Transcript
Nancy Rodriguez (00:00) good morning, Niccole. Can you hear me? Okay? Hey.
Niccole Russell (00:03) Good morning. Yes.
Nancy Rodriguez (00:04) I can. Oh, okay. They should be joining soon. Oh, hey, chendel. How are you? Chendel. How are you? Good. Okay. Jasmine is here all.
Niccole Russell (00:16) Right. Let me go ahead and share our agenda and we’ll get started there and we can have the remainder for any questions that you have. Okay. All right. So for tasks, we have overall 42 provider 29 admin, 13. Just speaking on this a little bit, I did add some comments to some admin tasks that were for provider signature. I let the team lead know once again that all signatures need to go to the provider, everything else would go to you. So I commented on that closed up and they should be reassigning that. And I asked for some of them that had notes to make sure those notes were still listed in the notes section. So we knew where, what action was taken for those… board cert, expirables. We don’t have any that are expiring within the next 30 days, payer enrollment requests. We have zero that are in a requested status processing. We have 153 and then need client attention. There are 74 for providers, outstanding tasks. There are 22… profile action required. There’s one for Sonia. She hasn’t signed her agreement yet profile zero to 84 percent. We have zero there. So we’re good. And then providers that have not signed into medallion yet, Verlaine Carter, Laura Ennis and Ken lamb. So just wanted to bring that stuff to your attention. So I will stop sharing now and we can go over. Let me move this back over here. We can go over any questions that you currently have.
Nancy Rodriguez (02:04) Okay. So, and then you can include this, what we’re going to tell you on your pre cap notes. Okay. Medicaid errors. We still continue to find several errors such as demographic instructions, mailing slips with a, that shows another provider’s name. We need someone from medallion, and it could be yourself as well. Just take a look at those medicaid errors. And we feel like if these errors, they’re like simple errors that can be corrected. We might need to escalate this to a higher management because we’re spending so much time reviewing these applications over and over again. And that was not the purpose of having medallion. We thought the medallion is going to do a great job. We send it to the providers. Boom, it’s done. We move on. But now you got to understand I work in credentialing but credentialing is not my major responsibility. I’m a senior director of human resources as well. And I cannot be spending so much time and Jasmine the same situation, she works also for human resources and we’re spending so much time trying to correct this medicaid error, simple errors that I don’t think they should be. We should not be spending time this morning. I checked Katherine Howard, Jenny martinez, Asha motu, no instructions at all. On the note side, no instructions. But then this morning they did something. But meanwhile, they sent it to the provider about a day ago with no instructions at all. Another thing, fsw provider emails, why very done is receiving emails intended for fsw providers? So, and I know you said that you do put the email there but it looks like it’s not.
Niccole Russell (04:12) So we don’t look at the documents. It’s there, yeah.
Nancy Rodriguez (04:15) But they’re sending it to be very done. And the reason we don’t well, I don’t want to get into that provider application status report. We keep, we keep seeing a report showing the provider applications for we actually need a pro. Okay? So we have a weekly meeting with Maria, the CEO team. So we want medallion to assist us in generally showing the status of provider applications for each insurance carrier and for each provider. So, I need this report on the weekly basis because then you can.
Niccole Russell (04:57) Look at that in medallion and run your own reports and look at that.
Nancy Rodriguez (05:00) We don’t I don’t know I need your help or I need somebody.
Niccole Russell (05:03) I can help you, look at that. I.
Nancy Rodriguez (05:05) Need your help because I don’t know what kind of fields I need, to do.
Nancy Rodriguez (05:08) I have never run a report. So I need somebody to assist us. Maybe we can not do it during this meeting. Maybe we can schedule another meeting because shendell is also in my meeting because they want to know exactly where are we? Where is it? Where would we want to know the details, where we are with the provider enrollment? So my second, yeah, that’s.
Niccole Russell (05:32) all on the platform, I can show you where to find that, right? You.
Nancy Rodriguez (05:36) can show me, but I need you to assist me on running this report. We can schedule another time for this report, but it has to be done before we have the meeting on Thursday. We also noticed that and I had many examples this week and it’s only Tuesday.
Nancy Rodriguez (05:57) We don’t need duplicate notifications from medallion. It is confusing and it’s time consuming. We have it on the provider side on the administrative side, and sometimes the provider goes in there and says, okay, I did it. I’m talking about the medicare perfect example today. I, last week, on Monday, I saw that this provider was missing medicare, right? I’m reminding them about, please go into the medicare website, please go into the medicare website and medallion is on the administrative side. So it’s like, why do we need so many notifications? I don’t want, I just want to not, I want you to notify me when the provider has not completed something in three days. So it’s like it’s so confusing. I’m like, okay, I need to close that, the administrative side, I need to close the provider. It’s like I’m bothering that provider. I’m wasting their time when they already did it. So, this is like going back and forth back and forth. So we wanted to know, please just leave it on the provider side. And if it’s if they don’t follow up, then let us know, but we don’t need duplicate notification. We’re already getting email. We’re getting, we’re going to as.
