Transcript
Rheta Larson (00:00) hello? Hello? Hi there. How are you doing today? Good. How are you doing well? Thank you for asking. I hope y’all had a lovely Easter. We did to hear. How was yours? It was good. It wasn’t as eventful as I thought it would be, but got to catch up with immediate family and some friends. So that was that’s always good. Excellent. Let’s see. I know we just had our meeting last week on Friday. So this is our typical sync which I think y’all have been a part of a few times on Tuesdays at one to 145. And I just got an email regarding the time availability that works for you all this week, which would be tomorrow at 115. Yeah. Does that still work for you? It does. So, I can put the reserve on the calendar for like a hold and that way you can go through platform training perfect. But really, we still have this time. I don’t know if we’re waiting on anyone else from Salma’s side. Yeah, raunaq should be there. We go. Oh, didn’t see you had joined. Hello?
Raunaq Singh (01:20) Raunaq. How?
Rheta Larson (01:21) Are you?
Raunaq Singh (01:22) Good. How are you doing?
Rheta Larson (01:24) Well… okay. What I was explaining is I know we just sunk on Friday. So, I think the only follow up was the calendar times which y’all aligned on. So I’ll set that cal time for Wednesday and then for the medi cal group enrollment denial, I know we were waiting to hear back from Salma to see if y’all can call the broker and then determine the nuance for the Coi, like the address change? Do we have an update with that? Do you want us to proceed with resubmission?
Raunaq Singh (02:01) So, Malia wasn’t able to connect with medi cal because I think the wait was too long. She did confirm that the Coi was in the right format. I do believe that it’ll be helpful for us to get on a call with medi cal to understand why they specifically rejected. Can we please have an action item to get someone from medallion to call medi cal, like from your support team to understand what was the actual reason? And give them this context that the Coi does have all the information that was needed before we do a resubmission?
Rheta Larson (02:39) Okay. So I think what we can do is submit the rebuttal… or, the request to appeal. And that way we can get someone on their end to reach out to us and have a further conversation as to why they didn’t accept it the first time since it appears to be accurate from y’all’s end.
Rheta Larson (02:59) So I’ll proceed with the next stuff there and then have the team submit that this week. I don’t know if we’ll be able to do it before end of day today, but I meet with the team again on Thursday, so I should be able to have an update at least before end of week there. Raunaq, did you see Malia’s, message to us?
Raunaq Singh (03:19) Right now?
Rheta Larson (03:21) Yeah. About two minutes ago.
Raunaq Singh (03:25) Oh… okay. Looks like Malia has procured some additional documents which will take seven to 10 days. So, let’s hold off on the medical stuff. She just messaged us. So let’s not do anything on the appeal just yet. Okay? Yeah.
Rheta Larson (03:55) And when you say that she got the documents from the broker, like is that, was she able to?
Raunaq Singh (04:01) I have no idea. Okay. She’s out of office today, so she’s back tomorrow. We’ll check with her tomorrow and then let you know.
Rheta Larson (04:08) Sounds good. Yeah. Just give us the heads up and we can pull the trigger on our end for the appeal. Cool. All right. Other than that, was there anything else on y’all’s end? Y’all, want to flag chat or go through?
Raunaq Singh (04:28) Any word… from Jake? He?
Rheta Larson (04:33) Did reach out to me and mentioned that he texted you last week. Did you get a text from him?
Raunaq Singh (04:40) No. The last text I have from him is let’s see… March 20 fourth. Oh.
Rheta Larson (04:52) Goodness. He said on April third that he was going to text to see if you had time to chat. So that was April third at like four P. M. So let me four P. M my time.
Raunaq Singh (05:03) Two P. M. No, I don’t have anything from him after March 20 fourth.
Rheta Larson (05:09) Okay. Let me slack him really quickly. Let me just see if he and… I can check to see if he’s available now, maybe with the time remaining, if he can join?
