Transcript
Sandhya Kapila (00:00) Lauren. Good morning.
Lauren Henderson (00:01) How are.
Sandhya Kapila (00:03) you? Good. How are you? How are your days off?
Lauren Henderson (00:08) I ended up working yesterday. I.
Sandhya Kapila (00:10) Saw, I saw something. I was like, she’s working too much.
Lauren Henderson (00:14) Going on. Yeah… if we have time today or maybe before Ashley jumps on, I have a couple questions about the group enrollment. Okay, cool. Really trying to finish that, but there’s just some things and I know you kind of said a lot of it’s just to act as our source of truth, so.
Lauren Henderson (00:40) Yeah.
Sandhya Kapila (00:41) Absolutely. We can talk about that for sure. Do you?
Lauren Henderson (00:44) Want to do that after Ashley’s here now, if we have time later after that?
Sandhya Kapila (00:48) Yeah. We can do that afterwards. Yep. Perfect. And Naomi will be on too. So if there’s like a question that I don’t have an answer to, she is the expert, so she’ll be able to chime in.
Lauren Henderson (00:58) Okay, awesome.
Sandhya Kapila (00:59) Okay, cool. Alrighty. Okay. I’m sharing my screen. It’s fine. How are you, Ashley?
Lauren Henderson (01:09) I’m good. How are you?
Sandhya Kapila (01:10) Good. Thank you.
Sandhya Kapila (01:18) Okay. So, okay. So logging into the platform, I’m going to just go ahead and start first with this top right section. You may have already seen it as you’ve logged in. We have the profile here where you can actually well, where it lists out your name, email address and the role that you have. You can edit your name if you’d like to. And the primary email address too. If you’d like your notifications to go to a different email versus what is currently in there, you can edit that here as well. Email preferences is what you would want to look at. Again, it has the email that we have for you here. But the email preferences section here allows you to toggle on and off the different notifications that you want to receive. So if there’s something here that you’re like, I don’t really need to know… what’s going on. Any alerts for ongoing monitoring, for example, which you probably do want. But if you don’t want to receive notification on that, you can just toggle that off. It’s pretty simple to use. You’ll. Also have access to update email preferences for your providers too. If they ask you to, I’ll show you how to do that in a minute too. Any questions? Cool. Alrighty. Okay. So next up, we will look at the members tab. This is where you will be able to add new members, deactivate them, change their email address if you want. You can also send invitations directly from here too. Or yeah, you can send invitations from here if you need to track invitations.
Sandhya Kapila (03:05) So we, this person was not invited. We already know that Ashley accepted her invite on March sixteenth. So we can track invitations that way if you did send somebody an invite, you can revoke their invitation too. Well, we don’t have anybody invited just yet who hasn’t accepted. But you’ll see like a revoke invitation button… from this menu here as well. So from the members tab, so you notice that you can deactivate members. And so there’s three buckets here all active and deactivated. If there are any deactivated members, you’ll see them here. There is a member that we deactivated earlier. So that member is now here. If they do need to be reactivated, you can do that here too by activating the member. We recommend prior to deactivating a member going into their providers tab. I’ll just click on this provider here… and marking their termination date from the employment details section, just mark the termination date for your records before you deactivate them. And then you can actually deactivate them. From.
Sandhya Kapila (04:24) here as well. So you don’t have to go to that members tab. You could deactivate them from the provider directory as well. All right. So just going back to the members tab real quick. Do you want to invite new members? You would do that from here, invite members. There are three main buckets of member types, roles, provider… admin, and auditor. The admin has access to everything. The auditor is just read only access. So if you only access, they can’t make any updates. They can’t make any requests. Lauren you are an admin and provider. So you have two roles in one… for providers. I think I sent you this loom video. But for right now, if you’re adding new members here, new providers, we don’t want to just send them their invitation email just yet. Once you do want to send them their invitation, our initial invites that we send over are going to be bulk invites that we send over to them. So you don’t have to go on by one and invite them. But once we are ready, if you do add a new member and you’re ready to invite them, then you just go ahead and send an invite from there. Cool. Any questions on the members page? Cool. Alrighty.
