Transcript
Kimberly A Harberts (00:00) good morning.
Kimberly A Harberts (01:13) Hey, Kim. Hello. How are you doing?
Rae Tompkins (01:18) Good. How are you? I’m.
Kimberly A Harberts (01:20) doing good. Thank you. How’s your va, you’re on vacation, right?
Rae Tompkins (01:27) Yes, we went to disney. It was, it was fun.
Kimberly A Harberts (01:30) That’s good. Was it really busy? It?
Rae Tompkins (01:33) Was a little crowded. Yeah. How.
Kimberly A Harberts (01:37) old are your kids or don’t? You have any kids?
Rae Tompkins (01:40) No, they’re four and five. So.
Kimberly A Harberts (01:42) Okay. So they enjoyed the pool a lot huh?
Rae Tompkins (01:46) Yeah, we skipped the long lines and just went to the shorter ones which they didn’t seem to mind. So sounds good. Yeah, perfect. Alrighty. I think we’re just missing Anna and Ashley, are they out of the office?
Kimberly A Harberts (02:03) Ashley’s coming and Anna is still out today. She’ll be back tomorrow, so.
Rae Tompkins (02:09) Perfect. Alrighty. Well, I think we have everyone on our side today, so we can go ahead and get started. The first agenda item that Anna had sent over prior to her being on pto was just a follow up on the metrics emails that was sent from Connie.
Rae Tompkins (02:23) I apologize. We haven’t had a chance to respond to those yet, Connie, but we have been looking at them internally to kind of come up with the best solution to getting our metrics to match more closely to what optum is seeing on their side. And I did want to call out based on the more recent email that was sent over regarding the file statuses. So we do only have two options as far as marching or, you know, the file statuses just being needs attention and clear. So, I know one of the providers that you had sent over was Carly Kramer. In this instance, the provider was missing a Coi. So we marked the file archived, no response or non responsive provider, and the file status was marked needs attention. So kind of want to continue the conversations there to kind of see how we can closely align the numbers you’re seeing on our end to our side since we’re just mapping those file statuses when archiving obviously needs attention or clear is what the files are marked out. But those archived reasons are the more appropriate… way of mapping.
Ashley M Frick (03:31) I just have a question, don’t you have an incomplete status?
Niko Byron (03:36) We do.
Ashley M Frick (03:39) So, I think for that one, our expectation would be it’s incomplete because something is missing. So maybe that’s where the gap is… yeah.
Niko Byron (03:50) I think that is like probably where some of the gap is because in a lot of cases, they do come back incomplete if it is archived for a non responsive provider. So that is something we’re trying to look at on our end is if there is, I think when the agent goes in is what we were looking at and like makes an adjustment, we weren’t sure there was a way for them to leave it complete. So their only option was to mark it needs attention. And if it was like the last verification, usually they just stop when they hit a point that like there’s a non responsive provider, right? Essentially, and that would leave the file incomplete because that was like the last verification they attempted to do. But if they, if it’s the like last one that is the last required verification, the file status is automatically set to needs attention as opposed to like incomplete if that makes sense. So there are some things we could look at on our end but I think we could also like potentially like on your end if it is an archived file for one of the reasons that either puts it in the missing information bucket or the no app complete bucket which I think your it team is currently mapping, maybe just ignoring the credentialing status in those cases instead of like including it in the mapping makes sense as well.
Ashley M Frick (05:08) Yeah. I think the issue here is we have different teams working a clean versus a needs attention versus an incomplete. So it gets to the wrong teams and that also affects the numbers. I think that’s why. And again, I don’t know, I only slightly heard the name of this provider in the situation, but from what I was hearing, I think that’s why now it seems like we’re getting closer on numbers, but we’re not quite there. I think these situations might be creating those kind of gaps that we’re still seeing where it’s like we’re close, but there’s still some discrepancy. Yeah.
Niko Byron (05:49) And I think that like… I guess from the optum side of things, maybe this is more of a question from the it team is like the only thing that determines whether a file goes into that missing information or no app, complete bucket. Like it seemed like it was just, they were all subsets of our archived reasons. Basically. I guess, is that correct? That’s.
Rae Tompkins (06:11) good. Yeah.