Rheta Larson (05:40) Okay. I’ve reached out to him to see if he can potentially jump in. I don’t know if he has a conflict, but I can definitely have him text you today. If you haven’t heard from him. Yeah, I’ll keep you posted there while we have the time remaining. Maybe he reaches out during that time, but that was the last I heard from him is that he was going to reach out and set up time with you to chat live. Okay… perfect. I’m just going to add that to the agenda so that way I can stay on him for the credit conversation.
Raunaq Singh (06:19) Yeah, Nikki, do you want to check medallion portal and see if there are any outstanding tasks and maybe share your screen and walk us through what you understand and where we are on that?
Rheta Larson (06:31) Yeah. With the time remaining, I’m happy to kind of help drive some platform refreshers here now, before we meet tomorrow as well for that.
Niki Ohmer (06:47) Oh, it’s not letting me share. I just sent a request though, I guess so.
Raunaq Singh (06:53) Gotcha.
Raunaq Singh (06:58) Yeah, it’s incredible. Yeah. Okay. Awesome. Okay.
Niki Ohmer (07:01) Can you guys see that?
Niki Ohmer (07:02) Yeah. So all that I have done in here so far has been adding the insurance to a list of providers that Malia sent me last week. It was the blue cross. I think it was blue cross. She gave me a list of like eight names and I went through like she showed me all the steps and I went through and basically added, I guess this.
Raunaq Singh (07:32) Blue shield, right? Not blue cross. What was that, blue shield, right?
Karissa Weight (07:38) Yeah, I think.
Niki Ohmer (07:39) So I can actually, I still have the screenshot from where we took it, so that I could make sure I was doing it, right? And it was, yeah, blue shield of California.
Raunaq Singh (07:50) Perfect. And have you been checking these? Like, so these tasks and following up with Ian and others?
Niki Ohmer (07:57) So, she told me that I shouldn’t have to do anything once I submitted these requests.
Raunaq Singh (08:03) Yeah, no, that is different. So, blue shield is great. Like on this screen that you’re sharing right now, do you see all the pending tasks? So ideally all of these tasks should be, this should become zero. So, since there’s like eight tasks pending most of them, do you see assignees or admins? So our admins in this case, are you and Karissa?
Niki Ohmer (08:24) Okay. So.
Raunaq Singh (08:25) Ideally, like we look at what that request is and then follow up with the request with the provider that’s mentioned there on slack and get them to do whatever the request says. So if you open the first one?
Niki Ohmer (08:38) What are you clicking on? Oh, there we go.
Raunaq Singh (08:40) Yeah.
Karissa Weight (08:42) I actually did follow up on this one. I had doctor, I had follow up with dr Ahmed. Yeah, this Ian task was, I believe holding on this one for Molly’s feedback. And then I have the follow up with Andrew and completed that task. So one was a caqh social security number that needed to be re verified. Dr Mose was a sign off in medicare the pcos. Yeah. And then this one we were holding.
Raunaq Singh (09:15) Okay. Let’s move on to the next one then.
Niki Ohmer (09:17) Next one?
Niki Ohmer (09:24) Okay. So for this, you, I would just reach out to Sarah through slack and let her know that she has a task that is required to be completed in medallion? Yes.
Raunaq Singh (09:36) Okay. Follow up with her and I get her to do it basically, yeah.
Niki Ohmer (09:41) Is there like a link that I can send? Like am I able to, or do they, just, do they know automatically how to go in and do it?
Raunaq Singh (09:48) She should know how to do it, but you can just copy paste the description here. I think the, what she needs to sign is the link in blue below. So it should copy paste as is in this case.
Niki Ohmer (10:01) Okay, perfect. Yeah.
Raunaq Singh (10:03) But this appears in like this will appear in Sarah’s medallion portal as a task. So she should know that.
Karissa Weight (10:09) Okay. So, that request is similar to one that was in Joseph Tran’s queue… but that was actually specific to a contract that I don’t believe we’re going to be pursuing? Is there a way for us to know which is which raunaq as to which insurance… we’re not going to pursue? So I don’t send him on like a hunt and sign goose chase.
Raunaq Singh (10:35) I think it’s just like, yeah, I can give you a list right after the call. Okay?