Niccole Russell (07:19) An admin, you would receive those duplicates. I don’t want duplicates.
Nancy Rodriguez (07:24) Just leave it on the provider side. Jasmine and I and chendel have access to medallion and we will make sure it gets done. I don’t need it. I don’t think.
Niccole Russell (07:32) There’s a way for us to take that away because that.
Nancy Rodriguez (07:35) is the sole purpose. Nicole, can you please find out I?
Niccole Russell (07:39) Can I just that’s the sole purpose of being an admin is, so you get the notifications and so you’re aware of what’s going on? It’s.
Nancy Rodriguez (07:47) too much for work for us. We already, we have access to the admin portal and we cannot listen. I want to work with medallion. I want to be able because if you do your job and we help you do your job, then we move forward, we move smoothly, but I don’t want this. I don’t want this friction. I want to work with you. And right now, I feel like every time I request something, I get this kind of friction I don’t want to do that. Believe me, I have so much responsibility going on right now that I just want everything to go smoothly. And I want your assistance to assist me with this. Okay? So the emed provider… enrollment okay. So, I have noticed on one application that for some reason you are asking, it’s a new application and I believe it’s ritachi, you ask medallion is asking them to complete sort of like a change form that we use when someone has medicaid. That form should not be in there. And I don’t know why it’s there because this is a brand new provider. So, and, you know, we can take it out since we are mailing it out, but I don’t understand why it’s in there. Okay? So you’re taking notes because I don’t see you taking notes, Niccole. Before the recap?
Niccole Russell (09:21) Yeah, we have an AI service that takes the notes. Oh.
Nancy Rodriguez (09:24) Okay. Perfect. Okay. So another error that we found on the application is on the street address. It looks like medallion. They were supposed to write like two 39 broadway and I can share with you. So you can actually see it. Okay? Let me see. Can you see right here? So, can you see this? You see the way they did it here?
Niccole Russell (09:58) It’s not populated yet. Okay, there we go. Okay. Do.
Nancy Rodriguez (10:01) You see, do you think medicaid is going to accept this? This is supposed to be the service address.
Niccole Russell (10:13) Yeah. It looks like it’s it doubled. Somehow. I’m not sure.
Nancy Rodriguez (10:17) It’s like they have to be careful. This is the kind of errors that I’m telling you about. It’s. Like, I don’t think.
Chendel Hooks (10:23) Niccole. The issue we’re running with is one, you know, just to, you know, really follow up with what Nancy’s saying, you know, Nancy and Jasmine, they’re just, you know, it’s constant and they’re having to do this. But, and you know, the biggest part of it really is that these are things that should have been caught like it seems like they’re filling this stuff out but not even going back over these proofreadings and say, hey, let me just, I put the information and I’m not even double checking my work. And so, you know what I mean? So these are small issues obviously in between, you know, small little demographic errors here and here, but they add up and they can cause our applications to be failed. But beyond that, the only reason they’re having is because Jasmine’s catching them, you know, Jasmine and Nancy are catching these. So, you know, so we have to skip but that’s not that’s really not, you know, like Nancy was saying, right? It’s not best practice and it’s not really what their job is. I mean, you know, they work credentialing, yes. And Nancy oversees the department, but, you know, like she said, she has other, you know, tasks to do and the reason we have, you know, medallion in place is so that we don’t have to do this like medallion is really supposed to take that place. You know, I mean, we have obviously the responsibilities that are going to come to us as, you know, as admins, or as liaisons, but really, this is that basic stuff that we really is the whole reason why we, you know, went to, you know, to, you know, outsource and get, you know, a credentialing outsource credentialing department. You know what I mean? So these things really shouldn’t be happening. I mean, errors happen and I’d expect maybe, you know, one every, at every 10 or maybe 15 to 20 possibly. But, you know, these are things that we’re just seeing repeatedly back to back and it’s bad because this is just, you know, we’re a new client, and, this is kind of the introduction we’re seeing, we know things are going to obviously take time, to, you know, to, you know, to work itself out and we have to come up with workflows and stuff like that. But these aren’t even like workflows. This is, this is a, you know, these are, you know, really areas that are just like, hey, I’m not paying attention, I’m just jotting in data and just moving on to the next one. And so that means that we’re not getting the attention. Our work is not getting the attention and quality that we’re paying for. So that’s really kind of where I think the frustration is coming to when we’re seeing all this. And, you know, because it’s becoming another job. You know what I mean? As a job that we really, this is not what we signed up for. You know what I mean? So, right? You know what I mean? So I think that’s really kind of where the frustration is that, you know, Nancy I mean to interrupt.