Niko Byron (06:12) So then I think that is the mapping for that. Does it look at credentialing status at all? Does it say, like does it look to make sure it’s incomplete or not needs attention or something along those lines? Yeah, it.
Rae Tompkins (06:25) Does, yeah, it does. I.
Niko Byron (06:26) Think if like to route it to the right team, like at least in the immediate term, if it just says any file that’s archived with the right status, reason, ignoring credentialing status, will get it into the right bucket on the optum side even if it’s not incomplete and it’s it needs attention. I guess the one issue that we might need to still look at further, go ahead.
Ashley M Frick (06:48) No.
Kimberly A Harberts (06:48) I’m sorry, it’s a little concerning. It seems like you guys need to define what you’re sending over and what statuses you’re using. I just am concerned because we’re trying to automate and drive our inventory and it seems like we’re making it more gray. Again. I just, I’m concerned about the quality if we keep changing the status as we were very clear and we went through exactly what you guys gave us. And so how long is it going to take you to fix this?
Rae Tompkins (07:25) I mean.
Kimberly A Harberts (07:25) Because you really should, I mean, incomplete is missing information. You really should have a missing information, needs attention, really is something that doesn’t meet the requirements. Has sanction has something wrong with it, you know, that’s what, you know, we trigger or identify something that needs attention. Archived again… can be incomplete. But like I said, it just seems like… we keep changing the definitions of what we’re and what we’re crosswalking. I just get concerned that we keep crosswalking… we have inventory, lots of inventory in current statuses. Right, now, we’re supposed to change it again. Ashley your thoughts on it? I guess.
Ashley M Frick (08:15) I don’t know again. Could you tell me what the file name is? I’m sorry, it’s hard to do something that I don’t know who I’m talking about?
Rae Tompkins (08:24) Carly, Kramer was the example that Connie had sent over last week?
Rae Tompkins (08:33) I didn’t pull up this email from Connie?
Ashley M Frick (08:36) I mean, my… ask is that we align to how we have mapped everything and what our expectation was. A clean file is clean, a needs attention file is everything’s there. But something was found like Kim was saying either whether you guys use incomplete or if you move to a missing information status, but that should be your kind of other option because we need to be able to know at a quick glance. Okay, all of these are missing something, you know, and something wasn’t complete versus we did everything. But there’s discipline or, you know, whatever the issue is, we notice an issue that’s really where we need to go to. And I think if we get to that point, the numbers are going to follow and we’re all going to be spending a whole lot less time trying to manipulate reports to get everything aligned, if that makes sense? Because those are really the only three buckets and that would align with the number expectations as well for the metrics. So I think if we can get there, it’s going to be cleaner for all parties and.
Kimberly A Harberts (09:43) the crosswalks are defined. And so they’re going into the right buckets. There’s no gray. We know this is going here here and here. And it concerns me when you’re saying disregard something because there’s reasons that statuses are in place and we’ve already coded for what is in place. We just need to your team just needs to define and get the inventory in the right three buckets. I think. Okay.
Niko Byron (10:12) Yeah. Fair enough. If we’re expecting that to come back incomplete every time and that’s like that makes sense. I hear what you guys are saying. So let’s Rae, you and I will we’ll sync with Yanni about this and we’ll try to get a solution on the books here.
Rae Tompkins (10:26) Absolutely. Thank you in regards to this example, particularly the malpractice insurance records. We did identify that. A lot of the sorry thing is right in the way… one of the prime examples of the ones that were sent over for incomplete files was that missing Coi? And I wanted to confirm with the optum team. Does optum require the Coi to be on file or is the information provided via caqh sufficient… that was more of an operational ask just based off the examples that were provided? OK?
Kimberly A Harberts (11:02) A couple of things concerning that we’re having this conversation now because we provided all the information, we can use the caqh attestation… page from caqh except for specific states that we’ve identified?
Rae Tompkins (11:19) And I didn’t look into this particular file as an example. We just saw that this particular file, Carly Kramer was being held up for a Nevada Coi. So I just wanted to confirm and I’ll go back and look at previous calls and notes to confirm that our operations team has the information they need.
Kimberly A Harberts (11:38) Because for Nevada, we don’t need a hard copy of the Coi, right? Connie, I can’t remember at the top of my head right now, sorry, which states, but I know that.
Rae Tompkins (11:49) Is not one.