Karissa Weight (10:42) Yeah. I was just wondering how you want us to do that? I’ve gotten in here a few times to see what was actionable, but I think others were related to applications that maybe we were holding on?
Raunaq Singh (10:53) Okay. So, yeah, the creator tries it. So then you can just like put a comment if you’re holding off on something, just put a comment. Okay? And so, for example, like the third one, if you, the second one is, yeah, sorry, the Sarah one we’re not holding off on. So please Nikki, you can go ahead and talk about it. Got it. This one. I just want.
Rheta Larson (11:16) To highlight really quickly, it’s not a provider. I don’t see a provider task assigned to her. So, when she logs in, if you direct her to do anything, she’s not going to see it because it’s just linked as an admin task. Do you all have the, I don’t know if this is a group like a, the authorization to sign off? It might have been that we created it in error and it should have been a provider task… but I think people.
Raunaq Singh (11:41) The provider needs to sign this, right?
Rheta Larson (11:45) They linked it as an admin. So, I’m assuming anyone can sign on Salma’s end, but let me flag this one to the team and see if they just need to flip it to the provider side. Additionally, this is time sensitive. So like it’s already expired, I can’t even like I need to request a new one. So, I’m just going to have them, I’m going to have them generate a new one, but I’ll alert.
Raunaq Singh (12:08) You when it’s done. Okay?
Rheta Larson (12:10) Thank you. Sorry. I don’t want you to like pinker, and she can’t.
Karissa Weight (12:12) if you click the link, Nikki, what does it open? Does it just open like a DocuSign? So you can kind of point her in the right direction? You guys?
Niki Ohmer (12:18) See that?
Karissa Weight (12:19) Okay. Yeah.
Raunaq Singh (12:20) Yeah, it’s expired. Okay?
Karissa Weight (12:23) Okay.
Raunaq Singh (12:23) So, Rheta, if you could please get us a new link and let us know whether it needs to be assigned to Sarah or us. Yes. So, Nikki, even if it is assigned to Sarah, I think we should still like follow up because like a lot of time clinicians are not opening up medallion to check. So, I guess like we should open it like twice a week at least and then basically just remember, remind them to do it.
Niki Ohmer (12:48) Yeah, I can select specific days to check it like if that’s helpful, like say days and Fridays or something like that.
Raunaq Singh (12:57) Yeah, yeah, just like, yeah, just space it out, right? Yeah, so.
Niki Ohmer (13:03) Is this Karissa, what you were talking about for the, we’re not going to be using payr. Yes. Yeah.
Raunaq Singh (13:11) Tri cities, we’re not doing. So, maybe just put a comment, you see bottom right as a note, just write a note there saying, please cancel all Tri city… requests. Oh, not Tri city. Sorry, this is don’t say Tri city, please, Claire?
Karissa Weight (13:27) Claire tev.
Raunaq Singh (13:28) Greater greater, Tri cities, ipa, just write full thing. Yeah.
Karissa Weight (13:33) Okay. And then Claire, tev is the one that we’re.
Niki Ohmer (13:36) not personally related to.
Raunaq Singh (13:37) Yes, ipa, you see it here? Yes, I.
Niki Ohmer (13:40) Just, I own a brewery. So I hear ipa and I’m like,
Karissa Weight (13:44) oh,
Raunaq Singh (13:44) wow.
Karissa Weight (13:45) Different kind, but that does sound good.
Raunaq Singh (13:50) Okay. Yes. And then you can put a comment and then mark this complete, so that this removes, this is removed from your queue.
Niki Ohmer (13:58) Okay. Was there anything after, please cancel all greater Tri cities ipa requests? Is that what you want me to put? Yeah.
Karissa Weight (14:05) Okay. And then post, I’ll put the same in here for Joseph and then mark.
Niki Ohmer (14:09) Complete, correct?
Raunaq Singh (14:10) Yes, yes. Yeah, perfect.