Sandhya Kapila (05:45) Okay. So then next up, we’re going to go to the overview section. So this is where all the tasks live. So as we’re making as we’re going through and starting to make requests, this is where our team will. If there’s something that they need from you guys or the provider, this is where you will see those tasks when they’re in their ready bucket, that means it’s ready for you to review. And this is where you have like tasks to be done. Once you’ve completed those tasks, you’ll need to mark them as complete. And then they will go into the in review bucket in the in review bucket that’s when our team looks at them, confirms that they’re actually complete and ready to go. Once they’ve completed them, it will be marked as in the completed it’ll be put in the completed bucket. So you’ll see provider tasks here as well as admin tasks. As an admin, you’ll have access to see all tasks, provider and admin tasks. And then the expirables bucket. This report here, it pulls anything from documents or existing license records or certification records that have an expiration date. It’ll be pulling that into this report. So you can see anything that is within 30 60 or nine days or it’s already expired in this table here. And this can be exported as a. CSV into a CSV file as well. So, you’ll see here that there are some that are expired and you can filter to see any that are already expired within 30 days, 60 days or nine days from this bucket here.
Ashley Johnson (07:25) Where are those? So, for this? Oh, sorry, go ahead. So, for, this pulled from their caqh profile, right?
Sandhya Kapila (07:36) This was pulled from their caqh profile, correct? Okay?
Ashley Johnson (07:39) So, would it be, is it necessary for us to go in and update it because this is being sent to payers, right?
Sandhya Kapila (07:48) Correct. Yes. Okay. So.
Ashley Johnson (07:50) That’s like another project? Okay. Got it.
Sandhya Kapila (07:53) Yeah, you’ll need to update that, yep, exactly.
Naomi Denson (07:57) Why doesn’t caqh flag that when they attest?
Ashley Johnson (08:01) I don’t know because.
Naomi Denson (08:03) caqh doesn’t require those documents to be loaded to attest the profile. They only require the Coi that’s annoying. Some providers add them. Some don’t but I think if the document that’s showing in the expirables tab, as long as the correct and updated document and licensing record is in the existing licenses, certifications records, to the left, there, if it’s expired in the documents tab, it’s not really going to make a huge deal because we’re pulling the current documentation from the existing licenses and certification record. Does that make sense? Yeah, you would be pulling it from here? Not the documents. Yeah. So we wouldn’t be submitting any if we pulled a document from the document section and it was expired, like truly had an expiration date on it, we would task out for a new one at that time, so.
Ashley Johnson (08:56) Basically where we have to go in and update it is just the certifications area, not the documents area.
Naomi Denson (09:01) And the existing licenses?
Ashley Johnson (09:05) Yeah. Okay.
Ashley Johnson (09:13) Sorry, quick question on that. So, is this also housed in documents?
Naomi Denson (09:21) Yes, it will flow over into documents. Okay? Gotcha. Once it’s loaded here. Okay? But the document itself when it’s loaded here. So the existing license record has the expiration date of the license, it doesn’t put an expiration date on the document per SE. So typically, like expirations on the documents in platform are for like driver’s licenses that are going to expire… you know, if there’s anything else that you’re going to track there, can you go back to the expirables tab, Sandhya, to see which one’s there? So let’s look at that provider that has an expired one… and then go to her document section. So the record here is expired. Let me see. Okay. So that’s not pulling from the document section that’s just showing that the board certification record is expired. Does that make sense? Let’s go back to the expirables report. Okay? So you can see the category on the right there. So will you click the filter by the category Sandhya? So you can see if it’s a document that’s expiring or if it’s the board certification? Gotcha. So if it’s a board certification, we.
Ashley Johnson (10:43) would update in the expired area or the certifications area. And then if it’s a document we update in the document area, correct? Gotcha. Yeah. I was more so wondering if it’s housed in both places because our emr works like that and it’s really frustrating sometimes. So I just wanted to make sure that if we updated in one, that’s all we needed to do or if it was housed in both, what that looks like. So. Okay. All right. So go ahead for.
Naomi Denson (11:14) Existing licenses, board certifications and malpractice insurance. You’re only updating the record there from the provider’s profile and it will flow into the document section if it needs to, but you don’t need to update both. But if you only add it to the document section, it doesn’t update the record.
Ashley Johnson (11:31) Right. Okay.
Sandhya Kapila (11:32) All righty.
Sandhya Kapila (11:38) Thank you Naomi.
Naomi Denson (11:41) You’re welcome, but you didn’t know I was here. Did you? I love that.