Jasmine P Feliz (12:51) I mean, also that I think that at this point, Nicole, I reviewed 16 applications and every single one of these had numerous errors and I’ve sent them back and then they still come back with more errors than what it was previously. And then I’m redoing it again. And for Lindsay March specifically, I had to do her application myself. And in easy and easy, even with their shipping labels, it has the other providers names on it. So they’re sending it to Jane doe, but it’s supposed to be for Jessica doe. Like it’s not making sense. They’re not looking at their names. And I think that whomever is at medallion completing these applications. I think another supervisor there needs to be assigned and reviewing them before they start sending it out to us because I can’t… keep on wasting my nine hour day in doing just this. I understand I have 20,000 more things I need to do, right? We have my resident group coming in and I have to start onboarding them that’s another group of 20. I can’t.
Niccole Russell (14:21) I hear you. I understand your frustration. I will escalate this for.
Jasmine P Feliz (14:25) Me right now, Nicole, it’s beyond frustration, right?
Niccole Russell (14:29) No, I understand. I will escalate this and make sure that someone.
Jasmine P Feliz (14:34) There needs to be assigned and reviewing these applications before they start coming over to us.
Chendel Hooks (14:40) Okay. Yeah.
Niccole Russell (14:42) I can definitely request to go through the receipt before.
Jasmine P Feliz (14:45) It’s over punctuation dashes city and state like.
Niccole Russell (14:49) Yeah, thank.
Nancy Rodriguez (14:50) You. Thank you, Jasmine. Sorry. So basically, so since we still have a little bit more time, so you got the idea. I also want to find out what’s the status of the facility medicaid application. Remember, they use the wrong form. I send it back to you. I don’t see it on the task anymore. Are they completing the correct form?
Niccole Russell (15:17) They should be sending it back. So what they did the last time was it went through QC. So that’s why it took a little bit to get back to you.
Nancy Rodriguez (15:25) Okay. So they’re working on it on the correct form, correct? Okay? Because I’m afraid that now that we’re sending the medicaid applications, and if the sites are not enrolled, then they’re going to, all those applications are going to come back, right? Okay, great. I’m glad that is.
Niccole Russell (15:42) On your, yeah, I know the last one went through QC. So I think that’s what they’re doing with those particular applications is sending through our quality control.
Nancy Rodriguez (15:52) Department? Oh, okay. Okay. Yeah, perfect. All right. So.
Niccole Russell (15:56) And let me share. I just want to show you how to find this report.
Nancy Rodriguez (16:02) Oh, yes.
Niccole Russell (16:03) Yeah. So over here, under analytics, you’ve got two. So you’ve got a report builder, this can help you build different reports. You can look at providers and it has all of the different information. You just hit this and it goes over and you can export or you can save it to receive it weekly. So these are the different reports you can have. You’ve got deactivated providers, licensing, payer enrollment requests. So if you’re wanting to see certain things with payer enrollment, you can look here another really helpful tab. And again, you can save any report and you can get it daily. You can get it weekly, however you want to schedule that.
Nancy Rodriguez (16:40) And how long does it take to get a report? Because I noticed Jasmine requested a report? Did you ever get that report? Jasmine… remember, you requested a report and you said, Nancy, I requested it. I don’t know if she ever got.
Niccole Russell (16:54) It, if you do a report through here, it goes to your email.
Nancy Rodriguez (16:57) Oh, it goes to it’s automatically.
Niccole Russell (17:00) Yeah. Well, it does take a moment for it to populate. So depending on how much information, how much data you’re wanting in that report, it will come to you same day, but it may, some are instant if you’re just wanting some quick information and some may be a little bit lengthy just so it puts all the data in there in the back end before, so.
Nancy Rodriguez (17:20) Why don’t I share the screen and let me or chendel?
Chendel Hooks (17:25) Yeah, let’s do it. Yeah.
Nancy Rodriguez (17:28) You want to, okay. Well.
Niccole Russell (17:29) And I want to show you this too before you share your screen. There’s. Also an analytics tab and you have a sorry, right here, you have provider enrollment or payer enrollment and this has lots of great data and you can also export any of this information. So you can scroll down here. It says what’s in progress? What’s been completed?
Nancy Rodriguez (17:52) Which one has been completed?
Niccole Russell (17:55) There are two that have been completed here. So for Alyssa and Lupita for?
Nancy Rodriguez (18:02) Which insurance?
Niccole Russell (18:05) Medicare.
Nancy Rodriguez (18:07) okay. So, does.
Niccole Russell (18:08) that mean?
Nancy Rodriguez (18:09) That they were approved? Yeah. Okay. And then,
Niccole Russell (18:15) turnaround times, it lets you know this. So this would be helpful for you to take back to Maria and show her, but you have all of this data that’s listed in here. That is, very helpful. But I will stop sharing and let you go through as well. I just wanted to show you those two things because our clients really use those analytics tab and report builder tab.
Nancy Rodriguez (18:41) So, basically, you want to share your screen chendel, yeah.
Chendel Hooks (18:44) So,
Nancy Rodriguez (18:45) basically, you’re saying that the only two insurances that have been approved is those two that’s it, everything else is in progress?
Niccole Russell (18:56) Yes.
Nancy Rodriguez (18:57) Okay. All right. Okay. Because that’s what they keep asking us that every single week, they don’t want to hear our issues. They just want to know, are they enrolled?