Rheta Larson (14:15) Take that action. Essentially, once you complete a task, Nikki and Karissa, for your knowledge, our team will get that notification back in their queue. So, whoever’s assigned to that, they typically will respond within 24 to 48 hours and action if it was done, and then mark it complete and just proceed with the request. If you all mark it and there’s still missing information or like the provider marks it because they don’t want to see the request anymore. Our team will just open it back up. And in the task, you can see the activity like the history of the back and forth that occurred. So it’ll take some getting used to as you action them, but I just wanted to call it out like we will review what you all put within 24 hours.
Niki Ohmer (15:00) Okay. And then in the case of like where there’s no like provider name on there.
Rheta Larson (15:06) Those are tied. You can see the open requests that it’s related to. So in this case, it’s going to be the group medicaid for center for neurohealth. So that one’s tied to not a provider enrollment, but a group enrollment.
Niki Ohmer (15:20) Okay. So, should I go ahead. Sorry, no.
Rheta Larson (15:23) I was going to say whenever you open these tasks, you should be able to see what it’s related to. If it’s a request that’s assigned to or a task that’s assigned to the request level, or if it’s like a provider profile, they are different, you can filter for that in the previous screen that you were into. But at least for this one, they’re just asking if you all can go in and sign that application. So.
Niki Ohmer (15:49) Would I reach out to Samira and ask… her to sign that in?
Raunaq Singh (15:56) This case, Nikki, this is a medicare request. So we’re holding off on medicaid right now. So you just don’t do anything in this one just yet. Yeah. But yes, you would have reached out to Samira on this one. Yeah. Do you see the one for Joseph Tran? Can you open that one? Yep? So that one is clarity.
Karissa Weight (16:21) So,
Raunaq Singh (16:22) yeah. So just awesome. And then close this. Please. This is done. Can I?
Rheta Larson (16:28) Get clarification there. Do you want us to mark that as an active and total or are you just holding on it for now?
Raunaq Singh (16:34) Just remove clarity and greater Tri cities ipa. We’re like not going to pursue those pairs?
Rheta Larson (16:42) For Joseph Tran, for all providers or for Joseph Tran?
Raunaq Singh (16:45) For all, I think, yeah, for all greater Tri cities, greater… Tri cities, ipa and clarity, those two. Okay?
Rheta Larson (16:55) I’ll go in and mark them or have the team mark them, and then we’ll stop the request. So we’re not doing work there. Thank.
Raunaq Singh (17:02) You… Nikki, do you want to just refresh this page?
Karissa Weight (17:13) Okay, perfect. I’m just making a note in that last one there.
Raunaq Singh (17:17) The first one, Karissa has already actioned on second one, we’re waiting for medallion third. We’re holding off fourth. We’re holding off the next one. Can we cancel clarity?
Karissa Weight (17:31) I just canceled it, Nikki. Okay.
Raunaq Singh (17:34) Okay. Awesome. And then the last one… also canceled, please just put a note.
Karissa Weight (17:45) So, is.
Niki Ohmer (17:46) that because this is the greater Tri cities?
Raunaq Singh (17:49) Correct. So we’re just, we’re not interested in that page.
Niki Ohmer (17:55) So, just put like not pursuing greater Tri cities ipa or not?
Raunaq Singh (18:00) Yes, just say, please cancel all greater Tri cities ipa requests.
Rheta Larson (18:07) I see that we have seven greater Tri cities ipa processing. I see Nathan child, Joseph, Tran, Bonnie monfils, Sarah, sanobari, flint, espel, Jill fleming, and then the group demographic. So all seven you want me to mark as stopped or inactive, correct?
Raunaq Singh (18:30) Sure. Yeah.
Rheta Larson (18:32) Okay. And then there’s one in needs attention, which is that Christopher ancho which you’re putting a note in. So I’ll mark that one too. So technically eight. Yeah. Okay. I’m going to pop a note in for myself so I can action that after the call and then I’ll put my notes in for greater Tri city should?
Niki Ohmer (18:53) I put, for Sarah, should I make a note there that says we’re waiting for medallion to send a new link? Yeah, or just leave it?
Raunaq Singh (18:59) Just put it there. Yeah. Okay. I,
Niki Ohmer (19:00) wasn’t sure if it was best to just go ahead and… yeah.