Sandhya Kapila (11:45) I love that. Okay. All right. So the next thing we have is the provider side which we already looked at. This is your full provider directory. This will show the most recently added provider at the top but you can also sort this out alphabetically. You can search. I think, do we do this? No, we don’t I did this for somebody else. You can search by their name, npi, caqh, you can sort as well. You can filter by profession and state they’re licensed in. So, and you can actually filter on each of these different columns… as well. So if you just want to see certain practices, you can filter that way. And so any filters that you set, you can actually bookmark? So in case you’re going to refer to them often, you can go ahead and set your filters and then set a bookmark here. Add a bookmark. So then when you go back to it, you don’t have to refilter, you can just access your bookmark. And this one too, you can export this list, you’re filtered or this full list here into a CSV file. The column on the right is the table field settings. So this actually allows you to hide or show certain columns. So if there’s certain columns that you’re like I don’t really need to know the date they joined medallion, you can hide that from here. And next time you go in, it won’t show that. So this is just how you customize your columns. Cool. All right. And so these little circles here, this is basically, it just helps you to identify profile completion for that specific provider. This information can also be seen when you log in or when you click into that provider in the overview tab. And so percentage of the profile that’s complete, what’s missing, what they need to still do. And then the tasks that we talked about that will be shown here for the providers as well. So when you go into the profile, this has their basic… information, their demographics, professional history, licenses, certifications, all of that good stuff.
Ashley Johnson (14:06) Can you do practices? Yes.
Ashley Johnson (14:13) Here we go. Okay. Gotcha. Lauren. What is the, is this just the offices they would work out of? So we wouldn’t like if something changes, do we have to come in here and update it or anything like that?
Sandhya Kapila (14:31) If they’re no longer working at a specific practice for?
Ashley Johnson (14:35) Whatever change, you know, we have people move, come back, things like that.
Sandhya Kapila (14:39) Yeah, you do that. In this list. It would be per provider unless Naomi has tips and tricks of another. Another way to do it.
Naomi Denson (14:50) Sorry, what was the question? So.
Sandhya Kapila (14:52) If there’s changes for a provider in terms of like practices that they’re working at additions or removals, they would have to go into each provider and into the practice tab and make updates from there, correct? From here, you.
Naomi Denson (15:05) Can either do it from the practices tab. You can do it in the providers profile. You can do it from the groups tab from the practice location itself or… the group profiles. There’s a gajillion different ways to do that. Just know that if there is a payr enrollment request for a provider that… or existing enrollments for a provider that are tied to a specific practice location, it will not allow you to remove associations. If there’s an existing enrollment tied to that practice. Does that make sense? Yeah. So you can do it from the providers practice profile itself, the practices tab. If you need to do it in bulk for multiple providers that are being assigned to a new practice. So if you click into the practice profile name Sandhya, right there. Yeah. So this will open up the practice profile and you see the providers tab at the top there, you would add, you can add providers there, or adjust. You can see the little trash can to the right there. If you need to remove an association.
Ashley Johnson (16:13) Okay. My thought process, the reason why I’m asking this and also just for Lauren’s background too is we’re opening offices in the coming year. So I’m thinking, you know, if people are going to be based out of there or added, then we would, when we’re creating their profile, we would have to add this for them. I’m thinking right? Lauren.
Naomi Denson (16:33) Yes, the providers can’t see all of the practice locations. So they won’t be able to associate them. However if you have a new provider that’s coming on with a new practice profile when you go to submit, if you go to submit an enrollment request with that group and new practice location, it’ll automatically associate it to the provider going forward. Okay, right? Because first we have.
Sandhya Kapila (16:54) to enroll the location with the payers too. Okay?
Sandhya Kapila (17:13) Bye. Yeah. So licenses… will show here for the providers, talk through their practices payers as we have enrollments. The payer list will populate here. And then any enrollment requests we make will be or you all make will be listed here. Current enrollments will be added in here. This is just the notes field. So you can communicate with the provider… and then email preferences that we chatted about. They can make edits to their email preferences or they can ask you to make edits here as well.
Sandhya Kapila (18:03) Naomi, anything additional on the providers tab that we?
Naomi Denson (18:07) Should review if you’ll just go back to the notes section really quick. So you can leave notes on… a provider’s profile. So you can leave notes in their file. If you need to click add note. But if you need to flag it to them, there’s a checkbox there that says notify provider via email. So if it’s something that you want to send to them, you would do that. Otherwise, it’s not going to send them any type of notification. Okay?
Sandhya Kapila (18:46) The groups profile, you have one group here. And so some homework for you all is to complete the missing profile information similar to the provider tab. It lists all the details that are missing. If you click… into the profile, each tab tells you like what percentage is complete, what is it? And then you just need to go in here. Sorry, I’m going to hide this Guy. Yeah, go down this list and update it based on what’s missing so that we can get started.
Sandhya Kapila (19:31) Intake I keep getting this error. Naomi, don’t know if you have this as well.
Naomi Denson (19:38) I get the same error. Okay?
Sandhya Kapila (19:40) I’m.