Chendel Hooks (19:10) Are you able to see my medallion?
Niccole Russell (19:12) Yes.
Chendel Hooks (19:13) Okay. So, I know this is the report builder tab, but I’ll go to the analytics because you just showed us that. So if we wanted to run a grid and show, hey, these are all our providers and where they are in the process. So we have 312 requests for that have gone out for our providers, right? What’s the best way to look at it and say, you know, hey, this is what, where we are. So, is… this here, this initial thing here, is that, is he showing me medicaid… housing?
Nancy Rodriguez (19:48) Service follow.
Chendel Hooks (19:51) up. So.
Niccole Russell (19:52) It’s that’s showing you what all is currently in progress. So it’s got the payer name, it’s got the provider and the… status in which it is. So if it was app submitted there at the very end, you can scroll and if you hit those three ulysses dots, you can download this report but yeah, it just shows the status, you can scroll through it’s app submitted pending pre application submission. So it has all of the statuses if it’s been submitted, it’s in follow up.
Chendel Hooks (20:34) Okay. So pending pre app submission, what does that mean?
Niccole Russell (20:38) So, that’s bedalian working on it. Okay. So, okay. So, the status is with the client. So, yeah, we’re pending something from you on that one.
Chendel Hooks (20:47) Okay. And what’s this third party is that the price, that, is that with the insurance or?
Niccole Russell (20:57) Pending pre app… let me see here.
Nancy Rodriguez (21:13) Can you scroll down? I want to see if health first is in the list.
Niccole Russell (21:18) So, this is pending a dependency?
Nancy Rodriguez (21:22) Oh, basically, they have to be enrolled in medicaid.
Niccole Russell (21:26) Yeah, it’s pending a prerequisite. See that service request id. So, if you’re ever curious as to what something is that’s what I did. I clicked that there’s a little thing that populated right below it. Yeah. And that’ll take you directly to the line and you can look to see exactly what’s pending there.
Chendel Hooks (21:44) Oh, I see. Okay. It brings it up. Okay? Is that health first?
Nancy Rodriguez (21:54) Yeah, health first? Oh, there’s health first. What is this client intake?
Niccole Russell (22:02) It’s an intake status?
Nancy Rodriguez (22:04) So, what does that mean client intake?
Niccole Russell (22:09) Well, I’d have to click on it. It’s with intake. So it hasn’t come out to PE yet. So, from what it looks like, intake has requested something from you. I can’t say for sure from me from the client. Okay, who?
Nancy Rodriguez (22:26) Is the client? Is the client me? Or is it health first?
Niccole Russell (22:30) Okay. You are the provider?
Nancy Rodriguez (22:32) Okay. I haven’t seen anything about health first?
Niccole Russell (22:37) Let’s see. Let’s open that line up. I?
Chendel Hooks (22:40) Did you might not be able to see it because it moved, I have to move the screen, let’s see.
Niccole Russell (22:48) Let’s see. So, this is, let’s see, I see there… and take.
Niccole Russell (23:02) So, medallion likes information needed from the provider and they have been notified.
Chendel Hooks (23:10) So, this is the, this was for Steve, Steven, right? So.
Niccole Russell (23:14) Yeah. So, when you request something, it goes to intake and then goes out to PE.
Nancy Rodriguez (23:21) Oh, you close his, you close his task?
Niccole Russell (23:29) go to review… I don’t know if it will unlock.
Nancy Rodriguez (23:34) It was the medicaid?
Niccole Russell (23:35) Can you uncheck. It?
Nancy Rodriguez (23:37) No, no, no, no, yeah, that’s how many was fixed, right? Yes, you only need to open the medicaid?
Niccole Russell (23:45) This one? Yeah, I’ll.
Chendel Hooks (23:47) take this one. Yeah.
Niccole Russell (23:50) And then it’ll show back up under the ready.
Nancy Rodriguez (23:53) Okay. But I don’t see any message for us about health first. So, are you saying that health first needs medicaid?
Nancy Rodriguez (24:08) So, what’s the message? I don’t.
Niccole Russell (24:10) I just pulled up one. I just pulled up a different one. I didn’t pull up the exact.
Nancy Rodriguez (24:14) Same one. Oh, okay. So, but,
Niccole Russell (24:17) I looked under client intake and what it’s saying is needs client attention is the status and then it’s with intake. Okay? So they’re requesting additional information.
Nancy Rodriguez (24:30) From us. But where is the task? How do we know this? If we don’t look at the?
Niccole Russell (24:35) Not everything has a task that’s what I was, I said last time on our call, not everything has a task. It can also be the provider’s profile. Let me see.
Nancy Rodriguez (24:47) I thought our profiles are complete 100 percent, so how can we, how do we find these out? So.