Rheta Larson (19:06) And I looped in the team on that one so they’ll respond directly to that thread and then we’ll switch it over to provider if we have to. If not, and it remains as admin, then y’all can sign it.
Niki Ohmer (19:15) And then, should I keep an eye on this? Because as soon as you guys send a link, then is it like I should go in and say something to Sarah? Okay?
Raunaq Singh (19:22) Yes, this, I think if you can check like every day or every other day just to see if there’s anything, and then just action on, that is basically, yeah.
Rheta Larson (19:34) Cool. So it looks like y’all have dwindled down the list to the four. Most of these were waiting on y’all’s, end or like holding I’ll action, the ones that are in review. So anything in review means that medallion now has gotten a response back from the client and we have that 24 to 48 hour to action and then move them appropriately. As I mentioned if we see something and it’s not accurate or we need clarity on we’ll move it back to an active status with you all. So then it prompts you to review it again. But this view is really great. All tasks will show you a list as an administrator of all open provider and administrative tasks. I always kind of show people the created filter there. We’ll show you how long ago these are created. So I would filter that and hit the ones that are oldest to newest, maybe just action it in that order moving forward… you can filter this down how you see fit. So if you want to filter for a particular test type, if you’re looking for a very specific task or just a specific provider, like let’s say you have like 10 for the same provider, you can filter this down. If you click on provider, you can just type in Brandon, and then it would pull all of his relevant requests. But that’s kind of like the all tasks providers don’t see this. They only see their tasks assigned to them in their profile. Y’all, have kind of the mass view for all of the organization. So if you ever need to like split the view, there’s the provider task at the top that’s going to show you a list of all open provider tasks which looks like there’s just the one out to Brandon. Admin tasks will be any ones that are specific to the administrators, meaning the admins, I mean, the providers might not have a task open or it might be duplicative where they have one. And we haven’t heard back. So then we test you to then kind of nudge them along. And we usually document that in the description. And then lastly expirables that’s kind of just an ongoing list of anything that’s in platform that has expired tied to the provider’s profile. So this is kind of a running list for you all if y’all need this internally or for any of the requests, our team will typically task and ask for it. But if y’all also pay attention to this, you can kind of nudge the providers to say, like, hey, your board cert is expired, please update a new one. So, on and so forth. But the overview task is really majority of where you’ll work out of. And as we get into kind of like a training session moving forward, I can show you how to action some of these things, how to look at the requests on the payer’s end. So the enrollment requests and then any analytics that y’all might need to pull, there’s specific reports, you can create that pull automatically. So instead of like having to filter all this each time, you can just have a running report pull each morning when you log on or however you see fit for your cadence. But do you have any other immediate questions here on the overview tab? Yeah, no… cool. I have my action items. I have the medi, cal, group enrollment. We’re going to wait for Malia to hear back from the additional documents. She said, she obtained credit conversation. I am waiting to hear back from Jake and I’ll have him reach out directly to you. I have not heard back as of yet. So he might have a conflict, but I’ll have him shoot you a text and then I’ll mark the requests that you all had flagged for greater Tri city ipa and claritive, am I missing anything there?
Rheta Larson (23:22) Okay. Once you hear back from Malia, just let me know if there’s anything we can do or if you just want us to proceed with the appeal to the payer. Awesome. Very good. Thank you. No problem. Anything else? I know we have a bit of a cushion.
Raunaq Singh (23:42) Nothing from me. Just waiting to hear back from Jake. It’s been, yeah… yeah.
Rheta Larson (23:49) We had a pretty extensive conversation last week, so I’m honestly surprised he didn’t reach out to you on Friday. I know he said he was going to, so I don’t know if that just fell off his radar or if I don’t know if it got filtered somewhere else, but I will make sure he reaches out to you today. Thank you. Yeah. Thanks for your patience and I hope you all have a lovely Tuesday. I will see you, Karissa and Nikki tomorrow and I’ll add anyone else’s optional. If y’all decide to join. Okay, perfect. Thank you. Bye bye.