Naomi Denson (19:41) not entirely sure on that one. To be very honest.
Sandhya Kapila (19:43) We’ll ignore that. So you’ll have a list of the providers here for that group. And as Naomi talked about, you can add your providers here… then practice locations similar to the other place. Actually, we don’t have caqh, you don’t think you have caqh management on your contract? Oh, yeah, we do. We do have caqh management on your contract. So once we add those in and it’s for all providers, it’s for 112 providers. So once we get everything loaded in, we can enable caqh management for all the providers that we have contracted you for.
Naomi Denson (20:25) What does that look like?
Sandhya Kapila (20:30) The caqh management piece?
Naomi Denson (20:33) Like how involved is it? I guess?
Sandhya Kapila (20:37) From what I know so far is we would simply enable it here. It is not here right now. I don’t know why.
Naomi Denson (20:46) Click the settings here.
Sandhya Kapila (20:47) Thank you. Did I disable it?
Naomi Denson (20:51) It’s there. So it is there. So click back out. It’s not scroll… all the way to the right.
Naomi Denson (21:06) Keep keep going my.
Sandhya Kapila (21:09) Mic is struggling, hold on.
Naomi Denson (21:12) I usually use my mouse pad on my laptop to just swipe. Okay, here. It is there, it is, yeah.
Sandhya Kapila (21:19) So we would enable these for everybody for all 112 providers. And then anytime a change occurs, I don’t actually, Naomi, I’m going to let you handle this one for.
Naomi Denson (21:33) Caqh management. So we only work caqh profiles for the regular maintenance and attestation, if they are enabled here. If you check this box, you cannot uncheck it. So if there are any providers that you do, we can uncheck it for you, but you can’t uncheck it. On your end. I’m going to immediately start counting. It immediately creates a request for caqh management. If there are any providers that do not want us or will not share their username and password, will not allow us to touch their caqh. We… need to be aware of those. So they don’t get enabled when we bulk enable, but.
Sandhya Kapila (22:11) The.
Naomi Denson (22:11) caqh management feature is not automated because of that reason, because there are providers that are not going to share that information. They don’t want us touching it. They have somebody else who manages it. So every time you invite a new provider going forward, you onboard a new provider, you have to enable this if you want us managing and keeping up with their caqh profiles.
Ashley Johnson (22:32) Yeah. Most of the errors of 16 people, I think there were maybe like five or six of them that we were able to just go in and authorize the way that the error required so that you guys could then import their profiles, but there were probably like 10 of them who.
Sandhya Kapila (22:49) Did.
Ashley Johnson (22:50) not provide their login info or it was the incorrect login info, which is what I’m assuming resulted in the error. So we’re doing a second touch point with them to make sure that that’s really what they want. So.
Naomi Denson (23:04) The caqh import to populate their profile has nothing to do with caqh management. So, the caqh management piece in your contract is that we are maintaining and updating the provider’s caqh profiles with the reattestations every 120 days, the import piece and the authorization piece is just because the providers have a setting in their caqh profile that they want to review and approve any organization such as a payer or medallion that tries to view their profile, we don’t have to have their logins to do that. So that wouldn’t be a reason why it’s failed. Okay?
Ashley Johnson (23:39) Because I’m looking at the, let me pull it up, I think I just have it. Oh.
Sandhya Kapila (23:45) Here we go. Okay?
Ashley Johnson (23:48) Let’s see.
Ashley Johnson (23:55) Because my question is also, what do we do for the people that we don’t have the login that have the error. So, let me,
Naomi Denson (24:02) look here, providers caqh, they have the error for caqh bulk import like they failed.
Ashley Johnson (24:07) Yeah. So, for example, we have Marley refuerzo, where it says ineligible provider status. The provider status is ineligible for import.
Naomi Denson (24:21) Did fierto?
Ashley Johnson (24:24) Yeah, that’s the right one. She.
Lauren Henderson (24:26) May not have a caqh. Does she have a caqh?
Ashley Johnson (24:30) I believe. So… let me double check.
Naomi Denson (24:36) Okay. Hold on fierto. Yeah.
Sandhya Kapila (24:39) We have a caqh number for her.
Lauren Henderson (24:43) What was the error?
Ashley Johnson (24:44) Ashley… here we go. Ineligible provider status. The provider status is ineligible for import caqh status must be initial profile completion or reattestation and it basically said look at the top left of the profile. And so when we logged in for one person who had the same error and we did have their login info, it showed it was complete. So I wasn’t really sure. And then this person did not provide their login at all. So we couldn’t go in and check.