Kimberly A Harberts (11:52) We don’t get that many files for Nevada quite honestly. So, yes, we provided all the information is on that state’s requirement grid we provided.
Kimberly A Harberts (12:05) I think back in July and August. So if you don’t have that information again, Anna can send it to you again when she gets back tomorrow, but I’d be concerned if you don’t have it, then we probably need to connect again and see what else we need to review again.
Rae Tompkins (12:27) Yeah, absolutely. I’ll reconfirm with our operations team that the expectations are set. If it was previously provided, we should have it on file. So I’ll definitely make sure that that’s resolved internally. Any additional questions on metrics, we’ll connect with Yenny, as Nico mentioned to make sure that incomplete file status is being utilized appropriately. And then I’ll get over this week’s numbers as soon as possible, just kind of playing catch up after being out of the office, but I’ll make sure to get them over so that we can have another set to kind of reference as we’re cleaning up these numbers.
Rae Tompkins (13:06) Okay.
Rae Tompkins (13:07) The next item was to discuss the packet update response from Ray’s 324 email. So that was in regards to the checklist update timeline, we’d allocated time in Q4 to address the initial changes that were proposed. But with the additional requests that came at the end of the year, we had to prioritize them against other credentialing work we had planned, we are able to… you know, initially do the initial set of changes that were scoped for Q4 and we can activate them at any point. But for the broader list of requests, it’s not on our active product roadmap. But we wanted to see the feedback from optum.
Kimberly A Harberts (13:47) I apologize. I have, I was out of the office a little bit too.
Kimberly A Harberts (13:52) Did you send an email with that with the list of items to prioritize? And what we need to add to that priority list?
Rae Tompkins (14:01) Did you send that over? I think Stephanie sent that last week, yes.
Kimberly A Harberts (14:04) Okay. I’ll look for it because we’ll probably put it in there and put it as what our priority is with it. Okay?
Rae Tompkins (14:14) Yeah, absolutely. We’ll circle back once that’s received.
Kimberly A Harberts (14:17) Okay. Thank you. Perfect.
Rae Tompkins (14:20) And then number three possibility of license crosswalk, assuming based on the previous feedback, the more than likely would be something that we add to that priority list that we can work to bring together or were there any questions on that? Yes?
Kimberly A Harberts (14:34) We’re almost done, but there’s specific license types that we’d like to make a priority if we can, because they have the biggest impact to the crosswalk and the inventory that’s coming into Salesforce?
Rae Tompkins (14:48) Okay. Can you share that list via email so I can get it in front of our teams to prioritize?
Kimberly A Harberts (14:54) Yes, we can do that. I think we have a meeting tomorrow or Thursday, and then we’ll get that over to you. Okay?
Rae Tompkins (15:01) Perfect. Yeah, that’d be great. And then there was just a note to review the email from form one about the priorities on our 324 meeting. I know there was a lot of information on that email. So I kind of just wanted to keep the optum team up to date with all the things that we had discussed. But were there any specific call outs here that I can help clarify?
Kimberly A Harberts (15:24) No. So these are on the calendar right now and then are these honestly? And we have the other priority list from that Stephanie sent over. So I think we just need to look at this and that, and then you can have an action plan going forward. Perfect.
Rae Tompkins (15:44) Yeah. If there’s any questions, just let me know. I’m happy to clarify… any items. I know Khushi you had sent over an email that you wanted to do some testing?
Khushi Soni (15:57) Right. Thanks, Ray. Yeah. So this is about the email that Nico had sent earlier. So we recently had our code refactored and because of that, we had some issues a rise in production, but we fixed those and we just wanted to check that if it’s working fine or not, can we do a little uat in a low environment to see if it’s still taking intake and progress pre cred files?
Niko Byron (16:32) Sorry, I was muted. Yeah, we can definitely do that. Is there a specific record you wanted me to re trigger or did you want me to create a re cred and see if it comes into intake?
Khushi Soni (16:42) Oh, the latter would work, I mean, if you want. Yeah.
Niko Byron (16:47) Yeah, I’ll try to kick one off right now, here. You guys can keep talking about other things while I mess around in the background here.
Rae Tompkins (16:57) Yeah. On the optumops side, was there anything additional we had questions about or anything I can help with?
