’s because we had those on rosters. Let me, I don’t… give me one more day to ask her about the updated roster and see if we have one from Aetna or carillon.
Sandhya Kapila (21:03) Okay. If.
Sarah Melby (21:04) that’s okay with you before now that I’m looking at it that it’s all highlighted. Yep, of course. But yes, for the reval dates for sure, can be currently na, until I get actual reval dates on some of these. Okay? That’s good.
Sandhya Kapila (21:22) Just looking at and for the payor id, do you have that information we?
Sarah Melby (21:30) Don’t most of our payors don’t give us payor ids. So, I wasn’t sure what you were wanting on that?
Sandhya Kapila (21:37) Okay. Yeah, it’s actually Dreama.
Sarah Melby (21:40) Do you, it says required, but I don’t know what a payor id necessarily is. So.
Dreama Hembree (21:46) The trading partner id, it was, it’s what you would use to talk to your clearinghouse and the payer?
Sarah Melby (21:53) Or just our Edi for each of them?
Dreama Hembree (21:56) Yeah, it’s if you ask the billing department for the trading partner id, they’ll know what you mean?
Sarah Melby (22:03) Well, I am the billing department and I don’t know what I’m sorry, no, that’s okay. We call it our electronic or Edi?
Dreama Hembree (22:10) Edi number. Yeah, it’s commonly referred to that. So some people refer to it as different, yeah, but it’s I,
Sarah Melby (22:17) just wanted to make sure. So, okay. So I’ll be the same based on payor then, but yes.
Dreama Hembree (22:23) Okay. Yeah, it should be the same across the payor. It shouldn’t differentiate like per line of business or anything like that. Okay?
Sarah Melby (22:32) So, yes, I can get that filled out as well. Then. And then they do not have individual provider ids that just goes off their mpis, okay?
Sarah Melby (22:46) And.
Sandhya Kapila (22:46) then enrollment method, it looks like this is also required. Okay?
Sandhya Kapila (22:56) Oh, and then we would need their lines of business.
Sarah Melby (22:59) Okay. Yeah. Okay. So, I will work on that today then.
Sandhya Kapila (23:06) Cool. Thank you. Awesome. And then Dreama, I just want to shoot it over back to you. Do you have any questions? Anything you wanted to talk to Sarah about in terms of the payor scoping I.
Dreama Hembree (23:21) need to look at it again. I think we were just waiting on that updated carelon roster?
Sarah Melby (23:27) I did send one last week that was still the older one, but we can go ahead with that one we’re going to go ahead with.
Dreama Hembree (23:35) That one. Okay. So let me look at that one. And then I’ll circle back with any questions that I have. When do we have the payor scope? Do we have the payor scoping meeting?
Sandhya Kapila (23:45) Scheduled yet, Sandhya, we don’t we can have another, we can schedule some time. Maybe we can do it actually because I think we still have our meeting on Friday. Well, Sarah, so let’s use that time. Do you want?
Dreama Hembree (23:57) Me to, okay. I’ll get ready for that then for Friday. So, Sarah, we’ll just go over kind of line by line, what your process is for enrollment and compare it to ours to make sure that we’re on the same page and we don’t need to call out anything custom or specific to the team in terms of submitting. Your enrollments.
Sandhya Kapila (24:16) Okay. That works. And.
Sarah Melby (24:20) In that one, I will have Wendy our credentialing specialist in since she does the majority of the enrollments. So I do not miss anything.
Dreama Hembree (24:26) For you. Okay. Yep. Awesome.
Sandhya Kapila (24:30) That is great. And I’m actually just checking to see. Okay, that sounds great. Do you all, in case we, I… don’t actually, Gemma, do you think we have enough to go through that?
Dreama Hembree (24:49) I’m looking at the rest right now. So pretty much all of them are standard. Can you scroll over to, that one? So I can just kind of where… it says non standard enrollment? Like, I think, yeah, that yep.
Sarah Melby (25:07) And I know we talked about this a little bit. I think they’re just.
Dreama Hembree (25:10) One that she has marked as not yes to non standard, which is that commercial and edp one. So we would need to look at, yeah, I think 30 minutes is going to be, is going to be perfect. Do you have delegated payers? Sarah? Sorry, I’m not looking at it right now. No. Okay. Yeah, 30 minutes is enough. Sandhya?
Sandhya Kapila (25:30) Okay, perfect. And then for any other like non payer specific information, if I need anything, I will follow up with you, Sarah this week so that we can focus that time on Friday on the payer piece.
Sarah Melby (25:45) Okay. That sounds great. Awesome.
Sandhya Kapila (25:47) Thank you guys so much.
Sarah Melby (25:48) Thank you all.
Sandhya Kapila (25:50) Right. Have a wonderful rest of your week.
Dreama Hembree (25:51) You too. Thanks.
Sarah Melby (25:53) Bye bye.