Naomi Denson (25:20) How do you spell her name?
Ashley Johnson (25:23) This is the correct person. What?
Sandhya Kapila (25:25) I’m looking at is M a RLI, and the last name is REFUERZZ o.
Ashley Johnson (25:38) Let’s go real quick. I’m 99 point nine percent. Sure that’s how you spell it, but I’ll double check.
Naomi Denson (25:45) Okay. I’m showing her import failed because provider status must be initial profile complete or re attestation. So either she’s never completed her initial caqh profile and attested it or the attestation is expired?
Ashley Johnson (26:01) Okay. Can you go to Fonta, saniyoko and I’ll spell that.
Lauren Henderson (26:07) I fixed hers yesterday. I meant to touch base with you but you were out. So I didn’t want to bother you.
Ashley Johnson (26:12) Oh, that’s okay. So that’s what I was asking because if hers, just if whatever happened yesterday is not showing an error anymore?
Lauren Henderson (26:20) Yeah.
Naomi Denson (26:21) She needed?
Lauren Henderson (26:21) To re, attest and she needed her liability insurance updated, I was enrolling her. I was working on enrolling some people with anthem through ability, and I was, luckily, we had all these logins so I was using their login information and she didn’t have her liability updated or she, and she needed to re attest so.
Ashley Johnson (26:41) I did both of those. Well, there’s a lot of people that I logged into that. They don’t have the updated Coi, but I was still able to authorize them for medallion and I’m hoping that’s enough. I,
Naomi Denson (26:52) mean, all right. So, Fonta, I’m going to re sync her import right now and,
Lauren Henderson (26:56) see if it works. Hopefully, it does.
Naomi Denson (27:03) It didn’t immediately fail and shows that it’s in progress.
Lauren Henderson (27:06) So, yeah.
Ashley Johnson (27:07) Small win for now.
Sandhya Kapila (27:10) So,
Lauren Henderson (27:10) Ashley, you did not upload the new documents?
Ashley Johnson (27:14) No, I was just on a check in with Megan to run her through the task. Oh, okay. So, for the cois, is that just the general slea Coi or does it have to be the one?
Lauren Henderson (27:27) For the form letter, that it has to be, they started denying the uploads unless there was a form letter that specifically stated their names. So I can forward you those. And I don’t know Naomi and Sandhya, if you guys, I mean, I’m assuming you guys will need those also.
Ashley Johnson (27:43) I mean, yeah, we’re fixing the errors is.
Lauren Henderson (27:46) That something you guys will maintain also is uploading the new cois once.
Naomi Denson (27:50) The caqh management is enabled and the providers have logged in and signed their agreement. Yeah, yes. Okay.
Lauren Henderson (27:59) Unless you guys know another workaround, we were just starting, we were, they were denying the uploads and it’s… probably instead of us having a Coi that it says additionally insured Ashley, you know, like with our vendors, I don’t know if we’d have to list everybody’s name. Well, I,
Ashley Johnson (28:17) remember sending medallion the letter that Dawn sent to show that our coverage extended to our providers. So we might have something already in place that we can just upload because that’s a signed form… signed and dated form for our current Coi. Okay?
Ashley Johnson (28:44) Or, I think maybe that was malpractice. I.
Sandhya Kapila (28:46) Think that might have been malpractice.
Lauren Henderson (28:48) I just forwarded you what Norma used to use and that’s what I used for ponce yesterday.
Ashley Johnson (28:53) I mean, I think we can deal with that separately… just because none of these were based on an error on the Coi. So I don’t think that’s impacting the import, right?
Naomi Denson (29:04) No, as long as the provider’s profile is like their caqh is attested, and that’s like as long as in the top right corner, when you log into caqh, it says, you know, 90 days until next free attestation and not showing an expired attestation. It should work unless they have their settings set to authorize organizations to view their profile. Most providers like 99 percent of them have it set to automatically do. So they don’t have to log in and approve.
Ashley Johnson (29:32) Yeah, but,
Naomi Denson (29:34) there are the select few that don’t have that setting enabled that have to log in and authorize.
Ashley Johnson (29:40) Yeah. So for example, Lauren, one of those people was Santoya joiner, and we went and we did the authorize super quickly, very easy. But then we also, this is a question for you guys, Sabrina, buziglou, she had the same exact error profile. I was able to go in and update the authorization for medallion, but she still has an attestation that’s overdue by 77 days. So, I’m assuming that would show like two missing or two errors rather than just the one, right?
Naomi Denson (30:11) No, we’ll only show one at a time. OK? So the first one was… Santoya. OK?