Niccole Russell (24:58) Birth city and state? And just let me say this, maybe that’s it that’s the only thing I’m seeing on this one provider that I’m looking at right now, I’ve been back and forth with the team on it being an optional field for you. So as it stands, they are trying to create a button, a field within platform that says if they are a, if the provider is a, an authorized official or a managing employee, because that information is needed for medicare, for the authorized official and managing employee. At this time, there is no way. And I just got this information yesterday. So I was waiting to meet with you to go over it at this time. There is no way for the team to distinguish who’s an ao, and who’s a managing employee. So it’s required for all providers.
Nancy Rodriguez (25:57) Okay. I’m going to help you with that. Okay? So if you look at our facilities, we clearly notify who was delegated official, and who is the authorized user.
Niccole Russell (26:08) No, I understand that. But when they’re populating they?
Nancy Rodriguez (26:11) Need to look at that, they need to look at that and they can decide which one. So it’s not required. Niccole. I’m not going back. Well, I.
Niccole Russell (26:20) understand that, but they’re not going to go through that process, right?
Nancy Rodriguez (26:23) They have access. It’s.
Niccole Russell (26:26) too many to go through when they’re trying to populate applications. So what the team is trying to do is on the back end, they are trying to create a field that says ao or managing employee. And if that is selected, then we know to prep for that to ask for that birth city and state if it’s not, then it’s no longer going to be a requirement. But as is across the board for all clients, it is a requirement until they get that field populated.
Nancy Rodriguez (26:56) I’m going to help you with this. We’re not going to go back and ask this to every single provider. We are already like way ahead of this. I.
Niccole Russell (27:09) mean, that’s fine. But I’m letting you know it will stay there as it will stay.
Nancy Rodriguez (27:14) They should not be holding the applications. Please tell them it’s not that many people. You can send them a PE to your team. So people that are authorized official and delegated, they’re like four people. So if we look at here on the facility, right? Exactly, tells, I don’t know exactly where it is, but everybody else, our employees there, it goes. Yes. Is that dr Wu, I’m the an employee tells you exactly what it is Lindsay, Farrah, Maria, everybody else are employees, no.
Niccole Russell (27:55) I understand that, but the system is not set up that way is what I’m trying to tell you. They can’t override something that’s already set for the system. So we can see that and we know that, but the system is set up to where it automatically requests that information due to.
Nancy Rodriguez (28:14) But, if you can tell your supervisor, your pin supervisor. So they, you said that they don’t even look at this?
Niccole Russell (28:23) It’s the engineers. They have set it as a requirement. So that’s what I’m saying, I am in contact with them trying to get a field added. So it shows if a,
Nancy Rodriguez (28:33) provider. Yeah. But in the meantime, in the meantime, you’re holding up the application in?
Niccole Russell (28:38) The meantime, we can’t do anything about that. That’s what I’m saying? So you,
Nancy Rodriguez (28:41) want me to tell Maria and my whole team I,
Niccole Russell (28:45) can I don’t mind telling her? Yeah, I don’t mind. I don’t mind explaining it to her.
Nancy Rodriguez (28:50) No, no, no, they don’t want to hear that Niccole, they want to hear that all the insurance are in process. So how do I can’t tell them by the way? You know, they’re still talking about, that city and the state. And now they’re saying it’s a requirement… come on, Niccole. We need to move on. They need to enroll these providers.
Niccole Russell (29:14) They will. So if there’s a task out there, if there’s a line out there where you’re seeing it, you can ask them to proceed. They are not an M, I don’t even know.
Nancy Rodriguez (29:23) where they are? You’re telling me, we’re following the task. There’s no task there. Now, you’re telling me that I have to go into this other place before you told us if we go to the payers and we look at the task right under the payers enrollment request, going to enrollment request and we look at that needs attention. So, there’s nothing in there that says anything about helpers.
Niccole Russell (29:52) Well, all of these are not birth city and state.
Nancy Rodriguez (29:56) Well, some.
Niccole Russell (29:57) Of them could be, but all of them are not birth city and state.
Nancy Rodriguez (30:03) But this is my thing. Where do you want me to look when they’re asking me for something? When they’re not even asking me? How am I supposed to know this, Niccole? Are they going to at least put them here? So I know what they’re asking me and I can reply, you see how difficult this is working with medallion. We just found out that they’re holding up something because of the city and state and we had went over that for so many times. So many times we talked about that.
Niccole Russell (30:38) We have, I’ve been back and forth with PE almost weekly on it and our engineering team.
Nancy Rodriguez (30:43) Maybe you need to get Nick involved, but they should not be holding our applications for that, Niccole.
Niccole Russell (30:49) Well, Nick reached out to the engineering team. There’s nothing he can do that’s why he reached out to them. It’s a set priority or a set mandatory action.
Nancy Rodriguez (30:58) So, how do we know? It’s like we have a I’m sorry, but you need to go back to Nick and come up with a solution but they should not, these applications should not be.
Niccole Russell (31:10) Well, it doesn’t have anything to do with. Nick can’t fix it. So that’s what I need.
Nancy Rodriguez (31:15) To touch with our.
Niccole Russell (31:16) Engineering department to see if we can get that field added into medallion. So it prevents that. But until that field is added, it is a requirement.