Rae Tompkins (17:09) I believe so. Thanks.
Kimberly A Harberts (17:10) Ashley Connie anything for you?
Rae Tompkins (17:17) No, I’m good, right?
Niko Byron (17:18) Now.
Kimberly A Harberts (17:18) Okay. Thank you… Rae. I’m like you, I was out for a couple days, so I need to dig back in and level set.
Ashley M Frick (17:27) Yeah, I think what they’re testing right now is the only thing that we identified since Ana would have sent out that email of topics. So this was the only issue we were really having this week.
Kimberly A Harberts (17:39) Okay. Thank you.
Rae Tompkins (17:42) Sorry, Nico, we all just have to sit and wait for you to do your thing.
Kimberly A Harberts (17:47) No.
Niko Byron (17:47) Worries… just put some random stuff here.
Niko Byron (18:02) Okay. I believe this should create one for us.
Khushi Soni (18:09) Yeah. Can you send me the npi so that I can open the record?
Rae Tompkins (18:11) Yeah, I’ll.
Niko Byron (18:12) send you the data in a second as well. Let me just make sure I’ve made one. It might take a little bit of time just to go into, I think it goes into schedule rather than like I’m like the 30 second minute of every hour. We have a job that moves them. So it might take a little bit of time, but this is the npi that I am using here. I did.
Khushi Soni (18:35) A little stimulation on my end as well using postman, so it was working fine, but I just wanted to check with you. Yeah.
Niko Byron (18:47) So I just made that. I just made it scheduled to re cred for that provider for may 30 first. So it should be within the re, cred period. It should actually create the recreate request. I guess my only, the only potential issue is if we’ve it looks like there have been other, this provider has also been utilized for other credit requests. So hopefully, that doesn’t cause an issue. But if not, we can sync over email if you don’t receive this one in the next hour, just shoot me an email and we’ll solve it together.
Khushi Soni (19:22) Okay. I think that works right now. I have not gotten anything. Yeah.
Niko Byron (19:26) It’s still scheduled right now.
Niko Byron (19:27) It should, it should in like 20 minutes, I think is when you can expect it to have sent an intake in progress and I’ll keep an eye on this as well just to make sure because I can see if we get another 422 or a 500 or something like that. So, yeah, we’ll just keep an eye on this one. And if it doesn’t create, then we’ll know something’s wrong and we can sort it out. Okay?
Khushi Soni (19:50) That works. Okay. I’ll update the opt in team on email as well.
Niko Byron (19:55) Okay, cool. Thanks so much. Great.
Khushi Soni (19:58) Thanks, Kashi.
Rae Tompkins (19:59) Alrighty. Team. I think, oh, go ahead. Sorry.
Khushi Soni (20:02) Just one thing. So, Kim, Ashley, if this works out and I hope it does, then, can I deploy it today itself?
Kimberly A Harberts (20:17) I’m good with it. Ashley. Are you good with it?
Ashley M Frick (20:19) Yeah. Did, you cut off or at least for me at the end? Did you say, can you deploy it today? Is that correct? Yes. Yeah, yeah, definitely.
Niko Byron (20:28) And we’ll and Kashi, will you need us to re, trigger all of those 420 twos again so that they hopefully come through properly after that deploy? Yes, please. Okay. Yeah, I’ll make a ticket for that.
Khushi Soni (20:42) I’ll respond on the email if everything works fine, and then we can move ahead with the re, triggering. Sounds great. Thank you.
Rae Tompkins (20:53) Perfect. And Kim, I did confirm that priority list was sent on Friday. So as.
Kimberly A Harberts (20:58) the team is okay, perfect. I will check that out since I wasn’t here Friday. I need to look at Friday emails. So thank you.
Rae Tompkins (21:06) Alrighty. Well, I’ll be in touch as soon as possible. We are working on mapping that incomplete file status so that we can get our numbers closely aligned. And obviously, you know, cause some less abrasion on the optum side. So we make sure things are being assigned to the right team and the right status. And also, I’ll be in touch as soon as possible.
Khushi Soni (21:23) Thank you have.
Rae Tompkins (21:25) A good day, everyone. You too.
Ashley M Frick (21:26) Thanks, all. Bye. Thanks.
Khushi Soni (21:29) All bye bye.