Ashley Johnson (30:19) Let me join her. J o y NER?
Naomi Denson (30:23) I’m going to try to re sync hers. So one thing with our system is if they go into there’s different buckets that they could go into caqh action required and failed. If they go into failed, they don’t automatically re sync when changes are made, if they go into caqh action required, which is usually that authorization section. They will re, sync a few times automatically each day. Let me see. Reset. Okay. So, fontos went through.
Ashley Johnson (31:04) And Lauren, all you needed to do for her was re attest.
Naomi Denson (31:07) I had to upload the combined form letter, which is a requirement for caqh to approve… the re attestation. So if they’re uploading Coi, the document has to match or they’ll deny the re attestation… okay?
Ashley Johnson (31:27) Gotcha. So that, okay, that fills in the blank for me then.
Naomi Denson (31:31) Joiners is still flagging as authorization… settings in caqh to authorize medallion. We.
Ashley Johnson (31:43) Just did it right before this meeting.
Naomi Denson (31:46) Okay. Yeah, I just re synced it. It did not go through. Let me see. Do we have her login? Yeah, let me see. Let me log into her caqh and look.
Naomi Denson (32:21) Close your eyes… Sandhya. Can I share my screen real quick? Oh, yes. Of course. Good. I logged into hers under authorize. Is still showing medallion here… authorize viewing your data. Yes?
Naomi Denson (32:46) So, are you guys good with me saying both of these?
Ashley Johnson (32:51) Yeah, but we did that already though.
Naomi Denson (32:54) Yeah, it doesn’t look like it took, let’s see.
Naomi Denson (33:04) Viewing your data. Okay? So it says, yes. Okay. All right. Let me give it a minute. And then I’ll re, sync it and we can… let’s see.
Ashley Johnson (33:14) Can you, I wanted to, if we can also see Sabrina bouzidlou because I did hers as well.
Naomi Denson (33:21) Sabrina? All right. Let me re, trigger her, Sabrina.
Ashley Johnson (33:24) Well, she’s probably not going to work because you said it only sees one error at a time and she’s got a couple from what I wrote in my notes.
Naomi Denson (33:32) So, it’s not, so our stimuli shows one error in the connection.
Ashley Johnson (33:36) Gotcha.
Naomi Denson (33:38) It doesn’t show errors for her caqh profile. Okay. Sabrina and Santoya are now back in progress syncing. So, let me keep an eye on those and watch them as they come through. Okay?
Naomi Denson (33:54) Do you want me to just re sync everybody?
Ashley Johnson (33:58) Not yet. I don’t think so because out of the 16 errors, really, there were only three that I was able to look into and say, okay, this is for sure what we need to do based on the instructions. And then our HR generalist is going to go through about five more. And then outside of that, we have another 10 people who we have to touch base with to get their login so that we can see if we could go in there and handle the error.
Naomi Denson (34:34) Okay. One six zero five.
Naomi Denson (34:41) Sabrina went through Fanta. Went through perfect. Let’s see data summary. All right. Sanctoia is being difficult, let’s see.
Naomi Denson (35:13) Thank you. This one, Toya toiner, one, six zero… five, eight, nine, zero, one, four… seven, seven zero zero. Yeah, I don’t know what is going on with sanctoia’s?
Naomi Denson (35:45) It looks.
Ashley Johnson (35:46) like I swear I did it.
Naomi Denson (36:05) I’m… wondering if they’re… looking at Santoya’s… so… so when you click into authorize, it takes you automatically to organizations. It says, authorize we’ve set it, but it has the settings here. I wonder if we have to reauthorize this.
Naomi Denson (36:39) There’s no box checked. You guys? Okay with me trying this?
Naomi Denson (36:56) I’m going to figure this out because I’ve never seen it, deny it this many times that’s.
Ashley Johnson (37:01) hard for the chorus. Slea has always been getting sick for challenges. I did.
Naomi Denson (37:06) Verify that her caqh id, her npi and her social all match what’s in caqh. So that should not come up. That’s the only other error that I can foresee happening with providers typically after we authorize it, because if it’s not authorized, we can’t see it. And then once we see it, then we’re like this doesn’t match. We don’t know who this is… or vice versa. So, all right, it is, it’s trying.
Naomi Denson (37:41) Sorry, Sandhya, I hijacked your train.
Sandhya Kapila (37:44) No, I mean, the whole purpose is really for the slea team to get what they need. So, this is fine. And I think we did most of it. The only pieces were the analytics tab and report builder, and the analytics tab has no data in it yet. But it’s just to give you guys an understanding of like what you will be able to see there at one point when we have requests, I mean, I can quickly share my screen, just go through like the different tabs.