Nancy Rodriguez (31:25) How long is that going to take?
Niccole Russell (31:27) They’re working on it? I can’t say,
Nancy Rodriguez (31:29) I can’t go to Maria and say they’re working on it. I can’t and I’m not going to go back to the providers and ask them for this.
Niccole Russell (31:37) Okay. Well, I mean, the only thing I can say is if you’re seeing a task which they should not be tasking for it, but if you see a task, you need to comment on it, saying that it’s not.
Nancy Rodriguez (31:48) Required. But I’m not seeing that. I’m not seeing that Niccole, you’re telling me that they’re holding the health first, but I don’t have a task. How am I supposed to know there is a task?
Niccole Russell (32:01) For health first? Yes.
Nancy Rodriguez (32:03) We’re just talking about health first. And you say they’re waiting on the client? I’m like what do they need from me?
Niccole Russell (32:11) Where’s the task? All right? Which I’m showing you, I was telling you what I was looking at here that it’s saying needs request. The only thing I see at first sight.
Nancy Rodriguez (32:21) I understand this task, but you’re telling me there’s another place that the client needs attention and.
Niccole Russell (32:29) that I’m not even aware, no, I’m not saying there’s another place I’m saying that you have to look outside of task. The whole system is designed to tell you exactly where it stands, but it’s not, it’s.
Chendel Hooks (32:42) so, Niccole. All right. So two quick questions. So, all right. If there’s things that we need to look at, it would be under either providers or the payers. These are only two places where we should be looking for tasks. Is there any place else that we need to know about that? Would that where these would be found? So.
Niccole Russell (33:00) The overview of the task, right? You can see task in the providers, you can see task in the payers, but not every issue has a task related to it. So you have to look at the system to see exactly where. So if you see needs attention and you drop the box down and there’s no task there, then I usually click on that needs attention, read the little print underneath it. And I’m like, okay, well, they need provider. So that lets me know. I need to go to the provider profile to look at that.
Chendel Hooks (33:33) But question. So, all right. So, okay. So it’s overview and that’s one set where we could see the provider and the admin and under payers that’s another set of tasks, correct? Correct? And they.
Niccole Russell (33:49) Should correlate.
Chendel Hooks (33:50) together. So, you mean like I could have the same task in both… or are they just like one step one then step two? So.
Niccole Russell (34:03) It could be the same task, but you’re going to see it in both areas. So it’s not like a duplicate task.
Chendel Hooks (34:10) So it’s not a duplicate. Okay. But it’s the same task in two different areas, correct? Okay. All right. I guess I’ll come back to that. So let’s say the problem that’s going on is not, I guess not identified as a task, right? Right? So this thing, whatever it is, let’s say it’s something that the provider has to do. So it goes out to the I’m guessing a notation or something like that or something’s going out to us or the provider, and it’s in their profile. So… will these things hold up an application from going out? It’s not a task?
Niccole Russell (34:49) They can. So if something isn’t completed in the profile, then if we are okay, as long as it’s 85 percent. So this is the requirement 85 percent and the provider signs the authorization, right? So that moves it into intake. At that point, intake will review whatever you have requested in the system and they will decipher what is needed for that enrollment. If something is needed for that enrollment, then they will task out for it.
Chendel Hooks (35:27) Okay. But the things that are going out that is not a task, right? How do we know? And kind of going back to what Nancy was saying? How do we know that it’s a problem? So you’re saying we have to go into each one of them or we have to do this all the time and see if, because, okay, if the provider’s profile is 85, no matter what you’re sending back, it shouldn’t stop the profile because they’re 85 percent. So they should be good to go it.
Niccole Russell (35:54) Wouldn’t stop it from falling into intake. So that’s what makes it fall into intake itself. Then intake reviews your request and they decide for what is needed for the request line that you’ve put in. Okay?
Chendel Hooks (36:09) So, 85 percent doesn’t necessarily state that it’s good to go to insurance. It just means that it’s good to go into intake, right? Okay. So, okay. I don’t know like that. I didn’t understand. My understanding was that it meant that it was good to go, that it was able to go out. So. All right. So, okay. So let’s say application goes out, it goes out to intake. They see something that’s needed, but they consider and what would be the deciding factor to say? This is a task that will go to one of these areas under overview or payers or something that I guess is not a task. And I guess it goes out at some kind of note, what, what’s the deciding factor?
Niccole Russell (36:54) I mean, I don’t work in intake, but I know that they are, they have a certain set of things that have to be added for each individual request, whether it’s PE, whether it’s licensing, credential, whatever the case is, they have certain things that have to be added in there. So, medicare being a good example, I know you don’t want birth city and stay there. But as of now, the system is set for that to be a requirement and there’s no way around it. So if you put in a medicare request and it goes to intake, now, if they create a task, you can say, hey, this task, it’s not needed for enrollment, please proceed. They can push it through. But if it’s just a needs client attention intake with no task, you would have to look at the provider profile and see what needs to be completed and completed.
Chendel Hooks (37:51) So, there’s no report that we could run to show us because if they’re not called tasks, what are all these things called? Like is there a report that I can run and say not tasks? But this is some kind of intake note. Is there a report that we can run? Because going into each provider is kind of crazy like, you know, just because we’re basically looking for problems. So now we’re going into your portal, which it’s nice to have the portal. But now we have to kind of go in and search for the problem. And I don’t understand why we can’t there’s not a report we can run or something like that. They can say, hey, these are just things that are not identified in the normal areas that are supposed to identify, you know, client responsibility. So, you know, is there a way that we can run these run reports that are, this is everything that needs to, that is not a task but still needs to be addressed because it, this could possibly hold up our applications. Is there any report?
Niccole Russell (38:45) That you want? Yeah, if you’re wanting to see what’s holding, if you go to payers, and you can run a report from any of these tabs, so go to enrollment requests. And then when you click on the needs attention over there on the right.
Niccole Russell (39:04) The 74 that need attention, click on that box. So this is going to populate just that information and.
Chendel Hooks (39:13) As.
Niccole Russell (39:14) you scroll through here, it’s going to show you if outstanding task over to the right?
Chendel Hooks (39:23) Okay. So, yeah.
Niccole Russell (39:26) Keep going just a little bit. This one here. Yeah. So that’s going to show you outstanding task. It’s going to let you know if it’s a medallion task. If it’s a client task, a provider task, it’s going to let you know who owns that task.
Chendel Hooks (39:48) Okay. So all these, so these things that are not considered tasks are… here under payers. So this is where this is where they’re not tasks. You guys don’t call them tasks, but this is where these things that could possibly stop applications are coming from. So this is where this is where we need to look in order to.
Niccole Russell (40:08) So there are 12 there that have provider tasks, the remainder, why?
Nancy Rodriguez (40:14) Don’t, you click on one of them and see what is the task.
Jasmine P Feliz (40:23) Okay. Well, that’s a perfect example because if you look on her medicaid application, it comes up with another provider that’s not even one of ours.
Chendel Hooks (40:35) Whoa, is that here? Yep?
Jasmine P Feliz (40:40) No, that’s not, it. I’m looking at it right now and it’s for Louisiana state board of medical examiners for an irathora, what that’s not, even, yeah, which provider is that? And they’re asking, they sent it to Natalia, asking her to sign it?
Nancy Rodriguez (40:59) Oh, what? Oh my God.
Chendel Hooks (41:02) Why is this blocked? Okay. So.
Jasmine P Feliz (41:06) Chendel, do you mind if I share it for the moment?
Chendel Hooks (41:08) Yeah, no, no problem. Thank.
Jasmine P Feliz (41:10) You.
Nancy Rodriguez (41:11) but don’t exit because I want to go back because I.
Jasmine P Feliz (41:16) so, here’s the medicaid application. This is for Natalia hoover, who is irathora? I.
Nancy Rodriguez (41:26) don’t know who that is neither.
Jasmine P Feliz (41:28) Do I, and we don’t have anybody in Louisiana, Nancy, and this is what they attached to her medicaid application asking her to sign it.
Nancy Rodriguez (41:37) Oh, my God. And.
Jasmine P Feliz (41:39) Then she says, my apologies. I’ll send it out right away.
Nancy Rodriguez (41:43) She didn’t even realize what she signed?
Jasmine P Feliz (41:45) She didn’t even realize what she was signing. And then of course, all the other errors that are within the application.
Chendel Hooks (41:50) So, wait.
Jasmine P Feliz (41:51) Hold.
Chendel Hooks (41:52) on, so, Jasmine, so this is for a different, this information is not for the provider, it went to. Yeah, yep. Can you scroll down just a little bit further? So here.
Jasmine P Feliz (42:03) At the top, wait. So here at the top, this is where the application starts. So they attach and they, Louisiana state board of medical examiners?
Niccole Russell (42:14) This is for a position that?
Jasmine P Feliz (42:16) We do not even have, but.
Chendel Hooks (42:20) Is, the demographic information? Is that the right information for the person it went to?
Nancy Rodriguez (42:26) They’re not looking at it.
Chendel Hooks (42:28) No. Can you go to, can you go to where the name information is? Yep.
Jasmine P Feliz (42:33) As you go down now, we start having an Italian information, okay?
Chendel Hooks (42:38) Stop, stop. Perfect. So, this is for Natalia. So, is this Natalia’s information?
Jasmine P Feliz (42:45) Yes. Is this? Yes, yeah.
Niccole Russell (42:48) They just attached the wrong provider’s verification?
Chendel Hooks (42:52) Okay. So, it’s not like private information from one person went to another, it’s.
Nancy Rodriguez (42:56) this is a serious. This is a serious error.
Jasmine P Feliz (42:59) Yeah. And then not to mention that even her name field, it’s supposed to be populated exactly how it appears on her registration.
Chendel Hooks (43:10) Yeah, that’s different than here’s.