Naomi Denson (38:12) It’s still saying not authorized. Do you have to review? Do you have to attest when you change?
Lauren Henderson (38:22) Authorizations? I didn’t think you did.
Ashley Johnson (38:25) Well, I think that, so there was that checkmark, but above, it didn’t say release my full. There was the one on the left that said release my full profile. And the one on the right that said, no, ask me every time. I think that even though we hit the checkmarks, we still stayed on the no and we might have to move it to the yes.
Lauren Henderson (38:45) No, that’s just automatically approving.
Naomi Denson (38:48) Yeah. So.
Lauren Henderson (38:48) It’s asking you.
Naomi Denson (38:50) To review… each organization’s request, which is what we’re doing with the other piece under organizations where it says medallion, it says authorize. And then it says viewing your data, yes, but it’s not pulling.
Naomi Denson (39:11) Which is weird. I don’t know how long it’s supposed to take for.
Lauren Henderson (39:15) Those to like sync.
Naomi Denson (39:17) Or if we should try to reattest her profile, it says 68 days until next attestation but I don’t know if maybe reattesting it now would just reset it… like to make it work. So if you guys want to try reattesting it, let me know and I can, because if everything else is up to date, we shouldn’t have to wait for cois to be approved and all of that, let’s see. Because as long as she has any active Coi, even if it’s not for you guys, it’s not looking that close at like the caqh import is not specifically saying your malpractice information isn’t in here for slea… we’re not going to this. Is it’s going to fail as long as the caqh is attested with some current malpractice insurance. And like they’re not flagging any issues or errors, then it will still work.
Naomi Denson (40:26) Yeah. I’m going to do, let’s see. I’m going to start a whole new one. Let’s see.
Naomi Denson (41:05) I just triggered a whole new request instead of re syncing the old one. So fingers crossed, maybe that works.
Naomi Denson (41:19) It hasn’t failed yet. Good.
Sandhya Kapila (41:25) Lauren, I know you had questions. We only have like 15 Ish minutes. So I’d rather go through those questions and then once we have data, we can go through the analytics tab and the report builder. Okay?
Lauren Henderson (41:47) So, for the group enrollments in… the payer name, I should be using the medallion payer name that’s on the payer scoping. Is that true or the payer name that we have in our system?
Sandhya Kapila (42:08) We usually do the mapping on our end when we’re ready to load it in. So whatever works easiest for you. Okay?
Lauren Henderson (42:19) Yeah. I guess it’s tied to the next question because so, for blue shield, this is the same for anthem too, like we have Aba contracts and speech and OT. So blue shield for example, for speech and OT, we call it also blue shield, but for Aba, it’s the blue shield promise plan. But you guys have it all under blue shield of California. So I wasn’t sure if I should just.
Lauren Henderson (42:58) Let me see. Because right now, as it stands, we’re waiting to have locations added for speech and OT, but all the locations are there for behavior. So if I, it just isn’t all accurate if I lump it all together. Like I could put, yes, we accept commercial. And I guess I just don’t know how to separate behavior from speech and OT, if the payer name is the same, yeah.
Sandhya Kapila (43:26) You know what? Go ahead and just put your payer name in there, and then we can talk to Nicole… on that piece. And then when it comes to the data loading, we’ll have conversations with our technical solutions, folks on that too.
Lauren Henderson (43:45) Something else about the group enrollment. I know that we removed a few people from or a few payers from the payer scoping because they don’t require credentialing or rosters or anything. It’s just the group enrollment. Is that something I should put on the group enrollment tab? Especially if, I guess, do you guys assist us with adding locations for those payers? Like Ashley was mentioning, we’re going to be at the end of this year, we’re opening an office in 1,000 oaks, and next early next year, we’re going to be relocating our encino office. So that address is going to be need to be updated with all the payers. Is that part of this service also or is that under us? Yeah?
Naomi Denson (44:32) You can do demographic updates in the platform to add new practice locations to existing enrollment.
Lauren Henderson (44:37) Okay. So then here’s, my here’s, another question with the rosters that I’ve gotten from our current payers, some of the addresses that our providers are enrolled with are old and they need to be updated. So on the provider enrollment tab, do I put the old addresses that they have, or do I put what they should have?
Naomi Denson (45:05) Say that one more time?
Lauren Henderson (45:08) So, I’ve been gathering all the data for the provider enrollment to make sure I fill that out accurately. And some of the locations that the providers are connected to with the payers… are old addresses, not the new addresses that have been relocated.