Jasmine P Feliz (43:12) her registration and.
Nancy Rodriguez (43:13) it clearly says on the application that you have to put the name exactly how it appears on the registration.
Jasmine P Feliz (43:20) Correct. And it also says it here as well, name exactly as it appears on the registration. They’re using first name and last name. They’re not using it exactly as it appears… but to attach… some physician from Louisiana onto her application and asking our provider to sign off.
Niccole Russell (43:48) So I’ll take, I’ll put, I’ll escalate a ticket for this. I am sorry about that.
Nancy Rodriguez (43:53) It.
Jasmine P Feliz (43:53) should be.
Nancy Rodriguez (43:55) For everybody, they need to be checked.
Niccole Russell (43:57) I mean, it will be for everybody. I’m just saying I’m going to report, put an escalation ticket in for your items to be reviewed.
Nancy Rodriguez (44:05) I know we’re running out of time. I want to go back to what chendel was saying. Okay. I understand that we have to go into that… all the errors, right? All the tasks. And we understand that we also, when we go to payers that their son needs attention, that’s I have no problem with that, that’s but my question is when we were looking at the report about helpers, it says client information needed. What kind of information you need. If you’re not telling me what you need, how are we supposed to know what you need?
Niccole Russell (44:54) So if there’s not a task, I would look at the profile that’s going to let you know what’s needed. So.
Nancy Rodriguez (45:01) Going back to chendel’s, question, I cannot be looking at every single provider. Is there a report that?
Niccole Russell (45:09) It says, I hear you, but if it says needs client attention, the application will not proceed until that has been taken care of. So it will kind of stand in limbo and not be submitted until that profile is complete in whatever it was requesting. I.
Nancy Rodriguez (45:26) Understand that. But going back to chendel’s request, is there a report? Because it’s not in the payr’s enrollment request needs attention, and it’s not under the overview. It looks like they’re somewhere else. So how are they going to communicate to me that they need attention?
Niccole Russell (45:48) So if you’re looking to see what is missing from a provider’s profile, you can run a provider report. There’s several different reports there. Like I said, you can look at, but it’s not. If there’s not a task. It’s not going to say, hey, this is what’s missing. It’s going to say pending provider profile or communication sent to the provider. It’s in regard to the profile. So you would have to look to see if it’s marked off there.
Chendel Hooks (46:19) So, for the duplicate notifications that we’re receiving, is there at least a way that if the provider, especially if it’s something for the provider only, but we’re also getting it, is there a way that if they complete it on their end, that it could disappear on ours, there’s.
Nancy Rodriguez (46:36) not because.
Chendel Hooks (46:38) Just like Nancy was saying, it’s not just that we’re going after them, we’re actually annoying them because now, it’s like, hey, did you do this? Hey, did you do that? And they’re like, well, I did this last week or we did this yesterday. Why are you calling about something? I just did yesterday? They’re practicing, they’re doing their medical practice, and now we’re bothering them to catch up with.
Niccole Russell (46:57) them. Well, you can look in the review in the task. Whenever it’s completed, it will fall in review and in a completed bucket. So you could look there and to see if it’s a duplicate task. But really, you shouldn’t be receiving a duplicate task unless it’s over 21 days or for medicare, which really isn’t a duplicate, but it requires the provider signature and the aos signature.
Chendel Hooks (47:23) So we shouldn’t be getting any duplicates.
Niccole Russell (47:26) You should, not, unless it says task over 21 days, and that’s alerting you. Hey, the provider has a task out here that’s over 21 days. So, yes, if you are seeing duplicates, let me know and I will definitely take that back to the team because it should not be duplicated for both. Because that’s the whole point of you being able to see the provider, you shouldn’t be getting those unless it’s over 21 days.
Nancy Rodriguez (47:50) Okay. I got one that is duplicate. Do you want to share Adeline Santana?
Niccole Russell (47:58) You could just send it over email. I actually have to hop for another call. But if you’ll send that over email, I will definitely have that taken care of and make sure that it’s in the appropriate bucket. And I will have an escalation, the mistakes we’re seeing is not okay. It’s not, it’s not legal.
Jasmine P Feliz (48:17) On.
Niccole Russell (48:18) some of those, the state verification being one of those. So… I will definitely escalate a ticket for you all and have everything reviewed and looked at, and.
Nancy Rodriguez (48:30) before.
Jasmine P Feliz (48:31) they’re sent to us, yes.
Niccole Russell (48:33) I’m going to request that it go through QC before it’s sent to you as well.
Jasmine P Feliz (48:38) And the ones that they’re sending through provider? I mean, I’m looking at another one right now for Ritchie. And again, it’s missing fields. Okay? I,
Niccole Russell (48:50) will I will request an audit on all of that?
Nancy Rodriguez (48:53) Thank you, Niccole. Thank you.
Chendel Hooks (48:55) Thank you.
Niccole Russell (48:55) All right. Have a good day.
Nancy Rodriguez (48:57) Chendel, I’m going to call you. Okay?