Naomi Denson (45:29) Are the new addresses already approved and confirmed linked to the enrollment? Or have they been changed with the payer yet?
Lauren Henderson (45:36) Yes, some, yes, some, no, I.
Naomi Denson (45:40) Would put so on the provider enrollment tab that’s existing enrollments, that is true source of truth for you. So that is what you have confirmed is appropriate with, is confirmed with the payer. So if you load the practices that should be and… they turn out not to be the system’s going to show that as part of the existing enrollment already and block you from submitting the demographic update. Okay? So if it, if the existing enrollment shows that the provider’s already enrolled at that practice location and you determine, no, they’re not, it hasn’t been changed yet. You have to go in and delete that from the existing enrollment before you can request the demographic update to add it. So only put true known information on there. Okay. Not what it should be or could be. Because we’re not verifying that once it’s loaded. Okay.
Lauren Henderson (46:29) Is it easy enough to switch that once we’re in the system? Yeah. Okay. Great.
Lauren Henderson (46:54) Here we go. Okay. Sorry for the groups that we don’t need credentialing, I should still put them on the group enrollment though. So preferred ipa is an example. And I have a form that you submit for any new locations?
Lauren Henderson (47:17) Does that make sense? Or like I just did this with cedars yesterday, I had to, in order to update locations and remove locations for them and they don’t require credentialing. So they’re not on our pay or scoping. I had to submit like a formal letter.
Naomi Denson (47:37) But I don’t know why.
Lauren Henderson (47:40) Letter of intent. Yeah. I guess. So, I mean, they didn’t really have a format. She just said it needed to be a formal notification. So I just put a grid together of like old, incorrect address and new and I grouped it by relocated error. One of them, two of them had errors with the suite numbers and then closed one location altogether.
Lauren Henderson (48:09) So, my question is, do I include those groups that don’t require credentialing just on the group enrollment or do they actually need to be on the pay or scoping also, but with just the information for demographic… update? Yes.
Naomi Denson (48:25) If there’s any actions that we would be taking on your behalf, they need to be on the pay or scoping regardless of if it’s the new initial enrollment process or demographic updates, revalidations. Anything that you have that pertains to, that payer?
Lauren Henderson (48:42) And then if I don’t have some of that information like or… I’m not totally clear on it, how easy is that once we’re in the system to add like a new payer to the system?
Naomi Denson (48:55) It’s very easy. You always have access to our full library of payers, okay?
Lauren Henderson (49:00) So, you.
Naomi Denson (49:01) can add existing enrollments or enrollment requests for any payer at any time. But if you have like processes already in place for them, you’ll want to connect with your engagement manager after implementation to make sure that we are aware of any nuanced processes. Otherwise, we would just follow our standard internal sops. Okay.
Lauren Henderson (49:20) So, as much information as I can get you guys on that payers scoping, the better, yes.
Lauren Henderson (49:31) Okay. I think for now that’ll help me continue on what I’m doing.
Lauren Henderson (49:41) And I’ll just email if I have anything else. Okay? Oh, I do have one more question for avility. How do you guys, I know you have access now? And maybe this is a question for Nicole tomorrow when we meet… but you guys maintain avility, because there’s like four places you have to meet avility. Like the provider data management, manage my organizations and there’s the payers spaces. Okay? Maybe she can kind of, I just want to make sure either you’re handling it all or if there is something that we need to do, we’re doing it just because my experience with learning the avility steps is it doesn’t all talk to each other. It’s like you have to add the providers in multiple places. And then that quarterly attestation that happens with avility too, just making sure they’re all there connected to the location.
Naomi Denson (50:41) Yeah. As far as I know you guys maintain and manage the rosters, okay? Within avility. And then any specific.
Lauren Henderson (50:50) Enrollment?
Naomi Denson (50:51) Processes, like if we were to go and enroll in a bleep plan, we would do the enrollment application and follow that. But as far as the roster updates, you guys handle that.
Lauren Henderson (51:01) And the quarterly attesting, Yes. Okay. That answers that one.
Lauren Henderson (51:13) Okay. I think that’s good for now. Okay?
Sandhya Kapila (51:30) Perfect. And we have our meeting with Nicole tomorrow or?
Lauren Henderson (51:34) Thursday? Yeah.
Sandhya Kapila (51:41) Yes. And then she’ll walk you through all of these also. Okay. Cool. All right. Well, thank you guys. So much. Thank.
Lauren Henderson (51:49) You. Thank.
Naomi Denson (51:51) You.
Lauren Henderson (51:53) see ya.